Surfactant proteins A and D are related to severity of the disease, pathogenic bacteria and comorbidity in patients with chronic rhinosinusitis with and without nasal polyps

Abstract

Surfactant proteins A and D play an important role in innate host defence of upper respiratory tract. Different expression of these proteins in patients with chronic rhinosinusitis indicates possible novel target of therapy in these patients.

Future topical medications in chronic rhinosinusitis

“…Biologically, surfactants have a major role in sinus mucosa, and recent data showed surfactant proteins as a possible novel target for therapy in CRS . Further research, including a standardization of surfactant formulation, is needed to further clarify the benefits and drawbacks of this therapy.…”

Non-Pulmonary Immune Functions of Surfactant Proteins A and D

“…Immunohistochemistry has shown that SP-A and SP-D are expressed in the nasal epithelium, more specifically in the cytoplasm of ciliated epithelial cells and in the serous acini of the submucosal gland [58] . Additionally, both SP-A and SP-D are present in the nasal lavage fluid [59] . Their possible role in immunity in the nasal mucosa has been supported by studies showing that they are differentially expressed in individuals with certain nasal pathologies.…”

“…In cystic fibrosis, SP-A1, SP-A2 and SP-D mRNA expression is significantly upregulated in the sinus mucosa [60] . Both SP-A and SP-D are more strongly expressed in the submucosal glands of patients with chronic rhinosinusitis (CRS) [59] . These increased levels of SP-A and SP-D are also seen in the nasal lavage fluid of patients with CRS without nasal polyps, but not in CRS with nasal polyps, and this is likely due to the secretion of the proteins being impaired due to severe damage of the mucosa in this case [59] .…”

“…Both SP-A and SP-D are more strongly expressed in the submucosal glands of patients with chronic rhinosinusitis (CRS) [59] . These increased levels of SP-A and SP-D are also seen in the nasal lavage fluid of patients with CRS without nasal polyps, but not in CRS with nasal polyps, and this is likely due to the secretion of the proteins being impaired due to severe damage of the mucosa in this case [59] . Experiments on CRS nasal tissue explants have shown that SP-D mRNA is upregulated in response to A. fumigatus and Alternaria tenuis [61] .…”

“…Experiments on CRS nasal tissue explants have shown that SP-D mRNA is upregulated in response to A. fumigatus and Alternaria tenuis [61] . Additionally, in patients with CRS without polyps, there is an association between colonisation of the nasal passages with pathogenic bacteria and higher levels of SP-A and SP-D in the nasal lavage fluid, indicating that SP-A and SP-D are upregulated in these cases due to infection [59] .…”