ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2020-2-104-111ssmu-2867Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL PAPERSВлияние курения на уровни сурфактантных белков SP-A и SP-D в крови у пациентов без бронхолегочных заболеванийEffects of smoking on the level of sp-a and sp-d surfactant proteins in the blood of patients without bronchopulmonary diseaseshttps://orcid.org/0000-0001-8788-685XХарламоваО. С.KharlamovаO. S.olga.kharlamova2016@yandex.ruhttps://orcid.org/0000-0003-4601-6203НиколаевК. Ю.NikolaevK. Yu.https://orcid.org/0000-0002-4936-8362РагиноЮ. И.RaginoYu. I.https://orcid.org/0000-0001-9425-413XВоеводаМ. И.VoevodaM. I.Научно-исследовательский институт терапии и профилактической медицины (НИИТПМ) – филиал Федерального исследовательского центра «Институт цитологии и генетики» Сибирского отделения Российской академии наук (ИЦиГ СО РАН)РоссияResearch Institute of Therapy and Preventive Medicine, branch of the Federal Research Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of SciencesRussian Federation202012072020192104111Copyright © Харламова О.С., Николаев К.Ю., Рагино Ю.И., Воевода М.И., 20202020Харламова О.С., Николаев К.Ю., Рагино Ю.И., Воевода М.И.Kharlamovа O.S., Nikolaev K.Y., Ragino Y.I., Voevoda M.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/2867Актуальность

Актуальность. Ежегодно около 6 млн человек умирают из-за употребления табака. Дыхательный эпителий – первая линия защиты против экзогенной инвазии, в частности вредных вдыхаемых частиц, патогенов и аллергенов. Однако эпителий дыхательных путей является не просто физическим барьером, но и регулятором иммунологических и воспалительных реакций посредством секреции медиаторов воспаления и рекрутинга иммунных клеток. Важным компонентом легочной иммунной системы является сурфактант, в частности его белки SP-A и SP-D, синтезируемые в основном пневмоцитами II типа.

Цель

Цель. Оценить уровень сурфактантных белков SP-A и SP-D в крови у курящих пациентов без наличия бронхолегочных заболеваний.

Материалы и методы

Материалы и методы. В исследование включены 59 пациентов, госпитализированных в терапевтическое отделение по поводу гипертонической болезни. Общая группа разделена на подгруппы:  некурящие пациенты (n = 31) и «здоровые курильщики» (n = 28). Всем пациентам проведены клиническое, функционально-диагностическое и лабораторное исследования. Содержание сурфактантных белков SP- A и SP-D в крови определяли методом иммуноферментного анализа.

Результаты

Результаты. Подгруппы не различались по полу, возрасту, росту, массе тела, уровню артериального  давления, частоте сердечных сокращений, частоте дыхательных движений, а также по распределению  сопутствующей патологии. Сравниваемые подгруппы достоверно отличались по уровню тромбоцитов, по остальным основным параметрам общего анализа крови, биохимического анализа различий не отмечено. Выявлено, что уровень в крови сурфактантных белков SP-A и SP-D в подгруппе «здоровых курильщиков» достоверно выше в сравнении с подгруппой некурящих пациентов. При корреляционном анализе прямая связь получена для сурфактантных белков SP-A и SP-D и курения (R = 0,360; p = 0,006; R = 0,274; p = 0,037). Обратная корреляционная связь выявлена SP-D с возрастом (R = –0,315; p = 0,016) и прямая связь белка SP-A – с диастолическим артериальным давлением (R = 0,271; p = 0,039). В подгруппе некурящих получена обратная связь SP-D с возрастом (R = –0,438; p = 0,016) и систолическим артериальным  давлением (R = –0,433; p = 0,017).

Заключение

Заключение. Отмечены более высокий уровень сурфактантных белков SP-A и SP-D в группе курящих  пациентов, их прямая связь патогенетически обоснована (воспалительные изменения, структурные аномалии в паренхиме легких при воздействии сигаретного дыма). Белок SP-D более значим в сравнении с SP-A при ремоделировании сосудистой стенки, матрикса ткани легкого, при окислительном повреждении ткани легкого и апоптозе, что объясняет его обратную связь с возрастом и систолическим артериальным  давлением. 

Every year, about six million people die from tobacco use. Respiratory epithelium is the first line of defense against exogenous invasion, in particular, harmful inhaled particles, pathogens and allergens. However, the epithelium of the respiratory tract is also a regulator of immunological and inflammatory reactions through secretion of inflammation and immune cell recruitment mediators. An important component of the pulmonary immune system is the surfactant, and, in particular, its proteins SP-A and SP-D, synthesized mainly by type II pneumocytes.

Aim

Aim. To assess the levels of surfactant proteins SP-A and SP-D in the blood of smoking patients without bronchopulmonary diseases.

Materials and мethods

Materials and мethods. The study included 59 patients admitted to the department of internal medicine with hypertension. The general group was divided into subgroups: non-smoking patients (n = 31) and healthy smokers (n = 28). All patients underwent clinical, functional, diagnostic and laboratory tests. The content of surfactant proteins SP-A and SP-D in the blood was determined by enzyme immunoassay.

Results

Results. The subgroups did not differ in sex, age, height, body weight, blood pressure, heart rate, respiratory rate, and the distribution of comorbidities. The subgroups differed in the platelet level; in other main parameters of complete blood count and blood biochemistry no differences were revealed. It was found that the blood levels of surfactant proteins SP-A and SP-D in the subgroup of healthy smokers were significantly higher in comparison with the subgroup of non-smoking patients. The correlation analysis revealed a direct relationship between surfactant proteins SP-A and SP-D and smoking (R = 0.360, p = 0.006, R = 0.274, p = 0.037), a negative correlation between SP-D protein and age (R = –0.315, p = 0.016), and a direct relationship between SP-A protein and diastolic blood pressure (R = 0.271, p = 0.039). In the non-smoking subgroup, a negative correlation between SP-D and age (R = –0.438, p = 0.016) and between SP-D and systolic blood pressure (R = –0.433, p = 0.017) was identified.

Conclusion

Conclusion. The direct relationship between higher levels of the surfactant proteins SP-A and SP-D and smoking in the group of healthy smokers is justified (inflammatory changes, structural abnormalities in the lung parenchyma under the influence of cigarette smoke). The SP-D protein is more significant in comparison with the SP-A protein in vascular wall remodeling, lung tissue matrix, oxidative lung tissue damage, and apoptosis, which explains its negative correlation with age and systolic blood pressure.

cурфактантсурфактантный белок Асурфактантный белок Dбиомаркеркурениеsurfactantsurfactant protein Asurfactant protein DbiomarkersmokingМатериал статьи является частью бюджетной темы НИИТПМ – филиал ИЦиГ СО РАН «Эпидемиологический мониторинг состояния здоровья населения и изучение молекулярно-генетических и молекулярно-биологических механизмов развития распространенных терапевтических заболеваний в Сибири для совершенствования подходов к их диагностике, профилактике и лечению». Работа выполнена в рамках государственного задания по интеграционному проекту (0324-2018-0040) «Разработка новых способов экспресс-диагностики заболеваний человека на основе детекции органоспецифических маркеров с помощью современных физических и физико-химических подходов». Работа выполнена на базе Государственного бюджетного учреждения здравоохранения Новосибирской области «Городская клиническая больница № 25», г. Новосибирск, Россия.ReferencesWHO. Global Report on Trends in Prevalence of Tobacco Smoking. 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The authors declare that there are no conflicts of interest present.