AIDS patients have increased surfactant protein D but normal mannose binding lectin levels in lung fluid

Abstract

Background: Surfactant protein D (SP-D) and Mannose Binding Lectin (MBL) are collectins that have opsonic and immunoregulatory functions, are found in lung fluid and interact with the human immunodeficiency virus (HIV). We compared collectin levels in lung fluid and serum from HIV infected and normal subjects to determine if alterations in lung collectin levels were associated with HIV infection and might result in increased susceptibility to other pulmonary infections.

Methods: Blood and bronchoalveolar lavage samples were collected from 19 HIV-infected individuals and 17 HIV-uninfected individuals, all with normal chest X ray at time of study. HIV viral loads and peripheral blood CD4+ T cell counts were measured in all subjects. SP-D was measured in lung fluid, and MBL in both lung fluid and serum.

Results: SP-D levels were not significantly different in lung fluid from HIV-uninfected (median 406.72 ng/ml) and HIV-infected individuals with high CD4 count (CD4 >200) (median 382.60 ng/ml) but were elevated in HIV-infected individuals with low CD4 count (median 577.79 ng/ml; Kruskall Wallis p < 0.05). MBL levels in serum were not significantly different between HIV-uninfected and HIV-infected individuals (median 1782.70 ng/ml vs 2639.73 ng/ml) and were not detectable in lung fluid.

Conclusion: SP-D levels are increased in lung fluid from AIDS patients but not in patients with early HIV infection. MBL levels are not altered by HIV infection or AIDS. There is no evidence that altered pulmonary collectin levels result in susceptibility to infection in these patients.

Figure 1

Levels of SP-D in BAL of both HIV-uninfected and HIV positive individuals. The bars represent median and interquartile range. a). The analysis was performed on 19 HIV-uninfected and 16 HIV Positive subjects. b). The analysis was performed on 19 HIV-uninfected, 10 HIV Positive with CD4 count > 200 and 6 AIDS patients (CD4 count < 200).

Figure 2

Levels of MBL in serum of both HIV-uninfected and HIV positive individuals. The bars represent median and interquartile range. a). The analysis was performed on 19 HIV-uninfected and 17 HIV Positive subjects. b). The analysis was performed on 19 HIV-uninfected, 10 HIV Positive with CD4 count > 200 and 7 AIDS patients (CD4 count < 200).