• The pathogenic role of surfactant protein B in formation of bronchopulmonary pathology in children

The pathogenic role of surfactant protein B in formation of bronchopulmonary pathology in children

SOVREMENNAYA PEDIATRIYA.2017.4(84):66-71; doi 10.15574/SP.2017.84.66

Yablon O., Zaichko N., Mazulov O., Rossokha Z. I., Popova O. F.
National Pirogov Memorial Medical University, Vinnytsya, Ukraine
State Institution «Reference-centre for molecular diagnostic of the Ministry of Healthcare of Ukraine», Kyiv

Introduction. Respiratory diseases cover a significant part of the somatic diseases of childhood. Most of these pathological conditions started during the neonatal period. The development of respiratory diseases is often the result of various factors that damage the airway epithelium, such as oxygen therapy, infection, and so on. These problems may occur on the background of morphological immaturity, which is characteristic of both premature and term infants. Among the frequent problems that lead to respiratory diseases, a surfactant system disorder has been recently considered. This may be caused due to not only the reduction or complete absence of its components, but also as a result of the insufficient functional active ingredients that are genetically determined.

Objectives. To identify the pathogenic role of surfactant protein B (SFTPB) and its polymorphisms as predictors for the formation of bronchopulmonary diseases in children.

Materials and methods. The examination of 50 children (25 boys and 25 girls) at the Vinnytsia Children's Regional Hospital was performed. All children in the study were Caucasians, members of their family have been living in the same area for three generations. The exclusion criterion was any congenital abnormality.

Results. It was determined that the highest level of SFTPB observed in the children with later diagnosed BPD, recurrent obstructive bronchitis, and asthma. The lowest serum SFTPB value was observed in the children without significant bronchopulmonary diseases. In studying the sensitivity and specificity of surfactant protein content, its high diagnostic significance for predicting the formation of BPD (AUC area under the ROC-curve was 0.775) was showed. In addition, the lowest average content of SFTPB was identified in the patients with genotype CC, which frequency distribution was reduced in the patients with BPD (28.57%) and asthma (16.66%) as compared to the children without bronchopulmonary pathology (50%). The highest average SFTPB value was observed in the patients with BPD and CT genotype, the percentage of the latter made up 45% of the total number of examined children, while the percent of genotype CT among the patients without lung diseases was 30%.

Conclusions. It was found that the most important factors that positively influence on the content of SFTPB in serum was a birth weight. While reverse dependency was observed for the gestation period and the duration of artificial pulmonary ventilation measured in days. The research results revealed the correlation between such factors as birth weight, gestational age and duration of artificial pulmonary ventilation with the higher serum level of SFTPB that corresponded to the higher probability of BPD in these children. In addition, the serum SFTPB value in the children devoid of the further development of bronchopulmonary pathology was significantly lower. It was also determined a high diagnostic significance of surfactant protein level for predicting the formation of BPD and the genetic polymorphism influence on the risk of lung disease events was non-significant.

Key words: polymorphism; surfactant protein B; respiratory morbidity; preschoolers.

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