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Involvement of eicosanoids and surfactant protein D in extrinsic allergic alveolitis

¹ Clinical Research Center, National Sagamihara Hospital, Sagamihara, ² Dept of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Science, Kagoshima, and ³ Division of Microbiology, National Institute of Health Sciences, Tokyo, Japan.

CORRESPONDENCE: N. Higashi, Dept of Allergy, Kagoshima Univeristy Graduate School of Medical and Dental Science, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. Fax: 81 992657164. E-mail: Noritaka.Higashi{at}ki.se

Keywords: Extrinsic allergic alveolitis, 8-iso prostaglandin F₂, prostaglandin D₂, surfactant protein D

Received: September 10, 2004
Accepted August 15, 2005

The pathophysiology of extrinsic allergic alveolitis (EAA) involves oxidative lung damage as well as interstitial and alveolar inflammation. Macrophages and mast cells are inflammatory components of EAA that produce both leukotrienes (LTs) and prostaglandin D₂ (PGD₂). In addition, PGD₂ is also produced by the free-radical-catalysed peroxidation of arachidonic acid during oxidative stress. Urinary 8-iso prostaglandin F₂ (8-isoPGF₂) and serum surfactant protein D (SP-D) are considered appropriate biomarkers of oxidative stress and interstitial lung disease activity, respectively. The present study aimed to assess the association of these biomarkers with the pathophysiology of EAA.

Two cases of acute EAA caused by the inhalation of fungi spores were reported. Eight asthmatic patients and six healthy control subjects were also enrolled in the current study.

The serum SP-D and urinary eicosanoid (LTE₄, PGD₂ metabolite (9,11ßPGF₂), 8-isoPGF₂) concentrations markedly increased during the acute exacerbation phase. These concentrations decreased following corticosteroid therapy in the EAA patients. There was a significant correlation between serum SP-D and urinary 9,11ßPGF₂ concentrations in the EAA patients.

In conclusion, although the present study proposes that serum surfactant protein-D and urinary eicosanoids are new biomarkers involved in the various immunological responses in extrinsic allergic alveolitis, further large-scale studies are needed to investigate the role of these compounds, not just as biomarkers, but also as biological potentiators of extrinsic allergic alveolitis.