Surfactant Analysis during Pneumocystis carinii Pneumonia in HIV-Infected Patients

Hypobaric hypoxia-related impairment of pulmonary surfactant proteins A and D did not favourPneumocystis cariniiFrenkel 1999 growth in non-immunocompromised rats

“…Present results suggest therefore that P. carinii development depends rather on a deep depression of the immune response than on the alteration of pulmonary surfactant composition. They suggest also that the early perturbation of surfactant properties induced by Pneumocystis organisms that we reported previously (Escamilla et al, 1992(Escamilla et al, , 1993Prévost et al, 1998;Dei-Cas, 2000), is not enough, in absence of immunodepression, to allow the active Pneumocystis proliferation associated with PcP. Most likely, the main finding of the present work was the decrease of lung surfactant proteins (SP-A and SP-D) involved in local defence.…”

“…This observation is consistent with our present observations in rats infected with P. carinii. In fact, Pneumocystis-related pulmonary surfactant changes, especially the early changes reported at the beginning of the infection (Escamilla et al, 1992(Escamilla et al, , 1993 could result from lung inflammatory changes (Grubor et al, 2006) that precede the Pneumocystis infection. Actually, in corticosteroidtreated hosts or in hosts in which immunodepression resulted from other causes, e.g.…”

“…In a previous study (Prévost et al, 1980), we demonstrated changes in surfactant phospholipids of rats exposed to hypobaric hypoxia. Furthermore, we have observed that in HIV infected patients, pulmonary surfactant abnormalities were present before PcP onset (Escamilla et al, 1992(Escamilla et al, , 1993Prevost et al, 1998). Likewise, in healthy young rabbits that develop currently benign PcP at weaning (Rajagopalan et al, 1998;DeiCas et al, 2006) marked surfactant changes occur before the development of PcP .…”

Surfactant protein-A levels increase during Pneumocystis carinii pneumonia in the rat

“…Recent reports analysing the surfactant lipids in BAL from HIV-infected pneumonia patients report either reductions [4,5] or abnormalities in lipid composition in these individuals [6]. A study using the rat model found that although the glucocorticoid treatment markedly elevated surfactant lipid levels, these levels were reduced to less than half of untreated control values when the animals became infected with P. carinii [7].…”

“…We have reported that surfactant-associated protein-A (SP-A) is markedly elevated in bronchoalveolar lavage (BAL) fluid from patients with acquired immune deficiency syndrome (AIDS)-related pneumonias caused by P. carinii [3]. Significant decreases [4,5], or abnormal lipid profiles [6], in surfactant phospholipid levels have recently been reported in BAL from HIV-positive patients. The finding of reduced phospholipids is consistent with experimental observations made in the glucocorticoid-immunosuppressed rat, a model commonly used to study P. carinii pneumonia.…”