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Linkage of neutrophil serine proteases and decreased surfactant protein-A (SP-A) levels in inflammatory lung disease

¹ CBR Institute for Biomedical Research Inc, Harvard Medical School, Boston, Massachusetts, USA
² Department of Pediatrics, University of Colorado School of Medicine and The Children’s Hospital, Denver, Colorado, USA
³ Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA

Correspondence to:
Correspondence to:
Dr E Remold-O’Donnell
Center for Blood Research, 800 Huntington Avenue, Boston, MA 02115, USA; remold{at}cbr.med.harvard.edu

Background: In patients with cystic fibrosis (CF) neutrophils are recruited in excess to the airways yet pathogens are not cleared and the patients suffer from chronic infections. Recent studies have shown a deficiency in airway fluids from patients with CF and other inflammatory pulmonary conditions of surfactant protein A (SP-A), a pattern recognition molecule that facilitates uptake of microbes by macrophages and neutrophils.

Methods: In vitro simulations were used to test the hypothesis that decreased SP-A levels in CF might be the result of degradation by neutrophil serine proteases.

Results: Very low levels of the neutrophil granule serine proteases cathepsin G, elastase, and proteinase-3 rapidly degraded pure SP-A when tested in buffered saline. The order of potency was cathepsin G>elastase>proteinase-3. The addition of cathepsin G or elastase to normal bronchoalveolar lavage (BAL) fluid caused a dose dependent degradation of endogenous native SP-A. Cathepsin G and elastase were present in the BAL fluid from many patients with CF. Simple incubation of protease positive BAL fluid from patients with CF caused a time dependent degradation of added SP-A or, where present, endogenous SP-A. The degradation of SP-A by protease(s) in BAL fluid of patients with CF was abrogated by diisopropylfluorophosphate and monocyte/neutrophil elastase inhibitor.

Conclusions: The findings strongly suggest that the neutrophil serine proteases cathepsin G and/or elastase and/or proteinase-3 contribute to degradation of SP-A and thereby diminish innate pulmonary antimicrobial defence.

Keywords: inflammation; neutrophil serine proteases; cathepsin G; surfactant protein A; cystic fibrosis

Abbreviations: BAL, bronchoalveolar lavage; CF, cystic fibrosis; CRD, carbohydrate recognition domain; DFP, diisopropyl fluorophosphate; MeOSuc, methoxysuccinyl; MNEI, monocyte/neutrophil elastase inhibitor; PVDF, polyvinyldine difluoride; SBzl, thiobenzyl ester; SP-A, surfactant protein-A; Suc, succinyl

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