The effectiveness of the serum surfactant protein D (Sp-D) level to indicate lung injury in pulmonary embolism.

BACKGROUND: Surfactant protein D (SP-D) is a biomarker specific to the lungs. Our aim was to investigate the relationship between clinical probability scores and the serum levels of SP-D to indicate the severity of lung injury that develops secondary to hypoxia in pulmonary embolism (PE). METHODS: We included three groups in the study: non-massive PE (n = 20), sub-massive PE (n = 20), and the control group (n = 20), which consisted of healthy volunteers. The modified Geneva and Wells clinical probability scoring systems were performed for PE, and the patients were classified as low risk, moderate risk, and high risk. SP-D levels were determined by the enzyme-linked immunosorbent assay. RESULTS: For risk factors, the most significant were deep vein thrombosis (DVT) and immobilization. There was no significant difference in SP-D levels between the patients identified with risk factors and those without risk factors in either the Geneva or Wells scores. Atelectasis was the most common radiographic finding, while tricuspid valve regurgitation was predominant in echocardiography. There was no significant difference between the non-massive PE group and the control group, while SP-D levels of the sub-massive group were significantly higher than the control group. CONCLUSIONS: In our study, SP-D levels were significantly higher in the sub-massive PE group overall. However, further prospective studies are required with a larger number of cases, including patients with massive PE, in order to clarify the findings.

The evaluation of different treatment protocols for trauma-induced lung injury in rats.

BACKGROUND: Lung contusion is an important factor that affects mortality and morbidity of lung injury after blunt chest trauma (BCT). The present study aims to evaluate the effectiveness of different treatment regimens on BCT-induced lung injury. METHODS: A total of 35 Sprague Dawley rats were divided into five experimental groups (n=7): sham, control; BCT; BCT + MP, BCT group treated with methylprednisolone (MP; 30 mg/kg on first day and 3 mg/kg/d on the following days); BCT + Q, BCT group treated with quercetin (Q; 50 mg/kg/d for seven days); and BCT + MP + Q, BCT group treated with the same doses of MP and Q. Serum Clara Cell Protein-16 (CC-16), thiobarbituric acid reactive substances (TBARS), and superoxide dismutase (SOD) levels were analyzed to determine histopathological changes in the lung tissues. RESULTS: Elevated serum CC-16 and TBARS levels and reduced serum SOD levels were found in the BCT group compared to the Sham group. There was a significant change in the serum CC-16 levels in the BCT + MP group compared to the Sham group. Serum TBARS levels were significantly lower in the BCT + MP and BCT + Q group compared to the BCT group. The combined therapy regimen yielded significantly decreased CC-16 levels and increased serum SOD levels compared to the individual treatment groups. Serum TBARS levels did not significantly differ between the BCT + MP + Q group and the other treatment groups. Compared to the BCT + MP + Q group, the BCT + MP group showed significantly lower alveolar edema (AED) and alveolar exudate (AEX) scores, while the BCT + Q group showed significantly lower peribronchial inflammatory cell infiltration (PICI) and AED scores. CONCLUSIONS: The combined usage of quercetin and low dose MP treatment after initial high dose MP at the early stage of lung injury after BCT is more effective.