Open Access Research article

Differences in serum SP-D levels between German and Japanese subjects are associated with SFTPD gene polymorphisms

Yasushi Horimasu1, Noboru Hattori1*, Nobuhisa Ishikawa1, Sonosuke Tanaka1, Francesco Bonella2, Shinichiro Ohshimo1, Josune Guzman3, Ulrich Costabel2 and Nobuoki Kohno1

Author Affiliations

1 Department of Molecular and Internal Medicine, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan

2 Department of Pneumology/Allergy, Ruhrlandklinik, University Hospital, University Duisburg-Essen, Tueschener Weg 40, 45239 Essen, Germany

3 General and Experimental Pathology, Ruhr University Bochum, Universitätsstraße 150, 44801 Bochum, Germany

For all author emails, please log on.

BMC Medical Genetics 2014, 15:4  doi:10.1186/1471-2350-15-4

Published: 8 January 2014



Surfactant protein A (SP-A) and SP-D are clinically established in Japan as serum biomarkers for diagnosing interstitial lung diseases (ILDs). Serum SP-D levels are affected by genetic variants. We conducted the present study to examine whether serum SP-A and/or SP-D levels in healthy subjects (HS) and patients with ILDs differ between populations with different genetic backgrounds.


German subjects (n = 303; 138 patients with idiopathic interstitial pneumonias [IIPs] and 165 HS) and Japanese subjects (n = 369; 94 patients with IIPs and 275 HS) were enrolled. Serum SP-A and SP-D levels were measured using an enzyme-linked immunosorbent assay, and four single-nucleotide polymorphisms (SNPs) in the SFTPD gene were genotyped using genomic DNA extracted from blood samples.


In both the German and Japanese cohorts, serum SP-A and SP-D levels were significantly higher in patients with IIPs than in HS. There were no significant differences in SP-A levels between the German and Japanese cohorts; however, we found that serum SP-D levels were significantly higher in the German cohort, both in patients with IIPs and in HS (p < 0.001 and p = 0.005, respectively). Furthermore, the genotype distributions of the four SNPs in the SFTPD gene (rs721917, rs1998374, rs2243639, and rs3088308) were significantly different between German and Japanese cohorts (p < 0.001, p < 0.001, p = 0.022, and p < 0.001, respectively), and univariate linear regression analyses revealed that the genotypes of rs721917, rs1998374, and rs2243639 significantly correlated with serum SP-D levels (p < 0.001, p < 0.001, and p = 0.011, respectively). Furthermore, multivariate analyses revealed that the genotypes of these three SNPs correlated independently with serum SP-D levels (p < 0.001, p = 0.001, and p = 0.038, respectively), whereas ethnicity did not significantly correlate with serum SP-D levels.


In patients with IIPs and HS, serum SP-D, but not SP-A, levels were significantly higher in the German than in the Japanese cohort, in part, because of the different frequencies of SFTPD gene polymorphisms.

Biological marker; Idiopathic interstitial pneumonia; Single nucleotide polymorphism; Surfactant protein-A (SP-A); Surfactant protein-D (SP-D)