{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:30:20Z","timestamp":1783488620614,"version":"3.55.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[1998,11,1]],"date-time":"1998-11-01T00:00:00Z","timestamp":909878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Surfactant proteins A and B (SP-A and SP-B) enter the circulation in a manner that acutely reflects changes in pulmonary function in patients with acute respiratory failure (ARF). There is a small but significant gradient in SP-A and SP-B from arterial to mixed venous (A\u2013V) blood, and since we have detected both proteins in urine, the kidney may be a major site of their systemic clearance. Clara cell secretory protein 16 (CC16), which leaks from the respiratory tract, is known to be freely eliminated by the kidney. Lung plasma protein levels will depend on the rates of both protein entry into and clearance from plasma. In order to study the limiting variable determining these levels, we compared plasma CC16, SP-A, and SP-B in matching A\u2013V blood samples from 37 ARF patients with indices of lung dysfunction and glomerular filtration rate (GFR) (of plasma cystatin C and creatinine). Cystatin C, CC16, SP-A, and SP-B were reduced in mixed venous plasma (all p &amp;lt; 0.001) and their A\u2013V gradients were directly related to their arterial levels (all p &amp;lt; 0.03). Whereas CC16, SP-A, and SP-B reflected blood oxygenation (all p &amp;lt; 0.05), only SP-A and SP-B were related to lung injury score (LIS) (both p &amp;lt; 0.05). In contrast, whereas the clearances of both CC16 and cystatin C were related to that of creatinine (p &amp;lt; 0.02 for both), the clearances of SP-A and SP-B were not. Our study confirms that all three lung proteins are acutely cleared from the circulation of patients with ARF (half-lives &amp;lt; 18 min), and we conclude that whereas the plasma concentration of CC16 depends on GFR, plasma concentrations of SP-A and SP-B reflect lung function independently of this variable.<\/jats:p>","DOI":"10.1164\/ajrccm.158.5.9712097","type":"journal-article","created":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T13:46:57Z","timestamp":1365083217000},"page":"1528-1535","source":"Crossref","is-referenced-by-count":52,"title":["Clearance of Clara Cell Secretory Protein 16 (CC16) and Surfactant Proteins A and B from Blood in Acute Respiratory Failure"],"prefix":"10.1093","volume":"158","author":[{"given":"IAN R.","family":"DOYLE","sequence":"first","affiliation":[{"name":"Departments of Human Physiology and Critical Care Medicine, School of Medicine, Flinders Medical Centre, Adelaide, Australia; and Industrial Toxicology and Occupational Medicine Unit, Medical School, Catholic University Louvain, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CEDRIC","family":"HERMANS","sequence":"additional","affiliation":[{"name":"Departments of Human Physiology and Critical Care Medicine, School of Medicine, Flinders Medical Centre, Adelaide, Australia; and Industrial Toxicology and Occupational Medicine Unit, Medical School, Catholic University Louvain, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ALFRED","family":"BERNARD","sequence":"additional","affiliation":[{"name":"Departments of Human Physiology and Critical Care Medicine, School of Medicine, Flinders Medical Centre, Adelaide, Australia; and Industrial Toxicology and Occupational Medicine Unit, Medical School, Catholic University Louvain, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"TERENCE E.","family":"NICHOLAS","sequence":"additional","affiliation":[{"name":"Departments of Human Physiology and Critical Care Medicine, School of Medicine, Flinders Medical Centre, Adelaide, Australia; and Industrial Toxicology and Occupational Medicine Unit, Medical School, Catholic University Louvain, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ANDREW D.","family":"BERSTEN","sequence":"additional","affiliation":[{"name":"Departments of Human Physiology and Critical Care Medicine, School of Medicine, Flinders Medical Centre, Adelaide, Australia; and Industrial Toxicology and Occupational Medicine Unit, Medical School, Catholic University Louvain, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1998,11,1]]},"reference":[{"key":"2026032709075964500_B1"},{"key":"2026032709075964500_B2","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1007\/s001340050400","article-title":"Anti-inflammatory therapies: application of molecular biology techniques in intensive care medicine.","volume":"23","author":"Liu","year":"1997","journal-title":"Intensive Care Med."},{"key":"2026032709075964500_B3","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1164\/ajrccm\/141.4_Pt_1.1071","article-title":"NHLBI workshop summary: workshop on techniques to evaluate lung alveolar-microvascular injury.","volume":"141","author":"Staub","year":"1990","journal-title":"Am. Rev. Respir. Dis."},{"key":"2026032709075964500_B4","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1164\/ajrccm.155.4.9105054","article-title":"Biological markers of acute lung injury: prognostic and pathogenetic significance.","volume":"155","author":"Pittet","year":"1997","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"2026032709075964500_B5"},{"key":"2026032709075964500_B6","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1164\/ajrccm.152.1.7599839","article-title":"Serum surfactant protein-A (SP-A) levels in patients with acute cardiogenic pulmonary edema and adult respiratory distress syndrome.","volume":"152","author":"Doyle","year":"1995","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"2026032709075964500_B7","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1164\/ajrccm.156.4.9603061","article-title":"Surfactant proteins A and B are elevated in plasma of patients with acute respiratory failure.","volume":"156","author":"Doyle","year":"1997","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"2026032709075964500_B8"},{"key":"2026032709075964500_B9","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/0009-8981(91)90374-L","article-title":"Determination by latex immunoassay of protein 1 in normal and pathological urine.","volume":"201","author":"Bernard","year":"1991","journal-title":"Clin. Chim. Acta"},{"key":"2026032709075964500_B10","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1038\/ki.1994.221","article-title":"Determinants of the serum concentrations of low molecular weight proteins in patients on maintenance hemodialysis.","volume":"45","author":"Kabanda","year":"1994","journal-title":"Kidney Int."},{"key":"2026032709075964500_B11","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1164\/ajrccm\/138.3.720","article-title":"An expanded definition of the adult respiratory distress syndrome.","volume":"138","author":"Murray","year":"1988","journal-title":"Am. Rev. Respir. Dis."},{"key":"2026032709075964500_B12","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/S0272-6386(86)80118-4","article-title":"The renal response produced by non-hypotensive sepsis in a large animal model.","volume":"8","author":"Walker","year":"1986","journal-title":"Am. J. Kidney Dis."},{"key":"2026032709075964500_B13","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1159\/000188621","article-title":"Cystatin C: a promising marker of glomerular filtration rate to replace creatinine.","volume":"70","author":"Jung","year":"1995","journal-title":"Nephron"},{"key":"2026032709075964500_B14","first-page":"S20","article-title":"Diagnostic value of analysis of cystatin C and protein HC in biological fluids.","volume":"38","author":"Grubb","year":"1992","journal-title":"Clin. Nephrol."},{"key":"2026032709075964500_B15","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1093\/clinchem\/29.6.1007","article-title":"Continuous flow system for the automation of latex immunoassay by particle counting.","volume":"29","author":"Bernard","year":"1983","journal-title":"Clin. Chem."},{"key":"2026032709075964500_B16","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1183\/09031936.93.05101231","article-title":"Clara cell protein in serum and bronchoalveolar lavage.","volume":"5","author":"Bernard","year":"1992","journal-title":"Eur. Respir. J."},{"key":"2026032709075964500_B17","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.1038\/ki.1995.495","article-title":"Factors influencing serum levels and peritoneal clearances of low molecular weight proteins in continuous ambulatory peritoneal dialysis.","volume":"48","author":"Kabanda","year":"1995","journal-title":"Kidney Int."},{"key":"2026032709075964500_B18"},{"key":"2026032709075964500_B19"},{"key":"2026032709075964500_B20","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1152\/jappl.1996.80.5.1431","article-title":"Alveolar epithelial clearance of protein.","volume":"80","author":"Folkesson","year":"1996","journal-title":"J. Appl. Physiol."},{"key":"2026032709075964500_B21","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1172\/JCI112743","article-title":"Protein permeability in the adult respiratory distress syndrome: loss of size selectivity of the alveolar epithelium.","volume":"78","author":"Holter","year":"1986","journal-title":"J. Clin. Invest."},{"key":"2026032709075964500_B22","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3109\/13547509609079341","article-title":"Clara cell protein (CC16): characteristics and potential applications as biomarker of lung toxicity.","volume":"1","author":"Hermans","year":"1996","journal-title":"Biomarkers"},{"key":"2026032709075964500_B23","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1164\/ajrccm.152.1.7541278","article-title":"Clara cell protein (CC-16) induces a phospholipase A2-mediated inhibition of fibroblast migration in vitro.","volume":"152","author":"Lesur","year":"1995","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"2026032709075964500_B24","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1038\/ki.1979.128","article-title":"Renal filtration, transport, and metabolism of low-molecular-weight proteins: a review.","volume":"16","author":"Maack","year":"1979","journal-title":"Kidney Int."},{"key":"2026032709075964500_B25","first-page":"49","article-title":"Proteinuria: causes, forms and methods of determination.","volume":"1","author":"Guder","year":"1988","journal-title":"Clin. Diagn. Lab. Med."},{"key":"2026032709075964500_B26","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1164\/ajrccm\/147.3.723","article-title":"Elevated levels of lung surfactant protein A in sera from patients with idiopathic pulmonary fibrosis and pulmonary alveolar proteinosis.","volume":"147","author":"Kuroki","year":"1993","journal-title":"Am. Rev. Respir. Dis."},{"key":"2026032709075964500_B27","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1164\/ajrccm\/137.1.95","article-title":"Adult respiratory distress syndrome as a specific manifestation of a general permeability defect in trauma patients.","volume":"137","author":"Kreuzfelder","year":"1987","journal-title":"Am. Rev. Respir. Dis."},{"key":"2026032709075964500_B28","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1097\/00005373-199706000-00012","article-title":"Prediction of posttraumatic adult respiratory distress syndrome by albumin excretion rate eight hours after admission.","volume":"42","author":"Pallister","year":"1997","journal-title":"J. Trauma"},{"key":"2026032709075964500_B29","first-page":"708","article-title":"Achievements and new directions in continuous renal replacement therapies.","volume":"3","author":"Ronco","year":"1995","journal-title":"New Horizons"},{"key":"2026032709075964500_B30","doi-asserted-by":"crossref","first-page":"2259","DOI":"10.1681\/ASN.V7102259","article-title":"Protein losses in continuous renal replacement therapies.","volume":"7","author":"Mokrzycki","year":"1996","journal-title":"J. Am. Soc. Nephrol."},{"key":"2026032709075964500_B31","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1164\/ajrccm.157.3.9707138","article-title":"Clara cell protein (CC16) in pleural fluids: a marker of leakage through the visceral pleura.","volume":"157","author":"Hermans","year":"1998","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"2026032709075964500_B32","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1002\/jcla.1860070614","article-title":"Protein 1: its purification and application in clinical medicine.","volume":"7","author":"Itoh","year":"1993","journal-title":"J. Clin. Lab. Anal."},{"key":"2026032709075964500_B33","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1378\/chest.96.4.885","article-title":"Mechanisms of multiple non-pulmonary organ failure in ARDS.","volume":"96","author":"Dorinsky","year":"1989","journal-title":"Chest"},{"key":"2026032709075964500_B34","first-page":"485","article-title":"Causes of mortality in patients with the adult respiratory distress syndrome.","volume":"132","author":"Montgomery","year":"1985","journal-title":"Am. Rev. Respir. Dis."},{"key":"2026032709075964500_B35","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/S0140-6736(96)91204-0","article-title":"Progressive cellular dehydration and proteolysis in critically ill patients.","volume":"347","author":"Finn","year":"1996","journal-title":"Lancet"},{"key":"2026032709075964500_B36","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/S0031-6997(25)06760-2","article-title":"Peptide hormones and their analogues: distribution, clearance from the circulation, and inactivation in vivo.","volume":"30","author":"Bennett","year":"1979","journal-title":"Pharmacol. Rev."},{"key":"2026032709075964500_B37","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1111\/j.1365-2362.1980.tb00036.x","article-title":"Turnover in humans of \u03b22-microglobulin: the constant chain of HLA-antigens.","volume":"10","author":"Karlsson","year":"1980","journal-title":"Eur. J. Clin. Invest."},{"key":"2026032709075964500_B38","doi-asserted-by":"crossref","first-page":"984","DOI":"10.2337\/diab.45.7.984","article-title":"Adipose tissue leptin production and plasma leptin kinetics in humans.","volume":"45","author":"Klein","year":"1997","journal-title":"Diabetes"},{"key":"2026032709075964500_B39","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1038\/ki.1997.269","article-title":"Plasma leptin is partly cleared by the kidney and is elevated in hemodialysis patients.","volume":"51","author":"Sharma","year":"1997","journal-title":"Kidney Int."},{"key":"2026032709075964500_B40"}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/158\/5\/1528\/67432233\/ajrccm_158_5_1528.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/158\/5\/1528\/67432233\/ajrccm_158_5_1528.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T13:08:17Z","timestamp":1774616897000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/158\/5\/1528\/8530354"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,11,1]]},"references-count":40,"journal-issue":{"issue":"5","published-online":{"date-parts":[[1998,11,1]]},"published-print":{"date-parts":[[1998,11,1]]}},"URL":"https:\/\/doi.org\/10.1164\/ajrccm.158.5.9712097","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1998,11]]},"published":{"date-parts":[[1998,11,1]]}}}