Changes of tumor necrosis factor, surfactant protein A, and phospholipids in bronchoalveolar lavage fluid in the development and progression of coal workers' pneumoconiosis.

OBJECTIVE To evaluate the alterations of biomarkers in the development and progression of coal workers' pneumoconiosis (CWP). METHODS The type and number of cells, and the levels of tumor necrosis factor-alpha (TNF-alpha), pulmonary surfactant protein, phospholipids and fibronectin in bronchoalveolar lavage fluid were assayed in 14 health active coal miners, 21 coal miners without CWP and 13 miners with CWP of 0/1 to 1/1. RESULTS Compared to active coal miners without CWP (8.23 microg/mL), TNF-alpha concentration was gradually decreased when dust exposure was stopped (5.90 microg/mL). Elevated surfactant protein A (SP-A) level and phosphatidylglycerol (PG) to phosphatidylinositol (PI) ratio were found in miners actively exposed to coal dust (6528 ng/mL for SP-A and 10. for PG/PI), and both parameters decreased when CWP progressed from CWP (0/1) (3419 microg/mL for SP-A and 5.9 for PG/PI) to CWP (1/1) (1654 microg/mL for SP-A and 5.5 for PG/PI). CONCLUSION Biomarkers in bronchoalveolar lavage fluid can be used to screen coal miners at high risk of developing coal workers' pneumoconiosis.