Cardiometabolic effects of surfactant protein D: literature review

Surfactant protein D (SP-D), traditionally considered in the literature as a marker of acute and chronic bronchopulmonary diseases, is also associated with cardiometabolic disorders. Both from the standpoint of molecular mechanisms of action and in terms of the few available clinical studies, the cardiometabolic effects of SP-D remain poorly understood. At the same time, given the relevance of atherosclerosis and metabolic disorders, scientific interest in SP-D remains high. SP-D indirectly promotes the secretion of tumor necrosis factor (TNF-α) and interferon gamma (IFN-γ), exerting a proinflammatory effect, and by binding to lipids, affects atherogenesis. The purpose of the literature review was to systematize modern knowledge about SP-D as a promising marker of cardiometabolic disorders. The article highlights the results of recent studies that allow us to clarify and supplement the already known mechanisms of action of SP-D, as well as to determine the role of SP-D in atherogenesis and metabolic disorders. The search for relevant information on the topic of the article was performed in the search engines PubMed, Google Scholar, and in the scientific electronic library eLibrary.ru. The search depth was 35 years: from 1990 to 2025. Full-text original scientific articles, open-access literature reviews in English and Russian were selected that corresponded to the stated topic. The following tags were used for the search in English and in Russian: «SP-D», «Surfactant protein D» including in combination with the following tags «Atherosclerosis», «Atherosclerotic plaque», «Coronary artery disease», «Peripheral artery disease», «Dyslipidemia», «Metabolic Disorders», «Hypertension», «Diabetes», «Obesity». A total of 40 foreign and domestic publications were subjected to critical analysis. A literature review demonstrated the potential role of SP-D as a cardiometabolic marker and a marker of cardiovascular prognosis in patients with coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), diabetes mellitus type 2 (T2DM), obesity, peripheral artery disease (PAD) and in hemodialysis patients.