TY - CHAP M1 - Book, Section TI - Pulmonary Alveolar Proteinosis Syndrome A1 - Trapnell, Bruce C. A1 - Suzuki, Takuji A2 - Grippi, Michael A. A2 - Elias, Jack A. A2 - Fishman, Jay A. A2 - Kotloff, Robert M. A2 - Pack, Allan I. A2 - Senior, Robert M. A2 - Siegel, Mark D. PY - 2015 T2 - Fishman's Pulmonary Diseases and Disorders, 5e AB - Pulmonary alveolar proteinosis (PAP) syndrome is characterized by the accumulation of surfactant in alveoli and terminal airways resulting in hypoxemic respiratory failure.1 This fascinating syndrome continues to serve as a paradigm for disease discovery and development due to a globalized collaborative network, employment of diverse clinical, basic, and translational research approaches, and active patient involvement. While PAP occurs in many clinical settings including recently identified genetic etiologies, its molecular basis is now known in more than 90% of cases, and the molecular basis of the role of granulocyte macrophage colony–stimulating factor (GM-CSF) in surfactant homeostasis has been defined. Diseases associated with PAP can be grouped into primary PAP, secondary PAP, and congenital PAP based primarily on pathogenesis involved. Primary PAP is caused by impairment of GM-CSF–dependent surfactant clearance by alveolar macrophages and accounts for approximately 90% of all cases.2 Secondary PAP occurs as a consequence of a comorbid condition that impair surfactant clearance by alveolar macrophages and accounts for about 5% of cases.3 Congenital PAP is a clinically distinct and pathogenically heterogeneous group of genetic disorders associated with the production of abnormal surfactant and accounts for about 5% of cases.4 Because of its increased frequency and greater research attention, primary PAP will be the focus of this chapter and data for secondary and congenital PAP will be provided where available. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2023/01/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=1122362135 ER -