PT  - JOURNAL ARTICLE
AU  - Coline H.M. van Moorsel
AU  - Joanne J. van der Vis
AU  - Jan C. Grutters
TI  - Genetic disorders of the surfactant system: focus on adult disease
AID  - 10.1183/16000617.0085-2020
DP  - 2021 Mar 31
TA  - European Respiratory Review
PG  - 200085
VI  - 30
IP  - 159
4099  - http://err.ersjournals.com/content/30/159/200085.short
4100  - http://err.ersjournals.com/content/30/159/200085.full
SO  - EUROPEAN RESPIRATORY REVIEW2021 Mar 31; 30
AB  - Genes involved in the production of pulmonary surfactant are crucial for the development and maintenance of healthy lungs. Germline mutations in surfactant-related genes cause a spectrum of severe monogenic pulmonary diseases in patients of all ages. The majority of affected patients present at a very young age, however, a considerable portion of patients have adult-onset disease. Mutations in surfactant-related genes are present in up to 8% of adult patients with familial interstitial lung disease (ILD) and associate with the development of pulmonary fibrosis and lung cancer.High disease penetrance and variable expressivity underscore the potential value of genetic analysis for diagnostic purposes. However, scarce genotype–phenotype correlations and insufficient knowledge of mutation-specific pathogenic processes hamper the development of mutation-specific treatment options.This article describes the genetic origin of surfactant-related lung disease and presents spectra for gene, age, sex and pulmonary phenotype of adult carriers of germline mutations in surfactant-related genes.Genes involved in monogenic surfactant-related parenchymal lung disease associate with age, ethnicity and pulmonary phenotype but not with sex. High disease penetrance and emerging genotype–phenotype correlations advocate genetic analysis in the clinic. https://bit.ly/2PrjAp6