SFTPA1 encodes surfactant protein A1 (SP-A1), a critical component of the pulmonary surfactant system that plays dual roles in lung homeostasis and host defense. The protein functions primarily in innate immunity through opsonization and pathogen recognition, with demonstrated ability to bind Mycobacterium pneumoniae CARDS toxin and serve as a receptor for this pathogen 1. SFTPA1 exhibits significant genetic variability with multiple variants that are differentially regulated at the transcriptional and post-transcriptional levels 2. The gene's 3' untranslated region contains polymorphic elements, including an 11-nucleotide indel, that affect translation efficiency and microRNA binding, leading to variant-specific expression patterns 34. Disease relevance includes susceptibility to tuberculosis, with specific SFTPA1 variants associated with increased risk 5. Pathogenic mutations cause interstitial lung disease with highly variable phenotypic expression, ranging from severe forms requiring lung transplantation to asymptomatic carriers 6. Importantly, SFTPA1 variant carriers show dramatically increased lung cancer risk compared to other genetic lung disease patients, with adenocarcinoma being the predominant histological type 7. The protein's dysfunction impairs secretion while preserving production, suggesting defective trafficking mechanisms 6.