Conductive Airway Surfactant: Surface-tension Function, Biochemical  Composition, and Possible Alveolar Origin

Bernhard, Wolfgang; Hp, Haagsman; Tschernig, Thomas; Cf, Poets; Postle, Anthony D.; Me, van Eijk; H, von der Hardt

doi:10.1165/ajrcmb.17.1.2594

Cited by 115 publications

(135 citation statements)

References 37 publications

(42 reference statements)

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“…The presence of a linear relationship between DSP and SP-A and -B in our LAF (data not shown) strongly suggests that this method of sampling reflects surfactant composition. BERNHARD et al [19] also found that conducting airway fluid reflected alveolar surfactant composition. Numerous other investigators have used aspirated fluid to examine surfactant composition in neonates [20][21][22], children [23] and adults [24] with respiratory failure, and noted that the relative surfactant composition is similar to that obtained from BAL.…”

Section: Surfactant Samplingmentioning

confidence: 94%

Surfactant composition reflects lung overinflation and arterial oxygenation in patients with acute lung injury

Bersten¹,

Doyle²,

Davidson³

et al. 1998

Eur Respir J

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Pulmonary surfactant abnormalities have consistently been documented in patients with acute lung injury (ALI), however, there is little evidence directly correlating them to altered respiratory mechanics. To explore this further, surfactant composition was measured in lung aspirate fluid collected on 15 occasions from 10 patients with ALI. The composition was compared with lung aspirate fluid from 11 intubated patients prior to elective cardiac surgery (CS), and bronchoalveolar lavage fluid from 16 normal subjects. In both the ALI and cardiac groups the proportion of disaturated phospholipids (DSP) and phosphatidylcholine was reduced. Plasma levels of surfactant proteins-A and -B (SP-A and -B) were elevated, but were unrelated to alveolar surfactant levels. In the ALI group, and the ALI + CS group, DSP, normalized to the total phospholipid content, sphingomyelin (SPH), and urea, showed strong direct correlations with arterial oxygen tension/inspiratory oxygen fraction (all p < or = 0.01). In the ALI group, normalized DSP was also directly related to the elastance of the positive end-expiratory pressure-induced increase in the end-expiratory lung volume (all p < or = 0.02), and indirect correlations were found with a measure of lung overinflation (%E2; all p < or = 0.01). We conclude that surfactant composition correlates with lung function abnormalities in acute lung injury and cardiac patients, and that both groups had elevated plasma surfactant proteins-A and -B levels, consistent with a concurrent increase in alveolocapillary permeability.

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Section: Surfactant Samplingmentioning

confidence: 94%

Surfactant composition reflects lung overinflation and arterial oxygenation in patients with acute lung injury

Bersten¹,

Doyle²,

Davidson³

et al. 1998

Eur Respir J

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“…Although the major physiologic function of pulmonary surfactant is to confer mechanical stability to the alveoli and the small airways (22)(23)(24), there is growing evidence that pulmonary surfactant also has a potential role in modulating infl ammation in normal and injured lungs (25)(26)(27)(28)(29)(30). Our previous work ( 31,32 ) and that of others (33)(34)(35)(36) have shown that surfactant lipids modulate the release of oxidative and infl ammatory mediators from infl ammatory cells.…”

Section: Lps Binding Assaymentioning

confidence: 99%

Surfactant lipids regulate LPS-induced interleukin-8 production in A549 lung epithelial cells by inhibiting translocation of TLR4 into lipid raft domains

Abate

Alghaithy

Parton

et al. 2010

Journal of Lipid Research

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“…Because Clara cells from the conductive airways are able to synthesize SPs (21,22), further studies will be needed to ascertain differences between surfactant samples from TA and alveolar surfactant. Several investigators found similar surfactant composition in TA and bronchoalveolar lavage fluid (23,24), but SP-A, SP-B, and SP-C were found to be lower in TA than in lung lavage fluid (23). Of note, surfactant analysis from TA is currently the standard method for the study on surfactant in human research (3).…”

Section: General Considerationsmentioning

confidence: 99%

Surfactant-Associated Protein B Kinetics In Vivo in Newborn Infants by Stable Isotopes

et al. 2005

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Surfactant-associated protein B (SP-B) is critical to the biophysical function of pulmonary surfactant. No information is available on SP-B synthesis and kinetics in humans. We administered a 24-h i.v. infusion of 13 C-valine as metabolic precursor of SP-B to six newborn infants (weight 3.5 Ϯ 0.5 kg; age 12 d, range 1-43 d). Three of the study infants also received i.v. 2 H-palmitate to label surfactant disaturated phosphatidylcholine (DSPC). SP-B and DSPC were isolated from tracheal aspirates, and their respective 13 C and 2 H enrichments were measured by gas chromatography-mass spectrometry. SP-B kinetics was measured successfully in all six infants. SP-B median (range) fractional synthesis rate was 30% per day (20 -78% per day), secretion time was 4.5 h (1-9 h), time to peak was 24 h (12-36 h), and half-life was 21 h (8 -35 h). The ascending part of the SP-B kinetic curve was similar to the DSPC curve, suggesting similar secretion pathways. SP-B half-life seemed to be shorter than DSPC half-life. These results agree with existing animal data. We conclude that the measurement of SP-B kinetics is feasible in vivo in humans by stable isotope technology. Surfactant-associated proteins B and C (SP-B and SP-C, respectively) represent Ͻ5% of surfactant by weight, but they play a pivotal role in maintaining surfactant function (1). Surfactant deficiency is the hallmark of respiratory distress syndrome in preterm infants. In respiratory distress syndrome, there is a reduced amount of phospholipids (2) and of SP-B and SP-C (3). The key role of SP-B became evident in congenital SP-B deficiency, which is characterized by severe respiratory failure leading ultimately to death unless lung transplant is performed (1,4). To date, there are no data on SP-B kinetics in humans, but information is available in adult and newborn animals, in which radioactive labels can be used. These studies showed differences in SP-B clearance and kinetics depending on animal species and postnatal age (5-7).We recently described methods based on stable isotopes to measure surfactant disaturated-phosphatidylcholine (DSPC) kinetics in humans (8,9). The main objective of this study was to demonstrate the feasibility of measuring SP-B kinetics in vivo in newborn infants by means of stable isotopes. (Table 1) who were admitted to the neonatal intensive care unit, Department of Paediatrics, University of Padua. Inclusion criteria were 1) gestational age Ͼ37 wk, 2) respiratory failure requiring endotracheal intubation for an estimated length of at least 48 h, 3) arterial and venous lines placed for clinical monitoring, and 4) written parental consent. Exclusion criteria were congenital chromosomal abnormalities and exogenous surfactant given at Ͻ48 h before study start. The local Ethics Committee approved the study protocol. METHODS SP-B kinetics was studied in six infantsAll patients received a 24-h constant i.v. infusion of 2 mg/kg/h 1-13 C valine (Mass Trace, Woburn, MA), dissolved in normal saline, while they were on a lipid-free i.v. infusion. In ...

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Conductive Airway Surfactant: Surface-tension Function, Biochemical Composition, and Possible Alveolar Origin

Cited by 115 publications

References 37 publications

Surfactant composition reflects lung overinflation and arterial oxygenation in patients with acute lung injury

Surfactant composition reflects lung overinflation and arterial oxygenation in patients with acute lung injury

Surfactant lipids regulate LPS-induced interleukin-8 production in A549 lung epithelial cells by inhibiting translocation of TLR4 into lipid raft domains

Surfactant-Associated Protein B Kinetics In Vivo in Newborn Infants by Stable Isotopes

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