ABSTRACT. The microstructure of aqueous dispersions of pulmonary surfactant lipids extracted from bovine lung lavage was investigated by electron microscopic analysis. Following organic solvent extraction (chloroform/methanol) from natural lung surfactant, the mixed lipids (CLL), with 1% residual protein, were dispersed in water by two techniques, probe sonication at 4" C and mechanical vortexing. Surface pressure-time adsorption isotherms were defined for the CLL dispersions, followed by staining with tannic acid, uranyl acetate, and lead citrate for electron microscopy of microstructure. CLL extract dispersions adsorbed in seconds to surface pressures near 45 dynes/cm (surface tension 25 dynes/cm) at low concentrations 5 0.25 mglml after dispersion by sonication of 4" C and by mechanical vortexing. Ultrastructurally, the CLL dispersions were somewhat heterogeneous, but large thin-walled phospholipid vesicles, both intact and fragmented, predominated. No tubular myelin was formed. By contrast, natural lung surfactant (LS) from bronchoalveolar lavage had characteristic regions of tubular myelin when it adsorbed well at low concentrations (5 0.25 mg phospholipid/ml). When divalent cations were removed from solution with 5 mM EDTA, this distinctive microstructure was not present and natural LS adsorbed less rapidly; higher concentrations of 0.63 mg phospholipid/ml were necessary for maximal adsorption of natural LS without tubular myelin. These results suggest that while tubular myelin is associated with optimal adsorption for natural LS, it is not a required configuration for rapid adsorption facility at low phospholipid concentrations in general. Specifically, for dispersions of surfactant extracts, other microstructures allow adsorption facility equivalent to that of natural LS with tubular myelin. (Pediatr Res 20:97-101,1986)
AbbreviationsThe behavior of phospholipid dispersions in an aqueous bulk phase is directly relevant to the RDS of premature neonates which is due to a deficiency of pulmonary surfactant (1, 2). In the mature lung, pulmonary surfactant undergoes a series of structural changes as it is released from the lamellar bodies of type I1 pneumocytes, enters the aqueous alveolar hypophase, and adsorbs to the air-water interface. A number of studies with a variety of models, including alveolar type I1 cells in culture, have demonstrated the distinctive LS microstructure known as tubular myelin when secreted LS is present in an aqueous bulk phase (e.g. References 3-6). This LS microstructure appears to be associated closely with adsorption facility, and surfactant associated apoproteins are considered to play an important role in tubular myelin formation in natural LS (5, 6).The administration of exogenous surfactants to the lungs is a promising approach in neonatal RDS therapy (e.g. References 2, 7-1 1) and may also have applications in other lung disorders such as the adult respiratory distress syndrome (e.g. References 8, 12). For in vivo effectiveness, replacement surfactants must have a solut...