Pre-ischaemic exogenous surfactant reduces pulmonary injury in rat ischaemia/reperfusion

Abstract

The optimal timing of exogenous surfactant application to reduce pulmonary injury and dysfunction was investigated in a rat lung ischaemia and reperfusion injury model.Lungs were subjected to flush perfusion, surfactant instillation, cold ischaemia (4uC, 4 h) and reperfusion (60 min). Animals received surfactant before (group 1) or at the end (2) of ischaemia, or during reperfusion (3) or not at all (4). Control groups included ''worst case'' without Perfadex and surfactant (5), ''no injury'' without (6) or with surfactant (7), and ischaemia with pre-ischaemic surfactant (8). Intra-alveolar oedema and blood-air barrier injury were estimated by light and electron microscopic stereology. Perfusate oxygenation and pulmonary arterial pressure (Ppa) were determined during reperfusion in groups 1 to 4.Intra-alveolar oedema was almost absent in groups 1, 6, 7 and 8, pronounced in 2, 3 and 4, and severe in 5. Blood-air barrier injury was moderate in groups 1 and 8, slightly pronounced in 2, 3 and 4, extensive in 5 and almost absent in 6 and 7. Perfusate oxygenation was significantly higher in group 1 compared with groups 2 to 4. Ppa did not differ between the groups.In conclusion, exogenous surfactant attenuates intra-alveolar oedema formation and blood-air barrier damage and improves perfusate oxygenation in the rat lung, especially when applied before ischaemic storage.

Lung preservation in experimental ischemia/reperfusion injury and lung transplantation: A comparison of natural and synthetic surfactants

“…The data of 3 further groups, which had been treated with Curosurf (a kind gift from Nycomed Pharma, Linz, Austria) before flush perfusion using exactly the same experimental settings, were taken from two previous publications (Group 7: I/R_Curo; Group 8: I_Curo; Group 9: Flush_Curo). 6,7 The experimental procedure regarding the ischemia/reperfusion model has been described in detail elsewhere. 6,14 Depending on the group affiliation, treatment with different surfactant preparations was performed by instillation prior to flush perfusion.…”

“…6,7 The experimental procedure regarding the ischemia/reperfusion model has been described in detail elsewhere. 6,14 Depending on the group affiliation, treatment with different surfactant preparations was performed by instillation prior to flush perfusion. The concentrations, according to the manufacturers' instructions, were 200 mg/kg body weight for Curosurf and SPC-33 and 100 mg/kg body weight for Survanta.…”

“…9,13 The aim of the present study was to analyze the therapeutic effect of a synthetic surfactant preparation containing SPC-33 in comparison to natural surfactant preparations of porcine (Curosurf) and bovine (Survanta) origin in a wellestablished model of ischemia/reperfusion injury of the rat lung. 6 …”

A review of recent developments and applications of morphometry/stereology in lung research

“…For several of these diseases, a set of wellsuited stereological parameters has been available for a long time, such as acute lung injury (103,112) and emphysema (113). In other cases, the application of stereology is just emerging such as fibrosis (9, 82) or bronchopulmonary dysplasia (83).…”

The Closer we Look the more we See? Quantitative Microscopic Analysis of the Pulmonary Surfactant System

“…preischemic donor lung) treatment with an exogenous surfactant preparation prevents atelectasis formation, intraalveolar edema formation and air-blood barrier damage and stabilizes intraalveolar surfactant composition [143][144][145] and may therefore become a therapeutic option to optimize lung preservation during clinical lung transplantation.…”