Surfactant analysis and replacement therapy: A future tool of the lung transplant surgeon?

Novick, Richard J.; Possmayer, Fred; Veldhuizen, Ruud A. W.; Menkis, Alan H.; McKenzie, Francine

doi:10.1016/0003-4975(91)91317-o

Cited by 29 publications

(18 citation statements)

References 43 publications

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“…These effects on intracellular surfactant have recently been shown to be paralleled by alterations in secreted alveolar surfactant [35]. Although the aetiology of ARDS is considered to be multifactorial, the bulk of the evidence supports a role of surfactant alterations in the development of ARDS [24]. In this respect, the unusual presence of homogeneous lipid bodies in the type II pneumocytes of case XII may be a further indication that intracellular lipid metabolism has been altered.…”

Section: Dependentmentioning

confidence: 96%

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Ultrastructural pathology of the alveolar type II pneumocytes of human donor lungs

et al. 1998

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Alveolar type II pneumocytes (PII) were studied in 12 human donor lungs perfused with modified Euro-Collins solution during single-lung transplantation (SLTx). While one lung was transplanted, the contralateral donor lung (cDL) was fixed at the time of SLTx for examination by electron microscopy, stereology, and microanalysis. Three groups were then formed: group A (n = 7), cDL without contusions, uneventful early postoperative course; group B (n = 3), cDL with conclusions, uneventful early postoperative course; group C (n = 2), cDL without contusions, early postoperative respiratory dysfunction. The major findings were that the presence of contusions had no effect on PII ultrastructure and that intracellular surfactant-storing lamellar bodies of cDL in group C were characterized by a higher volume-to-surface ratio (VsR) and larger area per cell profile than group A. Correlation analysis based on pooled data (groups A and C) showed that ischaemic time had little effect on PII ultrastructure and bore no relationship to postoperative clinical variables. The duration of preoperative donor intubation had a pronounced influence on ultrastructure and postoperative clinical variables. The stereologically estimated amount of intracellular surfactant and mitochondrial VsR were the only ultrastructural parameters that were significantly associated with early postoperative oxygenation. Lamellar bodies were the only ultrastructural components found to have a significant relationship to postoperative intubation time. The ultrastructural integrity of type II pneumocytes of human donor lungs is an important determinant of early respiratory function following clinical lung transplantation.

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Section: Dependentmentioning

confidence: 96%

“…Recent experimental studies have demonstrated that alterations of pulmonary surfactant contribute to the reimplantation-related early respiratory dysfunction observed after lung transplantation [2,20,24,37]. These findings are supported by the success of exogenous surfactant therapy in clinical treatment [32].…”

Section: Introductionmentioning

confidence: 93%

Ultrastructural pathology of the alveolar type II pneumocytes of human donor lungs

et al. 1998

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“…However, analysis of other BAL phospholipids and surfactant-specific proteins is lacking in this study, and it remains to be confirmed that carnitine infusions really have such in vivo effects. A current review of this subject [128] outlines some of the possible perspectives of surfactant analysis and treatment in lung transplantation in more detail. Certainly, much more work has to be done to assess the usefulness of surfactant studies or even surfactant replacement therapies in lung recipients.…”

Section: Othersmentioning

confidence: 99%

The surfactant system of the adult lung: physiology and clinical perspectives

1992

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Pulmonary surfactant is synthesized and secreted by alveolar type II cells and constitutes an important component of the alveolar lining fluid. It comprises a unique mixture of phospholipids and surfactant-specific proteins. More than 30 years after its first biochemical characterization, knowledge of the composition and functions of the surfactant complex has grown considerably. Its classically known role is to decrease surface tension in alveolar air spaces to a degree that facilitates adequate ventilation of the peripheral lung. More recently, other important surfactant functions have come into view. Probably most notable among these, surfactant has been demonstrated to enhance local pulmonary defense mechanisms and to modulate immune responses in the alveolar milieu. These findings have prompted interest in the role and the possible alterations of the surfactant system in a variety of lung diseases and in environmental impacts on the lung. However, only a limited number of studies investigating surfactant changes in human lung disease have hitherto been published. Preliminary results suggest that surfactant analyses, e.g., from bronchoalveolar lavage fluids, may reveal quantitative and qualitative abnormalities of the surfactant system in human lung disorders. It is hypothesized that in the future, surfactant studies may become one of our clinical tools to evaluate the activity and severity of peripheral lung diseases. In certain disorders they may also gain diagnostic significance. Further clinical studies will be necessary to investigate the potential therapeutic benefits of surfactant substitution and the usefulness of pharmacologic manipulation of the secretory activity of alveolar type II cells in pulmonary medicine.

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“…A lesão de IR após o transplante pulmonar é a principal causa de disfunção do órgão e está associada com inúmeras alterações estruturais e funcionais (Dreyer et al, 2008), como, por exemplo, edema intra-alveolar e intersticial e diminuição da integridade da barreira alvéolo-capilar (Novick et al, 1991;Mühlfeld et al, 2007;Dreyer et al, 2008).…”

Section: Lesão De Isquemia E Reperfusãounclassified

“…Diversas alterações estruturais e funcionais estão entre as possíveis explicações para este fato, como, por exemplo, a diminuição da integridade da barreira alvéolo-capilar e o consequente edema intra-alveolar e intersticial (Novick et al, 1991;Mühlfeld et al, 2007;Dreyer et al, 2008). Por outro lado, a lesão de IR é marcadamente atenuada quando macrófagos alveolares estão reduzidos, o que ocorre, em grande parte, devido à redução da expressão das citocinas pró-inflamatórias e quimiocinas (Zhao et al, 2006 Hengst et al, 2010), resultando na adesão maciça de células inflamatórias, tais como, macrófagos, neutrófilos e células T, que estão conectadas a arteríolas, vênulas e capilares alveolares (Kuhnle et al, 1998;den Hengst et al, 2010).…”

Section: D Di Is Sc Cu Us Ss Sã ãO Ounclassified

Efeitos da suplementação com creatina na lesão de isquemia e reperfusão após transplante pulmonar unilateral em ratos

Almeida¹

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EEf fe ei it to os s d da a s su up pl le em me en nt ta aç çã ão o c co om m c cr re ea at ti in na a n na a l le es sã ão o d de e i is sq qu ue em mi ia a e e r re ep pe er rf fu us sã ão o a ap pó ós s t tr ra an ns sp pl la an nt te e p pu ul lm mo on na ar r u un ni il la at te er ra al l e em m r ra at to os s Ao meu orientador Rogerio Pazetti por compartilhar sua experiência profissional comigo e por toda a confiança depositada em mim na última década.À CAPES e à FAPESP pelo apoio financeiro para a realização desta pesquisa. Muito obrigada!!!

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Surfactant analysis and replacement therapy: A future tool of the lung transplant surgeon?

Cited by 29 publications

References 43 publications

Ultrastructural pathology of the alveolar type II pneumocytes of human donor lungs

Ultrastructural pathology of the alveolar type II pneumocytes of human donor lungs

The surfactant system of the adult lung: physiology and clinical perspectives

Efeitos da suplementação com creatina na lesão de isquemia e reperfusão após transplante pulmonar unilateral em ratos

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