Surfactant chemical composition and biophysical activity in acute respiratory distress syndrome

• Published in: The Journal of clinical investigation Vol. 88; no. 6; pp. 1976 - 1981
• Main Authors: GREGORY, T. J, LONGMORE, W. J, MOXLEY, M. A, WHITSETT, J. A, REED, C. R, FOWLER, A. A, HUDSON, L. D, MAUNDER, R. J, CRIM, C, HYERS, T. M
• Format: Journal Article
• Language: English
• Published: Ann Arbor, MI American Society for Clinical Investigation 01.12.1991
• Subjects: Acute Disease; Adult; Biological and medical sciences; Bronchoalveolar Lavage Fluid - chemistry; Female; Humans; Male; Medical sciences; Middle Aged; Phospholipids - analysis; Pneumology; Pulmonary Surfactants - analysis; Respiratory Distress Syndrome, Adult - metabolism; Respiratory system : syndromes and miscellaneous diseases; Risk; Surface Tension; Human; Chemical analysis; Pulmonary surfactant; Respiratory disease; Acute; Etiopathogenesis; Risk factor; Phospholipid; Adult; Respiratory distress
• ISSN: 0021-9738; 1558-8238
• DOI: 10.1172/jci115523

Acute Respiratory Distress Syndrome (ARDS) is characterized by lung injury and damage to the alveolar type II cells. This study sought to determine if endogenous surfactant is altered in ARDS. Bronchoalveolar lavage was performed in patients at-risk to develop ARDS (AR, n = 20), with ARDS (A, n = 66) and in normal subjects (N, n = 29). The crude surfactant pellet was analyzed for total phospholipids (PL), individual phospholipids, SP-A, SP-B, and minimum surface tension (STmin). PL was decreased in both AR and A (3.48 +/- 0.61 and 2.47 +/- 0.40 mumol/ml, respectively) compared to N (7.99 +/- 0.60 mumol/ml). Phosphatidylcholine was decreased in A (62.64 +/- 2.20% PL) compared to N (76.27 +/- 2.05% PL). Phosphatidylglycerol was 11.58 +/- 1.21% PL in N and was decreased to 6.48 +/- 1.43% PL in A. SP-A was 123.64 +/- 20.66 micrograms/ml in N and was decreased to 49.28 +/- 21.68 micrograms/ml in AR and to 29.88 +/- 8.49 micrograms/ml in A. SP-B was 1.28 +/- 0.33 micrograms/ml in N and was decreased to 0.57 +/- 0.24 micrograms/ml in A. STmin was increased in AR (15.1 +/- 2.53 dyn/cm) and A (29.04 +/- 2.05 dyn/cm) compared to N (7.44 +/- 1.61 dyn/cm). These data demonstrate that the chemical composition and functional activity of surfactant is altered in ARDS. Several of these alterations also occur in AR, suggesting that these abnormalities occur early in the disease process.