Abstract
A disease similar to acute respiratory distress syndrome may occur in neonates after aspiration of meconium. The aim of the study was to compare the inhibitory effects of human meconium on the following surfactant preparations suspended at a concentration of 2.5 mg/mL: Curosurf, Alveofact, Survanta, Exosurf, Pumactant, rabbit natural surfactant from bronchoalveolar lavage, and two synthetic surfactants based on recombinant surfactant protein-C (Venticute) or a leucine/lysine polypeptide. Minimum surface tension, determined with a pulsating bubble surfactometer, was increased >10 mN/m at meconium concentrations ≥0.04 mg/mL for Curosurf, Alveofact, or Survanta, ≥0.32 mg/mL for recombinant surfactant protein-C, ≥1.25 mg/mL for leucine/lysine polypeptide, and ≥20 mg/mL for rabbit natural surfactant. The protein-free synthetic surfactants Exosurf and Pumactant did not reach minimum surface tension <10 mN/m even in the absence of meconium. We conclude that surfactant activity is inhibited by meconium in a dose-dependent manner. Recombinant surfactant protein-C and leucine/lysine polypeptide surfactant were more resistant to inhibition than the modified natural surfactants Curosurf, Alveofact, or Survanta but less resistant than natural lavage surfactant containing surfactant protein-A. We speculate that recombinant hydrophobic surfactant proteins or synthetic analogs of these proteins can be used for the design of new surfactant preparations that are relatively resistant to inactivation and therefore suitable for treatment of acute respiratory distress syndrome.
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Abbreviations
- (A)RDS:
-
(acute)respiratory distress syndrome
- MAS:
-
meconium aspiration syndrome
- SP:
-
surfactant protein
- rSP-C:
-
recombinant surfactant protein C
- KL4:
-
SP-B–like peptide
- FFA:
-
free fatty acids
- DPPC:
-
dipalmitoylphosphatidylcholine
- PG:
-
phosphatidylglycerol
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Supported by the German Research Council (DFG He 2072/2-2) and a collaborative project (313/S-PPP) of the German Academic Exchange Service (DAAD), the Swedish Research Council (project MFR 3351), and the Swedish Institute (SI).
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Herting, E., Rauprich, P., Stichtenoth, G. et al. Resistance of Different Surfactant Preparations to Inactivation by Meconium. Pediatr Res 50, 44–49 (2001). https://doi.org/10.1203/00006450-200107000-00010
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DOI: https://doi.org/10.1203/00006450-200107000-00010
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