title: Sensitivity of synthetic surfactants to albumin inhibition in preterm rabbits.
abstract: Surfactant can be inhibited in vivo by plasma proteins invading the alveolar space during acute lung injury. The resistance to protein inhibition of surfactant preparations with various synthetic surfactant proteins B and C (B and C) was tested in preterm rabbits. Surfactants consisted of a palmitic acid containing phospholipid mixture (PL) with full-length SP-B peptide (B1-78), one of two SP-B mutants (Bserine and BR236C), the synthetic SP-B mimic KL4 (UCLA-KL4), a natural SP-B (Bbovine), synthetic palmitoylated SP-C peptide (C1-35), a combination of B1-78 + C1-35, a combination of BR236C + C1-35, and the clinical surfactant Survanta. Preterm rabbits born at 28 days of gestation were ventilated and received 100 mg/kg of albumin intratracheally at 30 min and 100 mg/kg of surfactant at 45 min after birth. Dynamic lung compliance (tidal volume/mean airway pressure) decreased from 0.82 to 0.57 mL/kg/cm H2O after albumin instillation and to 0.43 mL/kg/cm H2O over a 60-min period after saline placebo. Treatment with B1-78 + C1-35 and BR236C + C1-35 surfactant and Survanta returned dynamic compliance to prealbumin values, B1-78, BR236C, Bbovine, and C1-35 surfactant stabilized dynamic compliance, but PL, Bserine, and UCLA-KL4 surfactant were unable to prevent a further deterioration in dynamic compliance. These data suggest that a combination of synthetic surfactant peptides B1-78 and C1-35 and the clinical surfactant Survanta confer a high degree of resistance to surfactant inhibition by human albumin in ventilated preterm rabbits.
authors.affiliation: Department of Pediatrics, Charles R. Drew University of Medicine and Science, Los Angeles, California.
authors.forename: N
authors.initials: N
authors.lastname: Mbagwu
authors.forename: R
authors.initials: R
authors.lastname: Bruni
authors.forename: J M
authors.initials: JM
authors.lastname: Hernández-Juviel
authors.forename: A J
authors.initials: AJ
authors.lastname: Waring
authors.forename: F J
authors.initials: FJ
authors.lastname: Walther
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D001696:Biomechanical Phenomena; D018893:Bronchoalveolar Lavage; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000737:chemistry / Q000187:drug effects; D008170:Lung Compliance / Q000187:drug effects; D011247:Pregnancy; D011663:Pulmonary Surfactants / Q000037:antagonists & inhibitors* / Q000138:chemical synthesis; D011817:Rabbits; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000494:pharmacology*; D013499:Surface Properties / Q000187:drug effects