Surfactant protein profile of pulmonary surfactant in premature infants.
Although premature infants are known to be deficient in pulmonary surfactant, there is limited information regarding surfactant protein (SP) composition. To assess the postnatal profile of SPs, tracheal aspirate samples were collected from 35 intubated infants of 23-31 weeks of gestation between 8 and 80 days of age. In 71 large aggregate surfactant samples that had normal in vitro function (minimum surface tension of less than 1 mN/m by pulsating bubble surfactometry), mean +/- SEM contents of SP-A, SP-B, and SP-C (3.7 kD) were 7.1 +/- 1.4%, 1.8 +/- 0.2%, and 4.6 +/- 0.6%, respectively, of phospholipid. To assess SPs in the 1st week of life, we analyzed samples from additional infants receiving only synthetic replacement surfactant. On the 2nd day of life, contents of SP-A, SP-B, and SP-C were 13.4%, 8.4%, and 0.1%, respectively, of the mean levels for Day 8-80 samples. The major postnatal increases for SP-A, SP-B, and SP-C occurred during the 1st, 2nd, and 3rd weeks, respectively. We conclude that surfactant of newborn premature infants is markedly deficient in SPs, in particular SP-C. Despite continuing lung disease, some infants who are more than 1 week of age have surfactant with normal in vitro function that contains SPs at levels comparable to adult surfactant.
Ballard
Philip L
PL
Department of Pediatrics,University of Pennsylvania School of Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA. ballardp@email.chop.edu
Merrill
Jeffrey D
JD
Godinez
Rodolfo I
RI
Godinez
Marye H
MH
Truog
William E
WE
Ballard
Roberta A
RA
D015153:Blotting, Western; D004338:Drug Combinations; D005233:Fatty Alcohols / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D008297:Male; D010767:Phosphorylcholine / Q000008:administration & dosage; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011663:Pulmonary Surfactants / Q000032:analysis*; D012016:Reference Values; D012128:Respiratory Distress Syndrome / Q000175:diagnosis; D014132:Trachea / Q000737:chemistry
D004338:Drug Combinations; D005233:Fatty Alcohols; D011663:Pulmonary Surfactants; D010767:Phosphorylcholine; D011092:Polyethylene Glycols; C047049:dipalmitoylphosphatidylcholine, hexadecanol, tyloxapol drug combination