title: Synthetic and natural surfactant differentially modulate inflammation after meconium aspiration.
abstract: OBJECTIVE
  Meconium aspiration syndrome remains a relevant cause of neonatal respiratory failure and is associated with severe pulmonary changes including surfactant inactivation and pronounced inflammatory changes. The present study investigated the effect of two different surfactant preparations-recombinant surfactant protein C surfactant (rSP-C Surf) and natural bovine surfactant-on pulmonary gas exchange and inflammatory response.
  
  
  METHODS
  Twenty-three newborn piglets were intubated, mechanically ventilated, received 5 ml/kg 20% sterile meconium for induction of lung injury, and were randomized thereafter for controls ( n=7), rSP-C Surf ( n=8), or natural surfactant ( n=8). Surfactants were given as an intratracheal bolus (75 mg/kg) and animals were further ventilated.
  
  
  RESULTS
  Lung function variables, arterial blood gas samples and lung tissues were obtained. Histological evaluation was performed in right lung tissue using an established score. Cytokine mRNA expression (left lung tissue) was quantified using TaqMan real-time PCR (DeltaDeltaCT method, normalized to controls). In addition to significant improvement in gas exchange and lung function, histological evaluation showed significantly lower sum scores in the rSP-C Surf group than in controls). Cytokine mRNA expression of IL-1beta in whole lung tissue was significantly lower after administration of rSP-C Surf than in natural surfactant and controls whereas IL-10 mRNA expression was significantly induced in both surfactant groups.
  
  
  CONCLUSIONS
  Surfactant administration improved both gas exchange and pulmonary inflammatory cytokine transcription. Mechanisms underlying the differential inflammatory response in both surfactant preparations need to be further addressed.
authors.affiliation: Department of Pediatrics and Neonatology, Justus Liebig University of Giessen, 35392, Giessen, Germany. anne.hilgendorff@paediat.med.uni-giessen.de.
authors.forename: Anne
authors.initials: A
authors.lastname: Hilgendorff
authors.affiliation: Department of Pediatrics and Neonatology, Justus Liebig University of Giessen, 35392, Giessen, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rawer
authors.affiliation: Department of Pediatrics and Neonatology, Justus Liebig University of Giessen, 35392, Giessen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Doerner
authors.affiliation: Department of Pediatrics and Neonatology, Justus Liebig University of Giessen, 35392, Giessen, Germany.
authors.forename: Erol
authors.initials: E
authors.lastname: Tutdibi
authors.affiliation: Department of Pathology, University of Bochum, Bochum, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Ebsen
authors.affiliation: Department of Internal Medicine, Justus Liebig University of Giessen, 35392, Giessen, Germany.
authors.forename: Reinhold
authors.initials: R
authors.lastname: Schmidt
authors.affiliation: Department of Internal Medicine, Justus Liebig University of Giessen, 35392, Giessen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Guenther
authors.affiliation: Department of Pediatrics and Neonatology, Justus Liebig University of Giessen, 35392, Giessen, Germany.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Gortner
authors.affiliation: Department of Pediatrics and Neonatology, Justus Liebig University of Giessen, 35392, Giessen, Germany.
authors.forename: Irwin
authors.initials: I
authors.lastname: Reiss
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D002417:Cattle; D016207:Cytokines / Q000378:metabolism; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008471:Meconium Aspiration Syndrome / Q000150:complications*; D016133:Polymerase Chain Reaction; D011659:Pulmonary Gas Exchange; D037701:Pulmonary Surfactant-Associated Protein B / Q000627:therapeutic use*; D037721:Pulmonary Surfactant-Associated Protein C / Q000627:therapeutic use*; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology / Q000628:therapy*; D013552:Swine
chemical_list: D016207:Cytokines; D037701:Pulmonary Surfactant-Associated Protein B; D037721:Pulmonary Surfactant-Associated Protein C