title: Effects of Natural versus Synthetic Surfactant with SP-B and SP-C Analogs in a Porcine Model of Meconium Aspiration Syndrome.
abstract: BACKGROUND
  Meconium displaces surfactant from the alveolar surface and inhibits its function. The development of active synthetic surfactants is complicated, especially to synthesize the hydrophobic surfactant proteins SP-B and SP-C. A synthetic surfactant, CHF5633 containing SP-B and SP-C analogs, has been designed to act similarly to the natural surfactant poractant alfa.
  
  
  OBJECTIVE
  To test the resistance to meconium inactivation of CHF5633 compared to poractant alfa. Secondary outcome measurements were respiratory and inflammatory parameters.
  
  
  METHODS
  Twenty-six newborn pigs, bodyweight 1.4-2.0 kg were randomized to receive either poractant alfa or CHF5633. After anesthesia, surgery and final stabilization, meconium was instilled endotracheally followed by surfactant. Bronchial lavage fluid was obtained before intervention and every second hour. Respiratory parameters were registered and blood samples drawn before intervention and every hour.
  
  
  RESULTS
  Surfactant was inactivated in both groups 6 h after meconium instillation, but CHF5633 was more resistant than poractant alfa in terms of lipid peroxidation. Respiratory parameters were similar in both groups. Inflammatory and hemostatic parameters differed between groups, suggesting that the surfactants may play different roles in the meconium-induced inflammatory process. Due to the differential effects and complex pattern observed, the data do not indicate that one of the surfactants was superior with respect to inflammatory and hemostatic responses.
  
  
  CONCLUSIONS
  This study indicates that CHF5633 is as efficient as poractant alfa in experimental meconium aspiration syndrome.
authors.affiliation: Department of Pediatric Research, Oslo University Hospital, Rikshospitalet and University of Oslo, Oslo, Norway.
authors.forename: Bodil
authors.initials: B
authors.lastname: Salvesen
authors.forename: Tore
authors.initials: T
authors.lastname: Curstedt
authors.forename: Tom Eirik
authors.initials: TE
authors.lastname: Mollnes
authors.forename: Ola Didrik
authors.initials: OD
authors.lastname: Saugstad
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D001688:Biological Products / Q000627:therapeutic use; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000188:drug therapy; D008471:Meconium Aspiration Syndrome / Q000188:drug therapy* / Q000473:pathology; D010446:Peptide Fragments / Q000008:administration & dosage*; D010713:Phosphatidylcholines / Q000008:administration & dosage*; D010743:Phospholipids / Q000627:therapeutic use; D037701:Pulmonary Surfactant-Associated Protein B / Q000008:administration & dosage*; D037721:Pulmonary Surfactant-Associated Protein C / Q000008:administration & dosage*; D011663:Pulmonary Surfactants / Q000008:administration & dosage*; D011897:Random Allocation; D012119:Respiration / Q000187:drug effects; D013552:Swine
chemical_list: D001688:Biological Products; C000592408:CHF5633; D010446:Peptide Fragments; D010713:Phosphatidylcholines; D010743:Phospholipids; D037701:Pulmonary Surfactant-Associated Protein B; D037721:Pulmonary Surfactant-Associated Protein C; D011663:Pulmonary Surfactants; C068291:poractant alfa