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Mikolka P, Kronqvist N, Haegerstrand-Björkman M, Jaudzems K, Kosutova P, Kolomaznik M, Saluri M, Landreh M, Calkovska A, Curstedt T, Johansson J. Synthetic surfactant with a combined SP-B and SP-C analogue is efficient in rabbit models of adult and neonatal respiratory distress syndrome. Transl Res 2023; 262:60-74. [PMID: 37499744 DOI: 10.1016/j.trsl.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/13/2023] [Accepted: 07/24/2023] [Indexed: 07/29/2023]
Abstract
Respiratory distress syndrome (RDS) in premature infants is caused by insufficient amounts of endogenous lung surfactant and is efficiently treated with replacement therapy using animal-derived surfactant preparations. On the other hand, adult/acute RDS (ARDS) occurs secondary to for example, sepsis, aspiration of gastric contents, and multitrauma and is caused by alveolar endothelial damage, leakage of plasma components into the airspaces and inhibition of surfactant activity. Instillation of surfactant preparations in ARDS has so far resulted in very limited treatment effects, partly due to inactivation of the delivered surfactants in the airspace. Here, we develop a combined surfactant protein B (SP-B) and SP-C peptide analogue (Combo) that can be efficiently expressed and purified from Escherichia coli without any solubility or purification tag. NMR spectroscopy shows that Combo peptide forms α-helices both in organic solvents and in lipid micelles, which coincide with the helical regions described for the isolated SP-B and SP-C parts. Artificial Combo surfactant composed of synthetic dipalmitoylphosphatidylcholine:palmitoyloleoylphosphatidylglycerol, 1:1, mixed with 3 weights % relative to total phospholipids of Combo peptide efficiently improves tidal volumes and lung gas volumes at end-expiration in a premature rabbit fetus model of RDS. Combo surfactant also improves oxygenation and respiratory parameters and lowers cytokine release in an acid instillation-induced ARDS adult rabbit model. Combo surfactant is markedly more resistant to inhibition by albumin and fibrinogen than a natural-derived surfactant in clinical use for the treatment of RDS. These features of Combo surfactant make it attractive for the development of novel therapies against human ARDS.
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Affiliation(s)
- Pavol Mikolka
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia; Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Nina Kronqvist
- Department of Biosciences and Nutrition, Karolinska Institutet, Neo, Huddinge, Sweden
| | - Marie Haegerstrand-Björkman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Kristaps Jaudzems
- Department of Physical Organic Chemistry, Latvian Institute of Organic Synthesis, Riga, Latvia; Faculty of Chemistry, University of Latvia, Riga, Latvia
| | - Petra Kosutova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Maros Kolomaznik
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Mihkel Saluri
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Michael Landreh
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Andrea Calkovska
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Tore Curstedt
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Jan Johansson
- Department of Biosciences and Nutrition, Karolinska Institutet, Neo, Huddinge, Sweden.
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Pye ES, Wallace SE, Marangoni DG, Foo ACY. Albumin Proteins as Delivery Vehicles for PFAS Contaminants into Respiratory Membranes. ACS OMEGA 2023; 8:44036-44043. [PMID: 38027323 PMCID: PMC10666230 DOI: 10.1021/acsomega.3c06239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023]
Abstract
Poly- and perfluoroalkyl substances (PFAS) are a family of chemicals that have been used in a wide range of commercial products. While their use is declining, the prevalence of PFAS, combined with their chemical longevity, ensures that detectable levels will remain in the environment for years to come. As such, there is a pressing need to understand how PFAS contaminants interact with other elements of the human exposome and the consequences of these interactions for human health. Using serum albumin as a model system, we show that proteins can bind PFAS contaminants and facilitate their incorporation into model pulmonary surfactant systems and lipid bilayers. Protein-mediated PFAS delivery significantly altered the structure and function of both model membrane systems, potentially contributing to respiratory dysfunction and airway diseases in vivo. These results provide valuable insights into the synergistic interaction between PFAS contaminants and other elements of the human exposome and their potential consequences for human health.
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Affiliation(s)
- Evan S. Pye
- Dept. of Chemistry, St. Francis Xavier University, 2321 Notre Dame Avenue, Antigonish B2G 2W5, Nova Scotia, Canada
| | - Shannon E. Wallace
- Dept. of Chemistry, St. Francis Xavier University, 2321 Notre Dame Avenue, Antigonish B2G 2W5, Nova Scotia, Canada
| | - D. Gerrard Marangoni
- Dept. of Chemistry, St. Francis Xavier University, 2321 Notre Dame Avenue, Antigonish B2G 2W5, Nova Scotia, Canada
| | - Alexander C. Y. Foo
- Dept. of Chemistry, St. Francis Xavier University, 2321 Notre Dame Avenue, Antigonish B2G 2W5, Nova Scotia, Canada
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Addis DR, Lambert JA, Ren C, Doran S, Aggarwal S, Jilling T, Matalon S. Vascular Endothelial Growth Factor-121 Administration Mitigates Halogen Inhalation-Induced Pulmonary Injury and Fetal Growth Restriction in Pregnant Mice. J Am Heart Assoc 2020; 9:e013238. [PMID: 32009528 PMCID: PMC7033856 DOI: 10.1161/jaha.119.013238] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 01/07/2020] [Indexed: 12/16/2022]
Abstract
Background Circulating levels of sFLT-1 (soluble fms-like tyrosine kinase 1), the extracellular domain of vascular endothelial growth factor (VEGF) receptor 1, and its ratio to levels of placental growth factor are markers of the occurrence and severity of preeclampsia. Methods and Results C57BL/6 pregnant mice on embryonic day 14.5 (E14.5), male, and non-pregnant female mice were exposed to air or to Br2 at 600 ppm for 30 minutes and were treated with vehicle or with VEGF-121 (100 μg/kg, subcutaneously) daily, starting 48 hours post-exposure. Plasma, bronchoalveolar lavage fluid, lungs, fetuses, and placentas were collected 120 hours post-exposure. In Br2-exposed pregnant mice, there was a time-dependent and significant increase in plasma levels of sFLT-1 which correlated with increases in mouse lung wet/dry weights and bronchoalveolar lavage fluid protein content. Supplementation of exogenous VEGF-121 improved survival and weight gain, reduced lung wet/dry weights, decreased bronchoalveolar lavage fluid protein levels, enhanced placental development, and improved fetal growth in pregnant mice exposed to Br2. Exogenous VEGF-121 administration had no effect in non-pregnant mice. Conclusions These results implicate inhibition of VEGF signaling driven by sFLT-1 overexpression as a mechanism of pregnancy-specific injury leading to lung edema, maternal mortality, and fetal growth restriction after bromine gas exposure.
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Affiliation(s)
- Dylan R. Addis
- Division of Cardiothoracic AnesthesiologyDepartment of Anesthesiology and Perioperative MedicineUniversity of Alabama at BirminghamBirminghamALUSA
- Division of Molecular and Translational BiomedicineDepartment of Anesthesiology and Perioperative MedicineUniversity of Alabama at BirminghamBirminghamALUSA
- UAB Comprehensive Cardiovascular CenterUniversity of Alabama at BirminghamBirminghamALUSA
- University of Alabama School of MedicineBirminghamALUSA
| | - James A. Lambert
- Division of Molecular and Translational BiomedicineDepartment of Anesthesiology and Perioperative MedicineUniversity of Alabama at BirminghamBirminghamALUSA
- Graduate Biomedical SciencesBiochemistry, Structural and Stem Cell Biology ThemeUniversity of Alabama at BirminghamBirminghamALUSA
- University of Alabama School of MedicineBirminghamALUSA
| | - Changchun Ren
- Department of PediatricsDivision of NeonatologyUniversity of Alabama at BirminghamBirminghamALUSA
- University of Alabama School of MedicineBirminghamALUSA
| | - Stephen Doran
- Division of Molecular and Translational BiomedicineDepartment of Anesthesiology and Perioperative MedicineUniversity of Alabama at BirminghamBirminghamALUSA
- University of Alabama School of MedicineBirminghamALUSA
| | - Saurabh Aggarwal
- Division of Molecular and Translational BiomedicineDepartment of Anesthesiology and Perioperative MedicineUniversity of Alabama at BirminghamBirminghamALUSA
- University of Alabama School of MedicineBirminghamALUSA
| | - Tamas Jilling
- Department of PediatricsDivision of NeonatologyUniversity of Alabama at BirminghamBirminghamALUSA
- University of Alabama School of MedicineBirminghamALUSA
| | - Sadis Matalon
- Division of Molecular and Translational BiomedicineDepartment of Anesthesiology and Perioperative MedicineUniversity of Alabama at BirminghamBirminghamALUSA
- UAB Comprehensive Cardiovascular CenterUniversity of Alabama at BirminghamBirminghamALUSA
- University of Alabama School of MedicineBirminghamALUSA
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Vaickus M, Hsieh T, Kintsurashvili E, Kim J, Kirsch D, Kasotakis G, Remick DG. Mild Traumatic Brain Injury in Mice Beneficially Alters Lung NK1R and Structural Protein Expression to Enhance Survival after Pseudomonas aeruginosa Infection. THE AMERICAN JOURNAL OF PATHOLOGY 2018; 189:295-307. [PMID: 30472211 DOI: 10.1016/j.ajpath.2018.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/04/2018] [Accepted: 10/23/2018] [Indexed: 12/11/2022]
Abstract
Mild traumatic brain injury (mTBI) in a murine model increases survival to a bacterial pulmonary challenge compared with blunt tail trauma (TT). We hypothesize substance P and its receptor, the neurokinin 1 receptor (NK1R; official name TACR1), play a role in the increased survival of mTBI mice. Mice were subjected to mTBI or TT, and 48 hours after trauma, the levels of NK1R mRNA and protein were significantly up-regulated in mTBI lungs. Examination of the lung 48 hours after injury by microarray showed significant differences in the expression of 433 gene sets between groups, most notably genes related to intercellular proteins. Despite down-regulated gene expression of connective proteins, the presence of an intact pulmonary vasculature was supported by normal histology and bronchoalveolar lavage protein levels. To determine whether these mTBI-induced lung changes benefited in vivo responses, two chemotactic stimuli (a CXCL1 chemokine and a live Pseudomonas aeruginosa infection) were administered 48 hours after trauma. For both stimuli, mTBI mice recruited more neutrophils to the lung 4 hours after instillation (CXCL1: mTBI = 6.3 ± 1.3 versus TT = 3.3 ± 0.7 neutrophils/mL; Pseudomonas aeruginosa: mTBI = 9.4 ± 1.4 versus TT = 5.3 ± 1.1 neutrophils/mL). This study demonstrates that the downstream consequences of mTBI on lung NK1R levels and connective protein expression enhance neutrophil recruitment to a stimulus that may contribute to increased survival.
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Affiliation(s)
- Max Vaickus
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Terry Hsieh
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Ekaterina Kintsurashvili
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Jiyoun Kim
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Daniel Kirsch
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - George Kasotakis
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Daniel G Remick
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts.
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Hasan D, Satalin J, van der Zee P, Kollisch-Singule M, Blankman P, Shono A, Somhorst P, den Uil C, Meeder H, Kotani T, Nieman GF. Excessive Extracellular ATP Desensitizes P2Y2 and P2X4 ATP Receptors Provoking Surfactant Impairment Ending in Ventilation-Induced Lung Injury. Int J Mol Sci 2018; 19:ijms19041185. [PMID: 29652806 PMCID: PMC5979391 DOI: 10.3390/ijms19041185] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 04/08/2018] [Accepted: 04/10/2018] [Indexed: 12/16/2022] Open
Abstract
Stretching the alveolar epithelial type I (AT I) cells controls the intercellular signaling for the exocytosis of surfactant by the AT II cells through the extracellular release of adenosine triphosphate (ATP) (purinergic signaling). Extracellular ATP is cleared by extracellular ATPases, maintaining its homeostasis and enabling the lung to adapt the exocytosis of surfactant to the demand. Vigorous deformation of the AT I cells by high mechanical power ventilation causes a massive release of extracellular ATP beyond the clearance capacity of the extracellular ATPases. When extracellular ATP reaches levels >100 μM, the ATP receptors of the AT II cells become desensitized and surfactant impairment is initiated. The resulting alteration in viscoelastic properties and in alveolar opening and collapse time-constants leads to alveolar collapse and the redistribution of inspired air from the alveoli to the alveolar ducts, which become pathologically dilated. The collapsed alveoli connected to these dilated alveolar ducts are subject to a massive strain, exacerbating the ATP release. After reaching concentrations >300 μM extracellular ATP acts as a danger-associated molecular pattern, causing capillary leakage, alveolar space edema, and further deactivation of surfactant by serum proteins. Decreasing the tidal volume to 6 mL/kg or less at this stage cannot prevent further lung injury.
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Affiliation(s)
- Djo Hasan
- Mobile Intensive Care Unit Zuid-West Nederland, 3062 NW Rotterdam, The Netherlands.
- Department of Surgery, Erasmus MC, Erasmus Universiteit Rotterdam, 3015 CE Rotterdam, The Netherlands.
| | - Joshua Satalin
- Department of Surgery, Upstate Medical University, Syracuse, NY 13210, USA.
| | - Philip van der Zee
- Adult Intensive Care Unit, Erasmus MC, Erasmus Universiteit Rotterdam, 3015 CE Rotterdam, The Netherlands.
| | | | - Paul Blankman
- Department of Anesthesiology, Universitair Medisch Centrum Utrecht, 3584 CX Utrecht, The Netherlands.
| | - Atsuko Shono
- Department of Anesthesiology, Shimane University, Izumo, Shimane Prefecture 693-0021, Japan.
| | - Peter Somhorst
- Adult Intensive Care Unit, Erasmus MC, Erasmus Universiteit Rotterdam, 3015 CE Rotterdam, The Netherlands.
| | - Corstiaan den Uil
- Adult Intensive Care Unit, Erasmus MC, Erasmus Universiteit Rotterdam, 3015 CE Rotterdam, The Netherlands.
- Department of Cardiology, Erasmus MC, Erasmus Universiteit Rotterdam, 3062 PA Rotterdam, The Netherlands.
| | - Han Meeder
- Mobile Intensive Care Unit Zuid-West Nederland, 3062 NW Rotterdam, The Netherlands.
- Adult Intensive Care Unit, Erasmus MC, Erasmus Universiteit Rotterdam, 3015 CE Rotterdam, The Netherlands.
| | - Toru Kotani
- Department of Anesthesiology and Critical Care Medicine, Showa University, School of Medicine, Tokyo 142-8666, Japan.
| | - Gary F Nieman
- Department of Surgery, Upstate Medical University, Syracuse, NY 13210, USA.
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6
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Hasan D, Blankman P, Nieman GF. Purinergic signalling links mechanical breath profile and alveolar mechanics with the pro-inflammatory innate immune response causing ventilation-induced lung injury. Purinergic Signal 2017; 13:363-386. [PMID: 28547381 PMCID: PMC5563293 DOI: 10.1007/s11302-017-9564-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 04/26/2017] [Indexed: 02/06/2023] Open
Abstract
Severe pulmonary infection or vigorous cyclic deformation of the alveolar epithelial type I (AT I) cells by mechanical ventilation leads to massive extracellular ATP release. High levels of extracellular ATP saturate the ATP hydrolysis enzymes CD39 and CD73 resulting in persistent high ATP levels despite the conversion to adenosine. Above a certain level, extracellular ATP molecules act as danger-associated molecular patterns (DAMPs) and activate the pro-inflammatory response of the innate immunity through purinergic receptors on the surface of the immune cells. This results in lung tissue inflammation, capillary leakage, interstitial and alveolar oedema and lung injury reducing the production of surfactant by the damaged AT II cells and deactivating the surfactant function by the concomitant extravasated serum proteins through capillary leakage followed by a substantial increase in alveolar surface tension and alveolar collapse. The resulting inhomogeneous ventilation of the lungs is an important mechanism in the development of ventilation-induced lung injury. The high levels of extracellular ATP and the upregulation of ecto-enzymes and soluble enzymes that hydrolyse ATP to adenosine (CD39 and CD73) increase the extracellular adenosine levels that inhibit the innate and adaptive immune responses rendering the host susceptible to infection by invading microorganisms. Moreover, high levels of extracellular adenosine increase the expression, the production and the activation of pro-fibrotic proteins (such as TGF-β, α-SMA, etc.) followed by the establishment of lung fibrosis.
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Affiliation(s)
- Djo Hasan
- Department of Adult ICU, University Hospital Erasmus MC Rotterdam, 's-Gravendijkwal 230 3015 CE, Rotterdam, the Netherlands.
| | - Paul Blankman
- Department of Adult ICU, University Hospital Erasmus MC Rotterdam, 's-Gravendijkwal 230 3015 CE, Rotterdam, the Netherlands
| | - Gary F Nieman
- Department of Surgery, Upstate Medical University, 750 E Adams St, Syracuse, NY, 13210, USA
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Cimato A, Hoyos Obando A, Facorro G, Martínez Sarrasague M. Analysis of the structure and surfactant activity of novel formulations containing exogenous pulmonary surfactant and glucocorticoids. Respir Physiol Neurobiol 2016; 233:33-40. [DOI: 10.1016/j.resp.2016.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 07/22/2016] [Accepted: 07/27/2016] [Indexed: 01/03/2023]
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8
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Aiyelabegan HT, Zaidi SSZ, Fanuel S, Eatemadi A, Ebadi MTK, Sadroddiny E. Albumin-based biomaterial for lung tissue engineering applications. INT J POLYM MATER PO 2016. [DOI: 10.1080/00914037.2016.1180610] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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9
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Krafft MP. Overcoming inactivation of the lung surfactant by serum proteins: a potential role for fluorocarbons? SOFT MATTER 2015; 11:5982-5994. [PMID: 26110877 DOI: 10.1039/c5sm00926j] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In many pulmonary conditions serum proteins interfere with the normal adsorption of components of the lung surfactant to the surface of the alveoli, resulting in lung surfactant inactivation, with potentially serious untoward consequences. Here, we review the strategies that have recently been designed in order to counteract the biophysical mechanisms of inactivation of the surfactant. One approach includes protein analogues or peptides that mimic the native proteins responsible for innate resistance to inactivation. Another perspective uses water-soluble additives, such as electrolytes and hydrophilic polymers that are prone to enhance adsorption of phospholipids. An alternative, more recent approach consists of using fluorocarbons, that is, highly hydrophobic inert compounds that were investigated for partial liquid ventilation, that modify interfacial properties and can act as carriers of exogenous lung surfactant. The latter approach that allows fluidisation of phospholipid monolayers while maintaining capacity to reach near-zero surface tension definitely warrants further investigation.
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Affiliation(s)
- Marie Pierre Krafft
- Institut Charles Sadron (CNRS), University of Strasbourg, 23 rue du Loess, 67034 Strasbourg Cedex, France.
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10
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Martínez Sarrasague M, Cimato A, Piehl L, Brites F, Facorro G. Effect of serum lipoproteins and cholesterol on an exogenous pulmonary surfactant. ESR analysis of structural changes and their relation with surfactant activity. Respir Physiol Neurobiol 2013; 189:581-7. [PMID: 23994827 DOI: 10.1016/j.resp.2013.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Revised: 08/02/2013] [Accepted: 08/14/2013] [Indexed: 12/15/2022]
Abstract
The study of structural changes in the surfactant may help to understand the mechanisms by which the surfactant is inactivated by serum. Here, we compared the in vitro effects of serum, albumin, lipoproteins (VLDL, LDL, HDL) and cholesterol on the dynamic and structural properties of surfactant suspensions by electronic spin resonance and surface tension measurements. Our results showed that albumin seems to be responsible for macrostructure disaggregation and increased rigidity in the hydrophobic region, but it did not affect surfactant activity. Fluidity in the polar area seems to be critical for proper physiological activity, and the changes induced by serum observed in this area would be generated by HDL or cholesterol, but the amount of cholesterol transferred by serum is not significant. Statistical analysis showed that surfactant activity correlated with the fluidity in the polar area but not with that in the hydrophobic region. We obtained strong evidence that among all the serum components tested, HDL is the one that causes the structural changes that compromise surfactant performance.
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Affiliation(s)
- María Martínez Sarrasague
- Cátedra de Física, Departamento de Fisicomatemática, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina.
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11
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Seehase M, Collins JJP, Kuypers E, Jellema RK, Ophelders DRMG, Ospina OL, Perez-Gil J, Bianco F, Garzia R, Razzetti R, Kramer BW. New surfactant with SP-B and C analogs gives survival benefit after inactivation in preterm lambs. PLoS One 2012; 7:e47631. [PMID: 23091635 PMCID: PMC3473048 DOI: 10.1371/journal.pone.0047631] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 09/13/2012] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Respiratory distress syndrome in preterm babies is caused by a pulmonary surfactant deficiency, but also by its inactivation due to various conditions, including plasma protein leakage. Surfactant replacement therapy is well established, but clinical observations and in vitro experiments suggested that its efficacy may be impaired by inactivation. A new synthetic surfactant (CHF 5633), containing synthetic surfactant protein B and C analogs, has shown comparable effects on oxygenation in ventilated preterm rabbits versus Poractant alfa, but superior resistance against inactivation in vitro. We hypothesized that CHF 5633 is also resistant to inactivation by serum albumin in vivo. METHODOLOGY/PRINCIPAL FINDINGS Nineteen preterm lambs of 127 days gestational age (term = 150 days) received CHF 5633 or Poractant alfa and were ventilated for 48 hours. Ninety minutes after birth, the animals received albumin with CHF 5633 or Poractant alfa. Animals received additional surfactant if P(a)O(2) dropped below 100 mmHg. A pressure volume curve was done post mortem and markers of pulmonary inflammation, surfactant content and biophysiology, and lung histology were assessed. CHF 5633 treatment resulted in improved arterial pH, oxygenation and ventilation efficiency index. The survival rate was significantly higher after CHF 5633 treatment (5/7) than after Poractant alfa (1/8) after 48 hours of ventilation. Biophysical examination of the surfactant recovered from bronchoalveolar lavages revealed that films formed by CHF 5633-treated animals reached low surface tensions in a wider range of compression rates than films from Poractant alfa-treated animals. CONCLUSIONS For the first time a synthetic surfactant containing both surfactant protein B and C analogs showed significant benefit over animal derived surfactant in an in vivo model of surfactant inactivation in premature lambs.
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Affiliation(s)
- Matthias Seehase
- Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jennifer J. P. Collins
- Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Elke Kuypers
- Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Reint K. Jellema
- Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Olga L. Ospina
- Department of Biochemistry, Faculty of Biology, Complutense University, Madrid, Spain
- Department of Physics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - J. Perez-Gil
- Department of Biochemistry, Faculty of Biology, Complutense University, Madrid, Spain
| | - Federico Bianco
- Research and Development Department, Chiesi Farmaceutici SpA, Parma, Italy
| | - Raffaella Garzia
- Research and Development Department, Chiesi Farmaceutici SpA, Parma, Italy
| | - Roberta Razzetti
- Research and Development Department, Chiesi Farmaceutici SpA, Parma, Italy
| | - Boris W. Kramer
- Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands
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12
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Effect of serum proteins on an exogenous pulmonary surfactant: ESR analysis of structural changes and their relation with surfactant activity. Respir Physiol Neurobiol 2012; 183:48-57. [DOI: 10.1016/j.resp.2012.05.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 05/08/2012] [Accepted: 05/28/2012] [Indexed: 11/20/2022]
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13
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Damas JE, Cake MH. An albumin-associated PLA2-like activity inactivates surfactant phosphatidylcholine secreted from fetal type II pneumocytes. Am J Physiol Lung Cell Mol Physiol 2011; 301:L966-74. [PMID: 21908590 DOI: 10.1152/ajplung.00103.2011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Type II pneumocytes are responsible for the synthesis and secretion of pulmonary surfactant, which reduces surface tension in lung alveoli, thus decreasing their tendency to collapse during expiration. For this effect to be sustained, the integrity of the surface-active components of surfactant must be maintained. This study has shown that, when cultured type II pneumocytes are exposed to lipoprotein-free serum (LFS), the level of lyso-phosphatidylcholine (lyso-PC) in the secreted surfactant phospholipids is markedly elevated with a concomitant decline in the level of phosphatidylcholine (PC). This effect is the result of hydrolysis of surfactant PC by a phospholipase A(2) (PLA(2))-like activity present within serum. Anion-exchange chromatography, gel filtration chromatography and preparative electrophoresis of human LFS have shown that this PLA(2)-like activity coelutes with albumin and is biochemically distinct from the secretory form of PLA(2). Furthermore, specific inhibitors of PLA(2) such as p-bromophenacyl bromide, aristolochic acid, and palmitoyl trifluoromethyl ketone do not inhibit this activity of serum. Commercially purified human serum albumin fraction V and recombinant human serum albumin (rHSA) are almost as effective as LFS in enhancing the level of lyso-PC in the media. The latter finding implies that rHSA directly generates lyso-PC from secreted PC and suggests that this PLA(2)-like activity may be an intrinsic attribute of albumin.
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Affiliation(s)
- Jolanta E Damas
- School of Biological Sciences and Biotechnology, Murdoch University, Western Australia, Australia
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