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Abstract
Pulmonary surfactant is a critical component of lung function in healthy individuals. It functions in part by lowering surface tension in the alveoli, thereby allowing for breathing with minimal effort. The prevailing thinking is that low surface tension is attained by a compression-driven squeeze-out of unsaturated phospholipids during exhalation, forming a film enriched in saturated phospholipids that achieves surface tensions close to zero. A thorough review of past and recent literature suggests that the compression-driven squeeze-out mechanism may be erroneous. Here, we posit that a surfactant film enriched in saturated lipids is formed shortly after birth by an adsorption-driven sorting process and that its composition does not change during normal breathing. We provide biophysical evidence for the rapid formation of an enriched film at high surfactant concentrations, facilitated by adsorption structures containing hydrophobic surfactant proteins. We examine biophysical evidence for and against the compression-driven squeeze-out mechanism and propose a new model for surfactant function. The proposed model is tested against existing physiological and pathophysiological evidence in neonatal and adult lungs, leading to ideas for biophysical research, that should be addressed to establish the physiological relevance of this new perspective on the function of the mighty thin film that surfactant provides.
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Affiliation(s)
- Fred Possmayer
- Department of Biochemistry, Western University, London, Ontario N6A 3K7, Canada
- Department of Obstetrics/Gynaecology, Western University, London, Ontario N6A 3K7, Canada
| | - Yi Y Zuo
- Department of Mechanical Engineering, University of Hawaii at Manon, Honolulu, Hawaii 96822, United States
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 96826, United States
| | - Ruud A W Veldhuizen
- Department of Physiology & Pharmacology, Western University, London, Ontario N6A 5C1, Canada
- Department of Medicine, Western University, London, Ontario N6A 3K7, Canada
- Lawson Health Research Institute, London, Ontario N6A 4V2, Canada
| | - Nils O Petersen
- Department of Chemistry, University of Alberta, Edmonton, Alberta T6G 2G2, Canada
- Department of Chemistry, Western University, London, Ontario N6A 5B7, Canada
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2
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Szabová J, Mravec F, Mokhtari M, Le Borgne R, Kalina M, Berret JF. N,N,N-Trimethyl chitosan as a permeation enhancer for inhalation drug delivery: Interaction with a model pulmonary surfactant. Int J Biol Macromol 2023; 239:124235. [PMID: 37001781 DOI: 10.1016/j.ijbiomac.2023.124235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/13/2023] [Accepted: 03/26/2023] [Indexed: 04/08/2023]
Abstract
N,N,N-Trimethyl chitosan (TMC), a biocompatible and biodegradable derivative of chitosan, is currently used as a permeation enhancer to increase the translocation of drugs to the bloodstream in the lungs. This article discusses the effect of TMC on a mimetic pulmonary surfactant, Curosurf®, a low-viscosity lipid formulation administered to preterm infants with acute respiratory distress syndrome. Curosurf® exhibits a strong interaction with TMC, resulting in the formation of aggregates at electrostatic charge stoichiometry. At nanoscale, Curosurf® undergoes a profound reorganization of its lipid vesicles in terms of size and lamellarity. The initial micron-sized vesicles (average size 4.8 μm) give way to a froth-like network of unilamellar vesicles about 300 nm in size. Under such conditions, neutralization of the cationic charges by pulmonary surfactant may inhibit TMC permeation enhancer capacity, especially as electrostatic charge complexation is found at low TMC content. The permeation properties of pulmonary surfactant-neutralized TMC should then be evaluated for its applicability as a permeation enhancer for inhalation in the alveolar region.
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Affiliation(s)
- Jana Szabová
- Université Paris Cité, CNRS, Matière et Systèmes Complexes, 75013 Paris, France; Materials Research Centre, Faculty of Chemistry, Brno University of Technology, Brno, Czech Republic.
| | - Filip Mravec
- Materials Research Centre, Faculty of Chemistry, Brno University of Technology, Brno, Czech Republic
| | - Mostafa Mokhtari
- Neonatal Intensive Care Unit, Hôpitaux Universitaires Paris - Saclay, Hôpital Universitaire de Bicêtre, Espace Ethique/Île-deFrance, Hôpital Universitaire Saint-Louis - APHP, Paris, France
| | - Rémi Le Borgne
- Université de Paris, CNRS, Institute Jacques Monod, 75013 Paris, France
| | - Michal Kalina
- Materials Research Centre, Faculty of Chemistry, Brno University of Technology, Brno, Czech Republic
| | - Jean-François Berret
- Université Paris Cité, CNRS, Matière et Systèmes Complexes, 75013 Paris, France.
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3
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Abstract
The pathophysiology of acute respiratory distress syndrome (ARDS) is marked by inflammation-mediated disruptions in alveolar-capillary permeability, edema formation, reduced alveolar clearance and collapse/derecruitment, reduced compliance, increased pulmonary vascular resistance, and resulting gas exchange abnormalities due to shunting and ventilation-perfusion mismatch. Mechanical ventilation, especially in the setting of regional disease heterogeneity, can propagate ventilator-associated injury patterns including barotrauma/volutrauma and atelectrauma. Lung injury due to the novel coronavirus SARS-CoV-2 resembles other causes of ARDS, though its initial clinical characteristics may include more profound hypoxemia and loss of dyspnea perception with less radiologically-evident lung injury, a pattern not described previously in ARDS.
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Affiliation(s)
- Kai Erik Swenson
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 55 Fruit Street, BUL 148, Boston, MA 02114, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
| | - Erik Richard Swenson
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA, USA; Medical Service, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Campus Box 358280 (S-111 Pulm), Seattle, WA 98108, USA
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4
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Calkovska A, Haegerstrand-Björkman M, Curstedt T. Restoration of surfactant activity by polymyxin B in lipopolysaccharide-potentiated injury of immature rabbit lungs. Sci Rep 2021; 11:22. [PMID: 33420141 PMCID: PMC7794303 DOI: 10.1038/s41598-020-79679-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/10/2020] [Indexed: 02/03/2023] Open
Abstract
During postnatal adaptation pulmonary surfactant may be inactivated by lipopolysaccharide (LPS). We evaluated the effect of surfactant therapy in combination with antibiotic polymyxin B (PxB) in double-hit model of neonatal lung injury. Surfactant (poractant alfa, Curosurf) was exposed to smooth (S) LPS without/with PxB and tested in captive bubble surfactometer. Preterm rabbits received intratracheally saline (control) or S-LPS and were ventilated with 100% oxygen. After 30 min, LPS-treated animals received no treatment, or surfactant (200 mg/kg) without/with 3% PxB; controls received the same dose of surfactant. Animals were ventilated for further 2 h. In vitro, addition of 5% S-LPS to surfactant increased minimum surface tension (γmin) and addition of 1-3% PxB to surfactant/S-LPS mixture restored γmin to low values. Animals only given S-LPS had lower lung compliance and lung gas volume (LGV) compared to surfactant groups. Treatment with surfactant/PxB, but not with surfactant only, restored LGV. Addition of PxB to the surfactant increased the alveolar expansion. S-LPS interferes with surface activity of the pulmonary surfactant and PxB improves the resistance of surfactant to LPS-induced inactivation. In our neonatal model of respiratory distress syndrome surfactant gives positive response even in simultaneous exposure to S-LPS, when enriched with PxB.
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Affiliation(s)
- Andrea Calkovska
- Laboratory for Surfactant Research, Department of Molecular Medicine and Surgery, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden. .,Department of Physiology, Jessenius Faculty of Medicine, Comenius University, Mala Hora 4C, 036 01, Martin, Slovakia.
| | - Marie Haegerstrand-Björkman
- Laboratory for Surfactant Research, Department of Molecular Medicine and Surgery, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
| | - Tore Curstedt
- Laboratory for Surfactant Research, Department of Molecular Medicine and Surgery, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
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Michalicová P, Mravec F, Pekař M. Fluorescence study of freeze-drying as a method for support the interactions between hyaluronan and hydrophobic species. PLoS One 2017; 12:e0184558. [PMID: 28886150 PMCID: PMC5590968 DOI: 10.1371/journal.pone.0184558] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/25/2017] [Indexed: 11/18/2022] Open
Abstract
A freeze-drying method enabling solubilization of hydrophobic species in aqueous solutions of native hyaluronan is described. The method is based on opening the access to supposed hydrophobic patches on hyaluronan by disturbing its massive hydration shell. Hydrophobic and/or polarity-sensitive fluorescence probes were used as hydrophobic models or indicators of interactions with hydrophobic patches. Fluorescence parameters specific to individual probes confirmed the efficiency of the freeze-drying method. This work is the first step in developing biocompatible and biodegradable carriers for hydrophobic drugs with targeted distribution of the active compound from native, chemically non-modified hyaluronan.
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Affiliation(s)
- Petra Michalicová
- Brno University of Technology, Faculty of Chemistry, Institute of Physical and Applied Chemistry and Materials Research Centre, Brno, Czech Republic
| | - Filip Mravec
- Brno University of Technology, Faculty of Chemistry, Institute of Physical and Applied Chemistry and Materials Research Centre, Brno, Czech Republic
| | - Miloslav Pekař
- Brno University of Technology, Faculty of Chemistry, Institute of Physical and Applied Chemistry and Materials Research Centre, Brno, Czech Republic
- * E-mail:
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Echaide M, Autilio C, Arroyo R, Perez-Gil J. Restoring pulmonary surfactant membranes and films at the respiratory surface. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2017; 1859:1725-1739. [PMID: 28341439 DOI: 10.1016/j.bbamem.2017.03.015] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 03/14/2017] [Accepted: 03/19/2017] [Indexed: 02/08/2023]
Abstract
Pulmonary surfactant is a complex of lipids and proteins assembled and secreted by the alveolar epithelium into the thin layer of fluid coating the respiratory surface of lungs. There, surfactant forms interfacial films at the air-water interface, reducing dramatically surface tension and thus stabilizing the air-exposed interface to prevent alveolar collapse along respiratory mechanics. The absence or deficiency of surfactant produces severe lung pathologies. This review describes some of the most important surfactant-related pathologies, which are a cause of high morbidity and mortality in neonates and adults. The review also updates current therapeutic approaches pursuing restoration of surfactant operative films in diseased lungs, mainly through supplementation with exogenous clinical surfactant preparations. This article is part of a Special Issue entitled: Membrane Lipid Therapy: Drugs Targeting Biomembranes edited by Pablo V. Escribá.
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Affiliation(s)
- Mercedes Echaide
- Dept. Biochemistry, Faculty of Biology, and Research Institute "Hospital 12 de Octubre", Complutense University, Madrid, Spain
| | - Chiara Autilio
- Dept. Biochemistry, Faculty of Biology, and Research Institute "Hospital 12 de Octubre", Complutense University, Madrid, Spain
| | - Raquel Arroyo
- Dept. Biochemistry, Faculty of Biology, and Research Institute "Hospital 12 de Octubre", Complutense University, Madrid, Spain
| | - Jesus Perez-Gil
- Dept. Biochemistry, Faculty of Biology, and Research Institute "Hospital 12 de Octubre", Complutense University, Madrid, Spain.
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The Rise and Fall of Hyaluronan in Respiratory Diseases. Int J Cell Biol 2015; 2015:712507. [PMID: 26448757 PMCID: PMC4581576 DOI: 10.1155/2015/712507] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 02/11/2015] [Accepted: 05/03/2015] [Indexed: 12/24/2022] Open
Abstract
In normal airways, hyaluronan (HA) matrices are primarily located within the airway submucosa, pulmonary vasculature walls, and, to a lesser extent, the alveoli. Following pulmonary injury, elevated levels of HA matrices accumulate in these regions, and in respiratory secretions, correlating with the extent of injury. Animal models have provided important insight into the role of HA in the onset of pulmonary injury and repair, generally indicating that the induction of HA synthesis is an early event typically preceding fibrosis. The HA that accumulates in inflamed airways is of a high molecular weight (>1600 kDa) but can be broken down into smaller fragments (<150 kDa) by inflammatory and disease-related mechanisms that have profound effects on HA pathobiology. During inflammation in the airways, HA is often covalently modified with heavy chains from inter-alpha-inhibitor via the enzyme tumor-necrosis-factor-stimulated-gene-6 (TSG-6) and this modification promotes the interaction of leukocytes with HA matrices at sites of inflammation. The clearance of HA and its return to normal levels is essential for the proper resolution of inflammation. These data portray HA matrices as an important component of normal airway physiology and illustrate its integral roles during tissue injury and repair among a variety of respiratory diseases.
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Bodega F, Sironi C, Porta C, Zocchi L, Agostoni E. Pleural mesothelium lubrication after phospholipase treatment. Respir Physiol Neurobiol 2014; 194:49-53. [PMID: 24486606 DOI: 10.1016/j.resp.2014.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 01/16/2014] [Accepted: 01/17/2014] [Indexed: 11/28/2022]
Abstract
Coefficient of kinetic friction (μ) of rabbit pleural mesothelium increased after short treatment of specimens with phospholipase C. This increase was removed by addition of a solution with hyaluronan or sialomucin, as previously shown in post-blotting Ringer or after short pronase treatment. After phospholipase μ decreased with increase in sliding velocity, but at highest velocity it was still greater than control; this difference was removed by addition of hyaluronan or sialomucin, as in post-blotting Ringer or after short pronase treatment. Hyaluronan placed on specimen before phospholipase treatment reduced increase in μ by protecting phospholipids from enzyme, as shown by others for alveolar and synovial phospholipids. Samples of parietal pleura stained with silver nitrate showed that mesothelial cells were not disrupted by short phospholipase treatment. Instead, they were disrupted if this treatment was preceded by a short pronase treatment; but even after this disruption addition of hyaluronan or sialomucin brought μ back to control.
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Affiliation(s)
- Francesca Bodega
- Dipartimento di Fisiopatologia e dei Trapianti, Sezione di Fisiologia Umana, Università degli Studi di Milano, Milan, Italy
| | - Chiara Sironi
- Dipartimento di Fisiopatologia e dei Trapianti, Sezione di Fisiologia Umana, Università degli Studi di Milano, Milan, Italy
| | - Cristina Porta
- Dipartimento di Fisiopatologia e dei Trapianti, Sezione di Fisiologia Umana, Università degli Studi di Milano, Milan, Italy
| | - Luciano Zocchi
- Dipartimento di Fisiopatologia e dei Trapianti, Sezione di Fisiologia Umana, Università degli Studi di Milano, Milan, Italy
| | - Emilio Agostoni
- Dipartimento di Fisiopatologia e dei Trapianti, Sezione di Fisiologia Umana, Università degli Studi di Milano, Milan, Italy.
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