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 a...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2003-11, Vol.168 (9), p.1123-1128
Main Authors: Ballard, Philip L, Merrill, Jeffrey D, Godinez, Rodolfo I, Godinez, Marye H, Truog, William E, Ballard, Roberta A
Format: Article
Language:English
Subjects:
Biological and medical sciences
Blotting, Western
Chronic obstructive pulmonary disease, asthma
Drug Combinations
Fatty Alcohols - administration & dosage
Female
Humans
Infant
Infant, Newborn
Infant, Premature - metabolism
Male
Medical sciences
Phosphorylcholine - administration & dosage
Pneumology
Polyethylene Glycols - administration & dosage
Pulmonary Surfactants - analysis
Reference Values
Respiratory Distress Syndrome, Adult - diagnosis
Trachea - chemistry
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Summary: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.
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.200304-479OC