Intratracheal Administration Of Glucocorticoids Using Surfactant As A Vehicle

Abstract

SUMMARY 1. Glucocorticoids are an effective treatment in the amelioration of chronic lung disease in neonates. However, systemic administration of glucocorticoids to neonates is associated with significant side‐effects that preclude them as an early intervention to prevent onset of the condition. Conversely, local intratracheal administration of glucocorticoids may prevent inflammatory insult to the lungs without the development of systemic side‐effects. We therefore investigated whether local intratracheal delivery of corticosteroids could be facilitated using surfactant as a vehicle. 2. Addition of dexamethasone to either diluted or commercial artificial surfactant, Survanta (Abbott Industries, Sydney, NSW, Australia), did not alter the surface properties of the surfactant. 3. After intratracheal instillation to rats, radiolabelled dexamethasone in Survanta was well distributed throughout all four lobes of the lungs. A concentration gradient of the steroid was observed between the root and the peripheral sections of all lobes. 4. Our results suggest that surfactant is an effective vehicle for intratracheal delivery of glucocorticoids. Moreover, we propose that prophylactic intratracheal administration of glucocorticoids administered shortly after birth may prevent inflammatory insult to the lungs and thereby reduce the likelihood of chronic lung disease developing.

Effect of Surfactant and Budesonide on the Pulmonary Distribution of Fluorescent Dye in Mice

“…17,18 However, the results were not constant, and temporal and spatial information could not be attained. Fajardo et al 17 found that both surfactant and saline solution provided an efficient delivery of radiolabeled budesonide to the lungs of rabbits, with the solutions being equally effective.…”

Dexamethasone and outcome of meconium aspiration syndrome: Vijayapur, Karnataka experience

“…Addition of other drugs like surfactant to steroids has been tried and has shown better results 15,18 . The property of surfactant remained the same but still the advantage of steroids could be noticed.…”

Natural Surfactant Combined with Beclomethasone Decreases Lung Inflammation in the Preterm Lamb

“…Nonetheless, since administration of aerosolized corticosteroids to the preterm infant has limited effectiveness in preventing BPD and requires a delivery system which cannot guarantee selective delivery of inhaled steroids to the alveoli [38], their direct intratracheal administration using surfactant as a vehicle may be a suitable way to deliver topical steroids and thus avoid their side effects on cardiovascular function, glycemia, the immune system, and neurodevelopment, while maintaining their favorable effect on lung tissues. On the other hand, Nimmo et al [39] have previously demonstrated that natural surfactant is an effective vehicle for pulmonary delivery of corticosteroids. The possible absorption of beclomethasone administered through the intratracheal route has not been investigated so far, but data from studies on its intranasal use suggest that the propionate ester of this agent (which was used in our study) is highly lipophilic, and this favors its mucosal absorption and uptake across phospholipid cell membranes with negligible systemic absorption [40].…”