Surfactant and pulmonary blood flow distributions following treatment of premature lambs with natural surfactant.

Jobe, Alan H.; Ikegami, Machiko; Jacobs, Harris C.; Jones, S.

doi:10.1172/jci111280

Cited by 123 publications

(46 citation statements)

References 26 publications

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“…The subgross anatomy of the respiratory tract of sheep compares quite favorably to that of man (17,18). Several studies have utilized the premature lamb for studying the neonatal respiratory distress syndrome (9,(19)(20)(21) and recent work in our laboratory has demonstrated the feasibility of obtaining regional ventilation and perfusion measurements in this mode1 (22). Bronchoalveolar lavage is a routine procedure in the anesthetized lamb and cam be repeated at appropriate intervals without any apparent long-term effects.…”

Section: Discussionmentioning

confidence: 99%

“…We used neonatal sheep in these investigations for the following reasons: a. there exists an extensive body of knowledge about ovine fetal and neonatal immunocompetence (8); b. the surfactant deficient lamb is a good model of neonatal respiratory distress syndrome (9); c. the size of neonatal lambs allows for sequential sampling of relevant cellular and humoral components; and d. the feasibility of isolator maintenance of lambs permit studies on the effects of controlled environments on pulmonary host defense functions.…”

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confidence: 99%

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Postnatal Maturation of Pulmonary Antimicrobial Defense Mechanisms in Conventional and Germ- Free Lambs

1986

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ABSTRACT. The phagocytic and bactericidal capacities of ovine bronchoalveolar lavage (BAL) cells were investigated as a function of postnatal age. In addition, age-related changes in the elaboration by alveolar macrophages of chemotaxins for neutrophils, concentrations of BAL fluid and serum immunoglobulins, and serum opsonic capacity were determined. BAL cells exhibited major changes in morphology, composition, and in vitro proliferation during the 1st postnatal wk. Studies in germ-free lambs indicated that the antigenic burden of the ambient environment markedly influenced the concentration of BAL neutrophils but had no effect on the influx, phagocytic, and proliferative activities of alveolar macrophages. Phagocytic and bactericidal functions of BAL cells improved rapidly during the 1st postnatal wk, then declined, and did not reattain adult levels until day 180. The capacity of alveolar macrophages to elaborate chemotaxins for neutrophils was deficient at day 8, but not at subsequent ages. The concentration of BAL IgG, increased until day 8, fell at day 21, and then continued to increase gradually. IgA was not detected in BAL until day 21 and increased rapidly thereafter. Serum opsonic capacity at days 1 and 4 was comparable to that of adult serum, but sera from days 8 to 42 showed a marked reduction in opsonic capacity. Pulmonary antimicrobial defenses in neonatal sheep were thus found to be deficient to some degree throughout the first 3 months of life. It was not until day 180 that the parameters investigated in this study approximated those of adult sheep.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Postnatal Maturation of Pulmonary Antimicrobial Defense Mechanisms in Conventional and Germ- Free Lambs

1986

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“…25 Surfactant may distribute more homogeneously when given immediately at birth into lungs still filled with fluid, leading to improvement in response and decreasing the risk of lung injury. 26 There are few Indian studies on the use of surfactant in newborns. [27][28][29] These studies included babies given prophylactic surfactant as well as those given rescue surfactant.…”

Section: Discussionmentioning

confidence: 99%

Role of prophylactic surfactant in preterm infants

Singh¹,

Rana²,

Mathai

2011

Medical Journal Armed Forces India

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INTRODUCTIONRespiratory distress syndrome (RDS) in preterm neonates is caused by a deficiency or dysfunction of pulmonary surfactant. Surfactant lines the alveolar surface and prevents atelectasis at end expiration. Pulmonary surfactant is predominantly dipalmitoylphosphatidylcholine with lesser amounts of other phospholipids including phosphatidylglycerol, phosphatidylethanolamine, and phosphatidylinositol. Pulmonary surfactant also contains neutral lipids and distinct surfactant proteins. The physiologic function of surfactant includes the ability to lower surface tension, as well as the ability to rapidly adsorb and spread, associated with the respiratory cycle. The first attempts to utilise synthetic surfactants occurred in the 1960s. The first successful animal model of surfactant replacement therapy was conducted by Enhorning and coworkers in 1972. Enhorning administered a crude natural surfactant extract obtained from lavage of the lungs of mature rabbits 1 directly into the trachea of immature rabbits. Improvement in lung compliance and alveolar expansion was noted. Success in animal models led to widespread clinical trials of surfactant therapy in the human newborns. A systematic review of the seven randomised controlled trials that compare the prophylactic administration of synthetic surfactant to control treatment in preterm infants at risk of developing RDS suggests that prophylactic administration of synthetic surfactant leads to a significant decrease in the risk of pneumothorax, pulmonary interstitial emphysema, and neonatal mortality.2-4 So far, no trials of prophylactic surfactant in preterm neonates were carried out in our country because of the prohibitive cost of the imported drug. During the last decade, preparations of exogenous surfactant have been marketed in our country. This has made it possible to evaluate the prophylactic role of surfactant in preventing respiratory distress syndrome and its associated morbidities in preterm neonates. The present study was designed to find out whether prophylactic administration of surfactant leads to a significant decrease in the risk of neonatal mortality and neonatal morbidity. MATERIALS AND METHODSThis was an experimental study in which a total of 125 preterm newborns less than 34 weeks gestation were studied. The study was carried out in two phases from December 2003 to November 2006. The inclusion criteria were designed to include newborn babies who were less than 34 weeks gestational age at the time of birth. The gestational age assessment was Role of prophylactic surfactant in preterm infants

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“…Most experimental studies of surfactant distribution have used radiolabelled surfactant or other easily measured substances mixed with surfactant components [11]. JOBE et al [12] 125 I]-iodophenyldiazirine bound to albumin was used in the experiment of HENRY et al [16]. Each technique has different strengths and weaknesses, giving only partial information about surfactant distribution [11].…”

Section: Discussionmentioning

confidence: 99%

A new simple method of staining exogenous surfactant in experimental research

Krause¹,

Orlowska-Volk²,

Hendrik³

et al. 2000

Eur Respir J

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Two commonly used techniques in experimental lung research have helped to determine which variables influence surfactant distribution within the lung: radioactive labelling of surfactant components and admixture of coloured microspheres to surfactant. However, neither technique allows the description of surfactant distribution at the alveolar level. The aim of this study was to establish a new technique using histology colourants for admixture to exogenous surfactant to make exogenous surfactant visible by light microscopy.In a step by step approach the authors evaluated the properties of a variety of green colourants when added to a natural porcine surfactant preparation for their ability to homogeneously mix with surfactant, to bind to surfactant, to adhere to a glass slide, to not be "overstained" by standard haematoxylin-eosin and Elastica van Giesson staining, to not influence in vitro surface tension properties of surfactant using a Wilhelmy balance, to not influence oxygenation and ventilation in a lung-lavage rat model and to preserve their colour and adherence to exogenous surfactant on lung specimens visualized by light microscopy.Only one of the tested green histology colourants (Green Dye1) fulfilled all requirements and showed a brilliant green colour in a distribution pattern typical of surfactant at the alveolar level.It is concluded that the authors have established a new, simple and inexpensive method of staining exogenous surfactant for evaluation of its distribution by light microscopy at the alveolar level. Eur Respir J 2000; 15: 949±954.

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Surfactant and pulmonary blood flow distributions following treatment of premature lambs with natural surfactant.

Cited by 123 publications

References 26 publications

Postnatal Maturation of Pulmonary Antimicrobial Defense Mechanisms in Conventional and Germ- Free Lambs

Postnatal Maturation of Pulmonary Antimicrobial Defense Mechanisms in Conventional and Germ- Free Lambs

Role of prophylactic surfactant in preterm infants

A new simple method of staining exogenous surfactant in experimental research

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