Development of artificial lung surfactant

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1. Development of artificial surfactantA) Investigation for the best composition of lipids (1993) : Activity of several reconstituted surfactants that consisted of synthetic dipalmitoylphosphatidylcholine (DPPC) , phosphatidylglycerol (PG) and dioleoylphosphatidylcholine (DOPC) with different ratios plus surfactant-associated proteins-B and-C (SP-B and SP-C) was evaluated in immature rabbits. The surfactant composed of DPPC : PG : DOPC at a ratio of 60 : 20 : 20 showed the best activity.B) Investigation for the best composition of proteins (1994) : Activity of several reconstituted surfactants that consisted of isolated lipids from lung plus different doses of SP-B and SP-C were evaluated in immature rabbits. The surfactant containing SP-B at 0.7% and SP-C at 1.4% improved the static pressure-volume relationship of the lung at the best, but the tidal volume was not completely normalized. Further studies are necessary for method to combine lipids and proteins.2. Treatment of adult repiratory distress syndrome (ARDS) with surfactantA) Intratracheal instillation method (1993) . Instillation of surfactant suspension (50 mg/ml, 2 ml/kg) into the trachea of rats with ARDS that induced by endotoxin (50 mg/kg) improved the arterial oxygen pressure (PaO_2) from 85 mmHg to 345 mmHg (P<0.05) , but caused hypotension.B) Administration of surfactant by inhalation (1994) : Inhalation of surfactant aerosol improved the PaO_2 of ARDS rats from 84 mmHg to 243 mmHg (P<0.05) without causing hypotension.Comments and conclusionsThe present results suggest that inhalation of aerosolized surfactant can apply for treatment of clinical ARDS.We should make haste to develope an effective artificial surfactant.