Development of synthetic lung surfactants.

We have previously reported the development of a reconstituted lung surfactant consisting of an organic solvent extract of natural bovine lung surfactant supplemented with synthetic lipids. This "artificial" surfactant was used successfully to treat surfactant deficiency states both in animals and humans. We now report on the successful testing of a synthetic lung surfactant consisting of a lipid-bound protein isolated from natural lung surfactant and the lipids present in the "artificial" lung surfactant and now used in the same concentration but in a synthetic, commercially available form. The synthetic lung surfactant possessed the in vitro and in vivo surface properties characterizing the "artificial" lung surfactant. In order to identify the components of the synthetic lung surfactant that are responsible for the required surface properties, a series of 25 simple mixtures was prepared. Of these, three possessed surface properties very similar to those of the "artificial" lung surfactant and the synthetic lung surfactant, in vitro as well as in vivo. These three mixtures had four components in common. Besides dipalmitoyl phosphatidylcholine and the lipid-bound protein, they each had a saturated fatty acid, palmitic or stearic, and they each had an acidic phospholipid, phosphatidylglycerol or phosphatidylserine.