Häfner D, Germann P G, Hauschke D
Departments of Respiratory Pharmacology and Biometry, and Institute of Pathology and Toxicology, Byk Gulden, Konstanz, Germany.
Am J Respir Crit Care Med. 1998 Jul;158(1):270-8. doi: 10.1164/ajrccm.158.1.9712061.
We have tested two surfactant preparations with the same phospholipid (PL) composition, containing recombinant surfactant protein-C (rSP-C surfactant) and without SP-C (plain PL surfactant). The effects of rSP-C surfactant were compared with the bovine-derived surfactant preparations Alveofact, bLES, and Infasurf in a lung lavage model, with surfactant given 1 h after the last lavage. The effects of surfactant treatment on histopathologic changes (e.g., hyaline-membrane formation) and improvement of oxygenation were compared with changes in untreated controls. The surfactants were given in doses of 25, 50, and 100 mg PL/kg body weight. At 120 min after treatment, only the protein-containing surfactants showed a statistically significant increasing dose dependence with respect to improving oxygenation. The values were 318 +/- 120 mm Hg, 443 +/- 58 mm Hg, and 480 +/- 43 mm Hg (mean +/- SD) for the three doses of rSP-C surfactant and 105 +/- 81 mm Hg, 100 +/- 69 mm Hg, and 131 +/- 108 mm Hg for the three doses of PL surfactant. The respective values for Alveofact were 104 +/- 81 mm Hg, 105 +/- 93 mm Hg, and 260 +/- 143 mm Hg; for bLES 373 +/- 138 mm Hg, 441 +/- 88 mm Hg, and 467 +/- 43 mm Hg; and for Infasurf 146 +/- 96 mm Hg, 284 +/- 178 mm Hg, and 436 +/- 70 mm Hg. The oxygen values of controls remained low, at 74 +/- 46 mm Hg. Only the protein-containing surfactants dose-dependently inhibited the formation of hyaline membranes. We conclude that rSP-C surfactant is at least as effective as bovine-derived surfactants. Furthermore, the data imply that the difference between plain PL surfactant preparations and bovine-derived surfactant preparations containing both SP-B and SP-C can be overcome by addition of SP-C.
我们测试了两种具有相同磷脂（PL）组成的表面活性剂制剂，一种含有重组表面活性蛋白-C（rSP-C表面活性剂），另一种不含SP-C（普通PL表面活性剂）。在肺灌洗模型中，将rSP-C表面活性剂的效果与牛源性表面活性剂制剂Alveofact、bLES和Infasurf进行了比较，在最后一次灌洗1小时后给予表面活性剂。将表面活性剂治疗对组织病理学变化（如透明膜形成）的影响和氧合改善情况与未治疗对照组的变化进行了比较。表面活性剂的给药剂量为25、50和100mg PL/kg体重。治疗后120分钟，只有含蛋白质的表面活性剂在改善氧合方面显示出统计学上显著的剂量依赖性增加。三种剂量的rSP-C表面活性剂的值分别为318±120mmHg、443±58mmHg和480±43mmHg（平均值±标准差），三种剂量的PL表面活性剂的值分别为105±81mmHg、100±69mmHg和131±108mmHg。Alveofact的相应值分别为104±81mmHg、105±93mmHg和260±143mmHg；bLES的相应值分别为373±138mmHg、441±88mmHg和467±43mmHg；Infasurf的相应值分别为146±96mmHg、284±178mmHg和436±70mmHg。对照组的氧值保持在较低水平，为74±46mmHg。只有含蛋白质的表面活性剂剂量依赖性地抑制了透明膜的形成。我们得出结论，rSP-C表面活性剂至少与牛源性表面活性剂一样有效。此外，数据表明，通过添加SP-C可以克服普通PL表面活性剂制剂与同时含有SP-B和SP-C的牛源性表面活性剂制剂之间的差异。
