Surfactant in respiratory distress syndrome and lung injury

被引:80
作者
Hallman, M
Glumoff, V
Rämet, M
机构
[1] Univ Oulu, Dept Pediat, Oulu 90220, Finland
[2] Univ Oulu, Bioctr Oulu, Oulu 90220, Finland
[3] Massachusetts Gen Hosp Children, Lab Dev Immunol, Boston, MA 02114 USA
[4] Harvard Univ, Sch Med, Boston, MA 02114 USA
来源
COMPARATIVE BIOCHEMISTRY AND PHYSIOLOGY A-MOLECULAR AND INTEGRATIVE PHYSIOLOGY | 2001年 / 129卷 / 01期
关键词
lung surfactant; respiratory distress syndrome; adult respiratory distress syndrome; surfactant proteins; cytokines; premature infant; amniotic fluid;
D O I
10.1016/S1095-6433(01)00324-5
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
A deficiency in alveolar surfactant due to immaturity of alveolar type II epithelial cells causes respiratory distress syndrome (RDS). In contrast to animals, the fetal maturation of surfactant in human lungs takes place before term, exceptionally large quantities of surfactant accumulating in the amniotic fluid. The antenatal development of surfactant secretion is very variable but corresponds closely to the risk of RDS. The variation in SP-A and SP-B genes, race, sex and perinatal complications influence susceptibility to RDS. Surfactant therapy has improved the prognosis of RDS remarkably, Abnormalities in alveolar or airway surfactant characterize many lung and airway diseases. In the acute respiratory distress syndrome, deficiencies in surfactant components (phospholipids, SP-B, SP-A) are evident, and may be caused by pro-inflammatory cytokines (IL-I, TNF) that decrease surfactant components. The resultant atelectasis Localizes the disease, possibly allowing healing (regeneration, increase in surfactant). In the immature fetus, cytokines accelerate the differentiation of surfactant, preventing RDS. After birth, however, persistent inflammation is associated with low SP-A and chronic lung disease. A future challenge is to understand how to inhibit or redirect the inflammatory response from tissue destruction and poor growth towards normal lung development and regeneration. (C) 2001 Elsevier Science Inc. All rights reserved.
引用
收藏
页码:287 / 294
页数:8
相关论文
共 69 条
  • [61] RAMET M, 2000, IN PRESS J PEDIAT
  • [62] SOLL RF, 2000, COCHRANE DATABASE SY, V2
  • [63] Váyrynen O, 1999, PEDIATR RES, V45, P896
  • [64] Watterberg KL, 1996, PEDIATRICS, V97, P210
  • [65] Pulmonary parenchymal abnormalities in congenital diaphragmatic hernia
    Wilcox, DT
    Irish, MS
    Holm, BA
    Glick, PL
    [J]. CLINICS IN PERINATOLOGY, 1996, 23 (04) : 771 - +
  • [66] Bronchopulmonary segmental lavage with surfaxin (KL4-surfactant) for acute respiratory distress syndrome
    Wiswell, TE
    Smith, RM
    Katz, LB
    Mastroianni, L
    Wong, DY
    Willms, D
    Heard, S
    Wilson, M
    Hite, RD
    Anzueto, A
    Revak, SD
    Cochrane, CG
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1999, 160 (04) : 1188 - 1195
  • [67] Effects of endotoxin on surfactant protein A and D stimulation of NO production by alveolar macrophages
    Wright, JR
    Zlogar, DF
    Taylor, JC
    Zlogar, TM
    Restrepo, CI
    [J]. AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY, 1999, 276 (04) : L650 - L658
  • [68] YOST CC, 2000, COCHRANE LIB
  • [69] Zimmerman J J, 1994, Curr Probl Pediatr, V24, P159, DOI 10.1016/0045-9380(94)90033-7