RT Journal Article
T1 Surfactant-secreted phospholipase A2 interplay and respiratory outcome in preterm neonates
A1 De Luca, Daniele
A1 Shankar-Aguilera, Shivani
A1 Autilio, Chiara
A1 Raschetti, Roberto
A1 Vedovelli, Luca
A1 Fitting, Catherine
A1 Payré, Christine
A1 Jeammet, Louise
A1 Pérez-Gil, Jesús
A1 Cogo, Paola E.
A1 Carnielli, Virgilio P.
A1 Lambeau, Gérard
A1 Touqui, Lhoussaine
AB Secreted phospholipase A2 hydrolyzes surfactant phospholipids and is crucial for the inflammatory cascade; preterm neonates are treated with exogenous surfactant, but the interaction between surfactant and phospholipase is unknown. We hypothesize that this interplay is complex and the enzyme plays a relevant role in neonates needing surfactant replacement. We aimed to: 1) identify phospholipases A2 isoforms expressed in preterm lung; 2) study the enzyme role on surfactant retreatment and function and the effect of exogenous surfactant on the enzyme system; and 3) verify whether phospholipase A2 is linked to respiratory outcomes. In bronchoalveolar lavages of preterm neonates, we measured enzyme activity (alone or with inhibitors), enzyme subtypes, surfactant protein-A, and inflammatory mediators. Surfactant function and phospholipid profile were also tested. Urea ratio was used to obtain epithelial lining fluid concentrations. Follow-up data were prospectively collected. Subtype-IIA is the main phospholipase isoform in preterm lung, although subtype-IB may be significantly expressed. Neonates needing surfactant retreatment have higher enzyme activity (P 0.021) and inflammatory mediators (P always 0.001) and lower amounts of phospholipids (P always 0.05). Enzyme activity was inversely correlated to surfactant adsorption (  0.6; P 0.008; adjusted P 0.009), total phospholipids (  0.475; P 0.05), and phosphatidylcholine (  0.622; P 0.017). Exogenous surfactant significantly reduced global phospholipase activity (P 0.001) and subtype-IIA (P 0.005) and increased dioleoylphosphatidylglycerol (P 0.001) and surfactant adsorption (P 0.001). Enzyme activity correlated with duration of ventilation (  0.679, P 0.005; adjusted P 0.04) and respiratory morbidity score at 12 mo postnatal age ( -b 0.349, P 0.037; adjusted P 0.043) but was not associated with mortality, bronchopulmonary dysplasia, or other long-term respiratory outcomes.
PB American Physiological Society
SN 1040-0605; ESSN 1522-1504
YR 2020
FD 2020-06-25
LK https://hdl.handle.net/20.500.14352/6590
UL https://hdl.handle.net/20.500.14352/6590
LA eng
NO Association pour le Dévéloppement et la Recherche en Néonatologie (ADRN)
DS Docta Complutense
RD 7 abr 2025