RT Journal Article
T1 Surfactant injury in the early phase of Severe Meconium Aspiration Syndrome
A1 Autilio, Chiara
A1 Echaide Torreguitar, Mercedes
A1 Shankar-Aguilera, Shivani
A1 Bragado Herrero, Rafael
A1 Amidani, Davide
A1 Salomone, Fabrizio
A1 Pérez-Gil, Jesús
A1 De Luca, Daniele
AB Rationale. No in vivo data are available about the effect of meconium on human surfactant in the early stages of severe meconium aspiration syndrome (MAS). Objectives. To characterize the changes in surfactant composition, function and structure during the early phase of meconium injury. Methods. We designed a translational, prospective, cohort study on nonbronchoscopic bronchoalveolar lavages of neonates with severe MAS (n=14) or no lung disease (n=18). Surfactant lipids have been analysed by liquid chromatography-high resolution mass spectrometry. Secretory phospholipases A2 subtype-IB,-V and -X and surfactant protein-A were assayed by ELISA. Surfactant protein-B and -C were analysed by Western Blot both under non-reducing and reducing conditions. Surfactant function was assessed by adsorption test and captive bubble surfactometry, while lung aeration was evaluated by semi-quantitative lung ultrasound. Surfactant nanostructure was studied with cryo-electron and atomic force microscopy.Main Results. Several changes in phospholipid subclasses were detected during MAS. Lysophosphatidylcholine species released by the sPLA2 hydrolysis were increased. Protein-B and -C were significantly increased together with some shorter immature forms of proteinB. Surfactant function was impaired and correlated with poor lung aeration. Surfactant nanostructure was significantly damaged in terms of vesicles size, tridimensional complexity and compactness. Conclusions. Various alterations of surfactant phospholipids and proteins were detected in the early phase of severe meconium aspiration, due to hydrolysis and inflammation and as a defensive response. This impairs both surfactant structure and function, finally resulting in a reduced lung aeration. These findings support the development of new surfactant protection and anti-inflammatory strategies for severe MAS.
PB American Thoracic Society
SN 1044-1549, ESSN 1535-4989
YR 2020
FD 2020-04-20
LK https://hdl.handle.net/20.500.14352/6621
UL https://hdl.handle.net/20.500.14352/6621
LA eng
NO Ministerio de Ciencia e Innovación (MICINN)
NO Comunidad de Madrid
NO European Society of Pediatric
NO Association pour la Recherche et le Développement en Néonatologie
DS Docta Complutense
RD 24 abr 2025