Acute respiratory distress syndrome (ARDS) is an inflammatory condition that can be associated with capillary leak of serum into alveoli causing inactivation of
surfactant. Resistance to inactivation is affected by types and concentrations of
surfactant proteins,
lipids, and
polymers. Our aim was to investigate the effects of different combinations of these three components. A simple
lipid mixture (DPPC/POPG) or a more complex
lipid mixture (DPPC/POPC/POPG/
cholesterol) was used. Native
surfactant proteins SP-B and SP-C obtained from pig lung lavage were added either singly or combined at two concentrations. Also, non-ionic
polymers polyethylene glycol and
dextran and the anionic
polymer hyaluronan were added either singly or in pairs with
hyaluronan included. Non-ionic
polymers work by different mechanisms than anionic
polymers, thus the purpose of placing them together in the same
surfactant mixture was to evaluate if the combination would show enhanced beneficial effects. The resulting
surfactant mixtures were studied in the presence or absence of serum. A modified bubble surfactometer was used to evaluate surface activities. Mixtures that included both SP-B and SP-C plus
hyaluronan and either
dextran or
polyethylene glycol were found to be the most resistant to inhibition by serum. These mixtures, as well as some with either SP-B or SP-C with combined
polymers were as or more resistant to inactivation than native
surfactant. These results suggest that improved formulations of lung
surfactants are possible and may be useful in reducing some types of
surfactant inactivation in treating
lung injuries.