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Am J Respir Crit Care Med. 2006 Jun 15;173(12):1342-7. Epub 2006 Mar 23.

Intratracheal recombinant surfactant protein d prevents endotoxin shock in the newborn preterm lamb.

Author information

1
Cincinnati Children's Hospital, Division of Pulmonary Biology, 3333 Burnet Avenue, University of Cincinnati, Ohio 45229-3039, USA. machiko.Ikegami@cchmc.org

Abstract

RATIONALE:

The susceptibility of neonates to pulmonary and systemic infection has been associated with the immaturity of both lung structure and the immune system. Surfactant protein (SP) D is a member of the collectin family of innate immune molecules that plays an important role in innate host defense of the lung.

OBJECTIVES:

We tested whether treatment with recombinant human SP-D influenced the response of the lung and systemic circulation to intratracheally administered Escherichia coli lipopolysaccharides.

METHODS:

After intratracheal lipopolysaccharide instillation, preterm newborn lambs were treated with surfactant and ventilated for 5 h.

MEASUREMENT:

Survival rate, physiologic lung function, lung and systemic inflammation, and endotoxin level in plasma were evaluated.

MAIN RESULTS:

In control lambs, intratracheal lipopolysaccharides caused septic shock and death associated with increased endotoxin in plasma. In contrast, all lambs treated with recombinant human SP-D were physiologically stable and survived. Leakage of lipopolysaccharides from the lungs to the systemic circulation was prevented by intratracheal recombinant human SP-D. Recombinant human SP-D prevented systemic inflammation and decreased the expression of IL-1beta, IL-8, and IL-6 in the spleen and liver. Likewise, recombinant human SP-D decreased IL-1beta and IL-6 in the lung and IL-8 in the plasma. Recombinant human SP-D did not alter pulmonary mechanics following endotoxin exposure. Recombinant human SP-D was readily detected in the lung 5 h after intratracheal instillation.

CONCLUSIONS:

Intratracheal recombinant human SP-D prevented shock caused by endotoxin released from the lung during ventilation in the premature newborn.

PMID:
16556693
PMCID:
PMC2662974
DOI:
10.1164/rccm.200509-1485OC
[Indexed for MEDLINE]
Free PMC Article

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