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J Cyst Fibros. 2017 Sep;16(5):565-572. doi: 10.1016/j.jcf.2017.04.015. Epub 2017 Jun 7.

Pulmonary surfactant dysfunction in pediatric cystic fibrosis: Mechanisms and reversal with a lipid-sequestering drug.

Author information

1
Department of Cell Biology and Anatomy, University of Calgary, Calgary, Alberta, Canada; Snyder Institute of Chronic Diseases, University of Calgary, Calgary, Alberta, Canada.
2
Snyder Institute of Chronic Diseases, University of Calgary, Calgary, Alberta, Canada; Department of Cardiovascular & Respiratory Sciences, University of Calgary, Calgary, Alberta, Canada.
3
Snyder Institute of Chronic Diseases, University of Calgary, Calgary, Alberta, Canada; Department of Pathology & Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: fgreen@ucalgary.ca.
4
Pediatric Cystic Fibrosis Clinic, Alberta Children's Hospital, Calgary, Alberta, Canada.
5
Snyder Institute of Chronic Diseases, University of Calgary, Calgary, Alberta, Canada.
6
Department of Cell Biology and Anatomy, University of Calgary, Calgary, Alberta, Canada.
7
Department of Surgery, Alberta Children's Hospital, Calgary, Alberta, Canada.
8
Department of Pathology & Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.
9
SolAeroMed Inc., Calgary, Alberta, Canada.
10
Department of Cell Biology and Anatomy, University of Calgary, Calgary, Alberta, Canada; Snyder Institute of Chronic Diseases, University of Calgary, Calgary, Alberta, Canada. Electronic address: mamrein@ucalgary.ca.

Abstract

BACKGROUND:

Airway surfactant is impaired in cystic fibrosis (CF) and associated with declines in pulmonary function. We hypothesized that surfactant dysfunction in CF is due to an excess of cholesterol with an interaction with oxidation.

METHODS:

Surfactant was extracted from bronchial lavage fluid from children with CF and surface tension, and lipid content, inflammatory cells and microbial flora were determined. Dysfunctional surfactant samples were re-tested with a lipid-sequestering agent, methyl-β-cyclodextrin (MβCD).

RESULTS:

CF surfactant samples were unable to sustain a normal low surface tension. MβCD restored surfactant function in a majority of samples.Mechanistic studies showed that the dysfunction was due to a combination of elevated cholesterol and an interaction with oxidized phospholipids and their pro-inflammatory hydrolysis products.

CONCLUSION:

We confirm that CF patients have impaired airway surfactant function which could be restored with MβCD. These findings have implications for improving lung function and mitigating inflammation in patients with CF.

KEYWORDS:

Cholesterol, oxidative stress; Cystic fibrosis; Free fatty acids; Genotypes; Infection; Inflammation; Lung surfactant; Phospholipids; Surface tension

PMID:
28599957
DOI:
10.1016/j.jcf.2017.04.015
[Indexed for MEDLINE]

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