Am. J. Respir. Crit. Care Med., Volume 163, Number 1, January 2001, 95-100

Alteration of Fatty Acid Profiles in Different Pulmonary Surfactant Phospholipids in Acute Respiratory Distress Syndrome and Severe Pneumonia

REINHOLD SCHMIDT, UTE MEIER, MARIFE YABUT-PEREZ, DIETER WALMRATH, FRIEDRICH GRIMMINGER, WERNER SEEGER, and ANDREAS GÜNTHER

Medizinische Klinik II, Zentrum für Innere Medizin, Justus-Liebig University, Giessen, Germany

Impairment of alveolar surfactant function has been documented in the acute respiratory distress syndrome (ARDS) and in severe pneumonia (PNEU); however, the underlying mechanisms are not completely understood. In the current report we present a detailed analysis of fatty acid (FA) profiles of different surfactant phospholipid (PL) classes isolated from bronchoalveolar lavage fluids (BALF) and large surfactant aggregates (LSA) from mechanically ventilated patients with ARDS (n = 8), ARDS associated with lung infection (ARDS + PNEU, n = 9), and PNEU (n = 22). Healthy volunteers served as control subjects (n = 8). PLs were isolated by thin-layer chromatography, and the FA profile of each PL class was assessed by gas chromatography. In addition, the minimal surface tension ( min) of untreated LSA and of LSA after supplementation with additional dipalmitoylated phosphatidylcholine (DPPC) was analyzed (pulsating bubble surfactometer). As compared with control LSA, the percentage of palmitic acid in phosphatidylcholine (PC) was significantly decreased in all patient groups (ARDS 63.0 ± 2.0%, ARDS + PNEU 64.6 ± 4.9%, PNEU 65.6 ± 1.5%, control subjects 80.1 ± 1.7%), whereas the relative amount of unsaturated species in PC increased significantly in all groups. Phosphatidylglycerol (PG) and phosphatidylinositol (PI) presented similar FA profiles in control subjects, but differed in the patients. The FA pattern of sphingomyelin (SPH) and phosphatidylethanolamine (PE) displayed only minor changes under conditions of respiratory failure. As compared with control subjects a highly significant increase of  min from near zero to approximately 16 mN/m was observed in all patients and was found to be inversely correlated to the percentage of palmitic acid in PC of LSA or BALF. Accordingly, values for  min were significantly improved upon secondary supplementation of LSA with DPPC up to control values. We conclude that marked changes in the FA composition of the predominant surfactant PL classes occur, both in ARDS triggered by nonpulmonary events and PNEU. The marked reduction of palmitic acid in the PC fraction may be related to changes in surfactant function under these conditions.

This article has been cited by other articles:

				K. Kuronuma, H. Mitsuzawa, K. Takeda, C. Nishitani, E. D. Chan, Y. Kuroki, M. Nakamura, and D. R. Voelker Anionic Pulmonary Surfactant Phospholipids Inhibit Inflammatory Responses from Alveolar Macrophages and U937 Cells by Binding the Lipopolysaccharide-interacting Proteins CD14 and MD-2 J. Biol. Chem., September 18, 2009; 284(38): 25488 - 25500. [Abstract] [Full Text] [PDF]

				P. Markart, C. Ruppert, M. Wygrecka, T. Colaris, B. Dahal, D. Walmrath, H. Harbach, J. Wilhelm, W. Seeger, R. Schmidt, et al. Patients with ARDS show improvement but not normalisation of alveolar surface activity with surfactant treatment: putative role of neutral lipids Thorax, July 1, 2007; 62(7): 588 - 594. [Abstract] [Full Text] [PDF]

				M. Cepkova and M. A. Matthay Pharmacotherapy of Acute Lung Injury and the Acute Respiratory Distress Syndrome J Intensive Care Med, May 1, 2006; 21(3): 119 - 143. [Abstract] [PDF]

				I. Vadasz, R. E. Morty, M. G. Kohstall, A. Olschewski, F. Grimminger, W. Seeger, and H. A. Ghofrani Oleic Acid Inhibits Alveolar Fluid Reabsorption: A Role in Acute Respiratory Distress Syndrome? Am. J. Respir. Crit. Care Med., March 1, 2005; 171(5): 469 - 479. [Abstract] [Full Text] [PDF]

				W. Bernhard, C. J. Pynn, A. Jaworski, G. A. Rau, J. M. Hohlfeld, J. Freihorst, C. F. Poets, D. Stoll, and A. D. Postle Mass Spectrometric Analysis of Surfactant Metabolism in Human Volunteers Using Deuteriated Choline Am. J. Respir. Crit. Care Med., July 1, 2004; 170(1): 54 - 58. [Abstract] [Full Text] [PDF]

				A. H. van Kaam, R. A. Lachmann, E. Herting, A. De Jaegere, F. van Iwaarden, L. A. Noorduyn, J. H. Kok, J. J. Haitsma, and B. Lachmann Reducing Atelectasis Attenuates Bacterial Growth and Translocation in Experimental Pneumonia Am. J. Respir. Crit. Care Med., May 1, 2004; 169(9): 1046 - 1053. [Abstract] [Full Text] [PDF]

				M. E. Lekka, S. Liokatis, C. Nathanail, V. Galani, and G. Nakos The Impact of Intravenous Fat Emulsion Administration in Acute Lung Injury Am. J. Respir. Crit. Care Med., March 1, 2004; 169(5): 638 - 644. [Abstract] [Full Text] [PDF]

				A. Gunther, M. Balser, R. Schmidt, P. Markart, A. Olk, J. Borgermann, F. H. Splittgerber, W. Seeger, and I. Friedrich Surfactant abnormalities after single lung transplantation in dogs: Impact of bronchoscopic surfactant administration J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 344 - 354. [Abstract] [Full Text] [PDF]

				A. Fehrenbach, C. Bube, J. M. Hohlfeld, P. Stevens, T. Tschernig, H. G. Hoymann, N. Krug, and H. Fehrenbach Surfactant Homeostasis Is Maintained In Vivo during Keratinocyte Growth Factor-induced Rat Lung Type II Cell Hyperplasia Am. J. Respir. Crit. Care Med., May 1, 2003; 167(9): 1264 - 1270. [Abstract] [Full Text] [PDF]

				R. Schmidt, U. Meier, P. Markart, F. Grimminger, H. G. Velcovsky, H. Morr, W. Seeger, and A. Gunther Altered fatty acid composition of lung surfactant phospholipids in interstitial lung disease Am J Physiol Lung Cell Mol Physiol, November 1, 2002; 283(5): L1079 - L1085. [Abstract] [Full Text] [PDF]

				K. Mayer, R. Schmidt, M. Muhly-Reinholz, T. Bogeholz, S. Gokorsch, F. Grimminger, and W. Seeger In vitro mimicry of essential fatty acid deficiency in human endothelial cells by TNF{alpha} impact of {omega}-3 versus {omega}-6 fatty acids J. Lipid Res., June 1, 2002; 43(6): 944 - 951. [Abstract] [Full Text] [PDF]

				A. Gunther, R. Schmidt, J. Harodt, T. Schmehl, D. Walmrath, C. Ruppert, F. Grimminger, and W. Seeger Bronchoscopic administration of bovine natural surfactant in ARDS and septic shock: impact on biophysical and biochemical surfactant properties Eur. Respir. J., May 1, 2002; 19(5): 797 - 804. [Abstract] [Full Text] [PDF]

				D. Walmrath, F. Grimminger, D. Pappert, C. Knothe, U. Obertacke, A. Benzing, A. Gunther, T. Schmehl, H. Leuchte, and W. Seeger Bronchoscopic administration of bovine natural surfactant in ARDS and septic shock: impact on gas exchange and haemodynamics Eur. Respir. J., May 1, 2002; 19(5): 805 - 810. [Abstract] [Full Text] [PDF]

				M. J. TOBIN Pediatrics, Surfactant, and Cystic Fibrosis in AJRCCM 2001 Am. J. Respir. Crit. Care Med., March 1, 2002; 165(5): 619 - 630. [Full Text] [PDF]

				P. Juvin, T. Fournier, M. Grandsaigne, J.-M. Desmonts, and M. Aubier Diesel particles increase phosphatidylcholine release through a NO pathway in alveolar type II cells Am J Physiol Lung Cell Mol Physiol, May 1, 2002; 282(5): L1075 - L1081. [Abstract] [Full Text] [PDF]