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Published ahead of print on March 20, 2003, doi:10.1164/rccm.200207-782OC

Am. J. Respir. Crit. Care Med., Volume 167, Number 11, June 2003, 1562-1566

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Submitted on July 31, 2002
Accepted on March 12, 2003

TREATMENT OF THE ACUTE RESPIRATORY DISTRESS SYNDROME WITH rSP-C SURFACTANT

Roger G Spragg1*, James F Lewis2, Wilhelm Wurst3, Dietrich Haefner3, Robert P Baughman4, Mark D Wewers5, and James J Marsh1

1 Medicine, University of California San Diego School of Medicine and San Diego Veterans Affairs Health Care System, San Diego, CA, USA, 2 Medicine, Lawson Health Research Institute, St. Joseph's Health Centre, University of Western Ontario, London, Ontario, Canada, 3 ALTANA Pharma AG, Konstanz, Germany, 4 Medicine, University of Cincinnati, Cincinnati, Ohio, USA, 5 Medicine, Ohio State University, Columbus, Ohio, USA

* To whom correspondence should be addressed. E-mail: rspragg{at}ucsd.edu.

We performed a phase I/II trial in North America of a recombinant surfactant protein C based surfactant (Venticute®) as treatment for the acute respiratory distress syndrome. Patients were prospectively randomized to receive either standard therapy or standard therapy plus one of two doses of exogenous surfactant given four times over 24 hours. Surfactant administration was well tolerated. No significant treatment benefit was associated with surfactant treatment. Bronchoalveolar lavage of treated patients at 48 hours reflected the presence of exogenous surfactant components, did not show evidence of improved surface tension lowering function, and had interleukin-6 concentrations that were significantly lower than control group values, consistent with an anti-inflammatory treatment effect. The presence of exogenous surfactant was not detected in lavage fluid obtained at 120 hours. Future studies might rationally employ larger surfactant doses and a more prolonged dosing schedule.
Key words: Pulmonary surfactant, surfactant apoprotein C, phospholipids, interleukin 6




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