Surface and Tissue Forces, Surfactant Protein A, and the Phospholipid Components of Pulmonary Surfactant in Bleomycin-induced Pulmonary Fibrosis in the Rat

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Abstract
Administration of bleomycin to animals results in an alteration of the pressure-volume relationship of the lungs with an increased elastic recoil at any given volume. We sought to evaluate the relative importance of surface forces to elastic recoil by comparing the differences between the air and saline pressure-volume curves. The difference in elastic recoil between air- and saline-filled lungs was altered in bleomycin-treated rats when elastic recoil was compared at 35% of predicted TLC or at 80% of observed TLC. This pressure difference was present both during the early phase (Days 4 and 7) of the injury and acute inflammation as well as during the later phase (Days 14 to 28) when there was chronic inflammation and an elevation in the lung hydroxyproline content. The total amount of phospholipids recovered in lavage was decreased at Day 4 and increased more than 2.5-fold over saline-instilled control animals at Day 21 and 28. The percentage of phosphatidyl-glycerol was reduced and that of phosphatidylinositol increased. There was no consistent change in the percentage of phosphatidylcholine that was disaturated. The amount of surfactant protein A (SP-A) did not change during the course of the experiment and was not a useful independent marker of alveolar injury or changes in pulmonary compliance. The ratio of SP-A to total phospholipid decreased 14 to 28 days after instillation of bleomycin. These results support the hypothesis that indivdiual components of surfactant are independently regulated and indicate that SP-A content in lavage is insensitive to lung injury and repair.