Functional Abnormalities of Lung Surfactant in Experimental Acute Alveolar Injury in the Dog

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Abstract
Acute alveolar injury (AAI) was induced in dogs by injection of N-nitroso-N-methylurethane. Two to 20 days after injection, alveolar lavage phospholipids were quantified. Lavage surfactant was partially purified by centrifugation (27,000 g for 2 h), and further purified by centrifugation in NaBr density gradient (100,000 g for 4 h). Phospholipids, neutral lipids, surfactant-associated proteins, and surface properties of partially purified and purified surfactants were analyzed. Lavage disaturated phosphatidylcholine (DSPC) decreased to 37% of control at peak injury (Days 6 to 8) and increased to near normal during recovery (Days 10 to 20). Lavage phosphatidylglycerol (PG) decreased to 22% of control at peak injury and remained in that range through recovery. In both partially purified and purified surfactants, percentages of phosphatidylcholine (PC), DSPC, phosphatidylethanolamine, and cholesterol in all phases of injury and recovery were not different from those in control animals. However, percentage of PG decreased markedly during injury and remained low through recovery, whereas those of phosphatidylinositol and lysoPC increased with injury and remained elevated through recovery. The PC-to-sphingomyelin ratio (L/S ratio) and percentage of triglyceride decreased during injury and returned to control values during recovery. Surfactant apoprotein of molecular weight 38,000 from partially purified and purified surfactant decreased markedly at peak injury and recovered to normal during recovery. During early and peak injury, both preparations failed to reduce surface tension below 19 dyne/cm and their isopycnic densities were altered. These studies indicate that, in addition to decreased quantity, qualitative changes in lipids and apoproteins and reduced surface activity of the surfactant occur during nitrosourethane-induced AAI. These alterations may contribute to abnormal lung function and may serve as markers for the phases of injury and repair.