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Treatment of murine adult MLE-12 type-II and fetal-rat type-II cells with fetal-rat-fibroblast-conditioned medium (FFCM) resulted in a 2-fold stimulation of [14C]choline incorporation into phosphatidylcholine. Soluble CTP:phosphocholine cytidylyltransferase (CT) activity was increased approx. 3-fold in FFCM-treated fetal-rat type-II cells but was not changed in MLE-12 cells. Neither choline kinase nor cholinephosphotransferase activities were affected by treatment of MLE-12 cells with FFCM. Long-term labelling of MLE-12 cells with [14C]choline, followed by a 14-18 h chase with FFCM, resulted in a 2.5-fold decrease in [14C]phosphocholine levels relative to controls, suggesting that CT was being activated. In contrast, oleate treatment increased CT activity in the particulate fraction in both cells. Western blots indicate that soluble CT undergoes dephosphorylation in response to FFCM, but no translocation to the particulate fraction was noted. Treatment with oleate stimulated a marked translocation. Tryptic phosphopeptide maps from FFCM-treated cells revealed only minor alterations in the phosphorylation pattern. It is concluded that FFCM and oleate activate CT through different mechanisms. The results are consistent with FFCM activating CT in MLE-12 as well as fetal type-II cells. However, the reason why this activation cannot be detected in vitro is not known.

The effects of the reactive oxygen species (ROS) superoxide anion (O 2 . −) and hydroxyl radical (•OH) on the surface tension lowering properties of bovine lipid extract surfactant (BLES) were compared to the effects of calf serum protein (CSP) in a captive bubble surfactometer (CBS). O 2 . − was generated from xanthine/xanthine oxidase (X/XO), and •OH was generated by the Fenton reaction. ROS were demonstrated by electron spin resonance (ESR) using 5,5-dimethyl-1-pyrroline-N-oxide (DMPO) as the spin trap. Lipid peroxidation was measured using the thiobarbituric acid method. •OH had broad inhibitory effects on surface tension parameters, including adsorption, minimum surface tension, percentage film area change and film compressibility. O 2 . − showed inhibitory effects on adsorption, film area change and film compressibility but had no significant effect on minimum surface tension. Both O 2 . − and •OH treatment were associated with a large ‘squeezeout’ plateau around 20–25 mN/m in the surface tension—area relation, indicating poor film organization during the compression phase. At the concentrations used, ROS were associated with lipid peroxidation of BLES, which also demonstrated radical scavenging properties. Calf serum protein produced inhibitory effects on adsorption, minimum surface tension and percentage film area change that were quantitatively similar to those produced by •OH. The effects on film compression were significantly greater and qualitatively different from those seen with either O 2 . − or •OH. We conclude that the inhibition of BLES surface activity by ROS and inhibitory proteins can be distinguished in the captive bubble surfactometer and, particularly, by changes in the film compressibility modulus.

Pulmonary surfactant forms a surface film that consists of a monolayer and a monolayer-associated reservoir. The extent to which surfactant components including the main component, dipalmitoylphosphatidylcholine (DPPC), are adsorbed into the monolayer, and how surfactant protein SP-A affects their adsorptions, is not clear. Transport of cholesterol to the surface region from dispersions of bovine lipid extract surfactant [BLES(chol)] with or without SP-A at 37 degrees C was studied by measuring surface radioactivities of [4-(14)C]cholesterol-labeled BLES(chol), and the Wilhelmy plate technique was used to monitor adsorption of monolayers. Results showed that transport of cholesterol was lipid concentration dependent. SP-A accelerated lipid adsorption but suppressed the final level of cholesterol in the surface. Surfactant adsorbed from a dispersion with or without SP-A was transferred via a wet filter paper to a clean surface, where the surface radioactivity and surface tension were recorded simultaneously. It was observed that 1) surface radioactivity was constant over a range of dispersion concentrations; 2) cholesterol and DPPC were transferred simultaneously; and 3) SP-A limited transfer of cholesterol. These results indicate that non-DPPC components of pulmonary surfactant can be adsorbed into the monolayer. Studies in the transfer of [1-(14)C]DPPC-labeled BLES(chol) to an equal or larger clean surface area revealed that SP-A did not increase selective adsorption of DPPC into the monolayer. Evaluation of transferred surfactant with a surface balance indicated that it equilibrated as a monolayer. Furthermore, examination of transferred surfactants from dispersions with and without prespread BLES(chol) monolayers revealed a functional contiguous association between adsorbed monolayers and reservoirs.

Components of the airspace-lining material may contribute to the local regulation of immune function within the lung. We report here that recombinant rat pulmonary surfactant-associated protein D (SP-D) inhibits the lectin- and anti-CD3-stimulated proliferation of human PBMCs. Inhibition was associated with a decreased production of IL-2, and the addition of human rIL-2 blocked the inhibitory action of SP-D. These effects were not inhibited by maltose, indicating that the inhibitory activity was not dependent upon the lectin activity of SP-D. Studies employing mutant SP-D lacking N-linked sugars or defective in multimerization further indicated that inhibition was not dependent upon cellular interactions with the N-linked oligosaccharide on SP-D or the oligomerization of trimeric SP-D subunits. Although a peptide containing an inverted DGR showed similar IL-2-dependent effects on anti-CD3-stimulated proliferation, deletion of the conserved DGRDGR sequence near the amino-terminal end of the collagen domain did not decrease the suppressive activity of SP-D. We hypothesize that SP-D can dampen lymphocyte responses to exogenous stimuli and protect the lung against collateral immune-mediated damage.

Interaction of pulmonary surfactant protein A (SP-A) with pure and binary mixed dipalmitoylphosphatidylcholine (DPPC) and cholesterol (3.5 wt%) at the air/saline, 1.5 mM CaCl2 interface was investigated using a rhomboid surface balance at 37 degrees C. Surface tension-area isotherms were measured to access the surface active properties of the monolayers. The organization of DPPC and cholesterol in DPPC and DPPC/cholesterol mixed monolayers with or without SP-A at equilibrium surface tension (approximately 23 mN/N) was revealed by autoradiographs of Langmuir-Blodgett (L-B) films deposited from [14C]DPPC or [14C]cholesterol-labeled monolayers. The results showed that SP-A can interact with the polar head groups of DPPC monolayers and aggregate DPPC molecules. SP-A decreased the surface area reduction required for DPPC monolayers to achieve near zero surface tension from 30 to 25% of the area at equilibrium. SP-A also reduced the collapse surface tension of pure cholesterol from 27 to 23 mN/m. DPPC and cholesterol formed homogeneous mixed monolayers when both were dissolved in the spreading solvent prior to spreading, while separate cholesterol-rich domains appeared when DPPC and cholesterol were spread successively. Cholesterol resisted squeeze-out from either mixed monolayer through compression. Although SP-A could not promote the squeeze-out of cholesterol from homogeneous mixed monolayers, it facilitated that of cholesterol domains especially when SP-A had first interacted with DPPC. These results indicate that pulmonary surfactant protein A facilitates the squeeze-out of cholesterol domains from mixed monolayers by condensing DPPC and limiting lateral interactions of DPPC with cholesterol domains.

The effects of surfactant-associated protein A (SP-A) on lipid adsorption to the air-water interface and accumulation of dipalmitoylphosphatidylcholine (DPPC) in the surface region were investigated at 37 degrees C. Dispersions used were bovine pulmonary lipid extract surfactant with or without neutral lipid (NL). Lipid adsorption was examined with the Wilhelmy plate technique and DPPC accumulation by monitoring surface radioactivity from [14C]DPPC with a scintillation probe. SP-A enhanced the rate of lipid adsorption, while both SP-A and NL increased the extent of DPPC accumulation. At the specific radioactivity used [14C]DPPC monolayers were undetectable: the surface radioactivity arose from surface-associated DPPC beneath the monolayer. At the highest concentration studied (0.3 mg lipid/ml), NL greatly enhanced DPPC accumulation and SP-A attenuated this effect. Langmuir-Blodgett (L-B) films were prepared from [14C]DPPC-labeled dispersions (0.3 mg lipid/ml) at equilibrium surface tension. Autoradiographs of L-B films from lipid extract surfactant exhibited a diffuse misty appearance, while NL promoted formation of heterogeneous DPPC aggregates. Addition of SP-A to lipid extracts without NL generated DPPC aggregates; more uniform larger aggregates appeared in the presence of SP-A and NL. Radiation measurements confirmed that the L-B films were composed of more than monolayers. SP-A did not increase DPPC levels in films deposited from lipid extracts unless NL was present. These results indicate that neutral lipid cooperates with surfactant-associated protein A to organize dipalmitoylphosphatidylcholine in the surface films and enhance formation of a DPPC-rich reservoir below the air-water interface.

Previous work in our laboratory has documented alterations in surfactant composition and function after prolonged lung graft storage and transplantation in dogs (Am Rev Respir Dis 1993;148:208-15). To determine whether exogenous surfactant therapy was beneficial, we pretreated 13 canine double lung blocks with prostacyclin, flushed them with 4 degrees C modified Euro-Collins solution, and stored them at 4 degrees C for 37 to 38 hours. After left lung transplantation and immediately before reperfusion, eight dogs were administered 50 mg of bovine lung lipid extract surfactant per kilogram (50 mg/ml) directly into the left main bronchus and five served as nontreated control animals. Blood gases, peak inspired pressures, and individual pulmonary artery blood flows were measured every 30 minutes during 6 hours of reperfusion. The native right and transplanted left lungs were then lavaged and surfactant large and small aggregates and protein yields were analyzed. All nontreated animals had physiologic evidence of severe ischemia-reperfusion lung injury during reperfusion. Three of eight dogs treated with bovine lung lipid extract surfactant had near normal lung function at 6 hours of reperfusion, as reflected by maintenance of an oxygen tension/inspired oxygen fraction ratio of more than 400 mm Hg and a normal carbon dioxide tension. Five of eight dogs did not respond to surfactant therapy and had decreases in gas exchange identical to those of the control animals. Blood flow through the left pulmonary artery was maintained in the three animals that responded to exogenous surfactant, whereas flow significantly decreased to the left lung in all other animals, reflecting the patterns of gas exchange. In addition, the ratio of poorly functioning small surfactant aggregates to the well-functioning large aggregates isolated from lung lavage after 6 hours of reperfusion was decreased in surfactant-treated animals, especially in those exhibiting a beneficial physiologic response to surfactant therapy. We conclude that therapy with bovine lung lipid extract surfactant can result in excellent preservation of lung grafts after prolonged storage and transplantation, but that the results are not consistent. Further investigations are required to determine the factors responsible for the differential response to surfactant therapy.

The effect of surfactant concentration and supplementation with surfactant-associated protein A (SP-A) on the surface activity of lipid extract surfactant (LES) was examined using a captive bubble technique. Adsorption of LES is strongly concentration dependent over the range of 50-1,000 micrograms/ml. Addition of SP-A to LES at low concentrations in the presence of calcium dramatically increases the rate of adsorption. In quasistatic cycling experiments, samples containing SP-A require less compression to achieve low surface tensions even during the first compression cycle. Calculated film compressibilities at 15 mN/m indicate that SP-A alters the surfactant monolayer behavior such that in a small number of cycles the compressibility is indistinguishable from that of pure DPPC. Furthermore, SP-A reduces the incidence of bubble "clicking," suggesting a stabilization of the monolayer at low surface tensions. In dynamic cycling experiments, SP-A reduces compression of the film area required to achieve a low surface tension of approximately 1 mN/m. SP-A eliminated the plateau just below 25 mN/m normally observed during the compression phase with low concentrations of LES and the shoulder observed at approximately 35 mN/m during expansion. In the presence of SP-A and, to a lesser extent with high concentrations of LES, there is a marked lag in the increase in surface tension during the initial part of the dynamic expansion loop, with surface tensions remaining near 1 mN/m for approximately 10% of the increase in bubble area. The results indicate that SP-A enhances phospholipid adsorption during dynamic cycling and may enhance elimination of non-DPPC lipids during cycling.(ABSTRACT TRUNCATED AT 250 WORDS)

The influence of the timing of surfactant replacement therapy for the treatment of neonatal respiratory distress syndrome was evaluated in a study of 182 neonates of less than 30 weeks' gestation who were randomly assigned prior to delivery to one of three study groups: control (dummy instillation of air given at birth), early surfactant (surfactant given at birth), or late surfactant (surfactant given at less than 6 hours of age). Subjects in the late surfactant group could avoid treatment if they had a clear chest roentgenogram and required no supplemental oxygen at a mean airway pressure of less than 7 cm of water. All treated neonates were eligible to receive up to three additional doses during the first 5 days of life. The three groups were comparable with respect to birth weight, gestational age, and other perinatal parameters with the exception of a lower cord arterial pH and 1-minute Apgar score in the early surfactant group. Of the 60 neonates randomly assigned to late treatment, 29 (48%) were deemed surfactant sufficient and thereby avoided treatment; the other 31 received their first dose at a mean age of 2.9 hours. There was a significant improvement in gas exchange during the first week of life in both surfactant groups compared with the control group, reflected by differences in fraction of inspired oxygen, arterial/alveolar PO2, and ventilation index (peak pressure x rate on the ventilator) (P less than .001). Surfactant therapy also resulted in a lower incidence of pulmonary air leak and severe chronic lung disease (defined as requirement for respiratory support beyond 36 weeks post-conceptional age). There were no differences between early and late surfactant groups in any of these parameters. The only statistically significant difference between the surfactant groups was that the early group had a higher incidence of mild chronic lung disease (respiratory support beyond 28 days of age) than the late treatment group (P less than .005). Neonates in the late treatment group were extubated earlier and had a shorter neonatal intensive care unit stay than control neonates (P less than .05), whereas those in the early group were not significantly different from control neonates in these parameters. It is concluded that replacement therapy with bovine lung surfactant extract in neonates of less than 30 weeks' gestation results in decreased oxygen and ventilatory requirements during the first week of life and a lower incidence of pulmonary air leak and severe chronic lung disease.(ABSTRACT TRUNCATED AT 400 WORDS)

To assess the efficacy of a multiple-dose protocol of surfactant replacement therapy in neonates of 30 to 36 weeks' gestation, 75 neonates were randomly assigned to control, single-dose surfactant, or multiple-dose surfactant groups. Neonates at less than 6 hours of age with a diagnosis of respiratory distress syndrome were eligible. Subjects were randomly assigned to receive either 100 mg/kg of bovine surfactant or air placebo. Neonates in the multiple-dose group were eligible to receive up to three additional doses as indicated. Neonates in both surfactant groups showed a positive response to treatment, with marked improvement in oxygenation by 10 minutes postinstillation (P less than .0001). Both surfactant groups had better oxygenation than control subjects at lower ventilatory parameters over the first 24 hours. A deterioration in oxygenation and ventilatory requirements was seen in both treatment groups starting 6 to 12 hours after the first dose. The deterioration in oxygenation could be minimized by the use of multiple doses; however, extra doses had no effect on diminishing ventilatory requirements or time to extubation. It is concluded that surfactant therapy at less than 6 hours of age is effective in acutely reducing oxygen and ventilatory requirements in neonates of 30 to 36 weeks' gestation with respiratory distress syndrome. It appears that multiple doses of surfactant have a greater effect on sustaining improvements in oxygenation than on ventilatory requirements. Further study is required to determine optimal dosage and retreatment strategy.

We previously found that glucocorticoid treatment of pregnant sheep increases the content of surfactant proteins SP-A and SP-B in lung tissue and lavage of preterm lambs. To investigate the mechanism of this induction process, we quantitated SP mRNA levels after administration of betamethasone(0.5 mg/kg) to pregnant sheep prior to premature delivery of the fetus at 125 days. In the first protocol, 55 sheep were injected weekly with 1-4 doses of either saline (control) or betamethasone beginning at 104 days gestation with the last dose given 24 h prior to delivery. In a second protocol, 39 sheep were injected with 1-2 doses of saline or betamethasone at 24 and 48 h prior to delivery. Total RNA was extracted from fetal lung and hybridized with cDNAs for sheep SP-A, SP-B and SP-C and human β-actin. mRNA levels for control preterm lambs were 21%, 28% and 39% of the level in term lambs for SP-A, -B and -C, respectively. No increases in mRNA levels were demonstrated in sheep given 1-3 weekly doses of betamethasone vs. control. However, 4 doses of betamethasone, as well as both 48h treatment regimens, produced a 2- to 3-fold increase in each SP mRNA (p

The mammalian lung is stabilized by a specialized material, the pulmonary surfactant, which acts by reversibly reducing the surface tension at the air–liquid interface of the lung during breathing. Pulmonary surfactant contains approximately 90% lipid and 10% proteins. Dipalmitoyl phosphatidylcholine, the major lipid component, appears to be primarily responsible for the ability to reduce surface tension to near 0 dyn/cm (1 dyn = 10 μN). The other components of pulmonary surfactant promote the adsorption and spreading of this disaturated lecithin at the air–liquid interface. Surfactant activity can be accessed by physical and biological assays. Apparent discrepancies between the results obtained with the Wilhelmy plate surface balance and the pulsating bubble surfactometer have led to the suggestion that separate "protein-facilitated" (catalytic type) and "protein-mediated" (chemical type) processes may be involved in adsorption and (or) spreading at the different surfactant concentrations used with these two techniques. Artificial surfactants, which mimic the essential properties of the natural product with the pulsating bubble surfactometer, can be produced with synthetic lipids. Treatment of prematurely delivered infants suffering from the neonatal respiratory distress syndrome with lipid extracts of pulmonary surfactant leads to a marked improvement in gaseous exchange.

Under optimal conditions, rat lung microsomal cholinephosphotransferase (EC 2.7.8.2) activity is markedly stimulated by exogenously added 1,2-sn-diacylglycerols containing an unsaturated fatty acid at the 2-position. Diacylglycerols containing long-chain saturated fatty acids at the 1- and 2-positions did not stimulate the incorporation of CDP[14C]choline above the incorporation observed with the endogenous diacylglycerols present in the microsomal preparation. 1-Oleoyl,2-palmitoyl-sn-glycerol was also ineffective in stimulating phosphatidylcholine synthesis. Diacylglycerols containing linoleate or linolenate at the 2-position were not as effective as 1-palmitoyl,2-oleoyl-sn-glycerol. Identical stimulations were observed with the latter diacylglycerol and 'natural' diacylglycerols prepared from egg-yolk phosphatidylcholine or pig liver phosphatidylcholine. Marked selectivities were observed with diacylglycerols containing two unsaturated fatty acids. Only minor amounts of 1,2-[14C]dipalmitoyl-sn-glycerol were incorporated into phosphatidylcholine, even when this radioactive diacylglycerol was dispersed with 'egg' diacylglycerols. When CDP[14C]choline was incorporated into rat lung microsomal lipids with endogenous diacylglycerols or diacylglycerols endogenously generated by phospholipase C (EC 3.1.4.3) (Bacillus cereus), little radioactivity was associated with the disaturated species of phosphatidylcholine.It has previously been suggested that cholinephosphotransferase catalyses the rate-limiting reaction in the biosynthesis of phosphatidylcholine by lung and that this enzyme is specifically induced in fetal lung by glucocorticoids. The present results indicate that these proposals are untenable and must be reevaluated. These experiments also suggest that dipalmitoyl phosphatidylcholine is not synthesized readily by the de novo pathway for lecithin synthesis and must be produced through reacylation or transesterification mechanisms.

Six preterm infants with severe hyaline membrane disease requiring ventilation were treated, at a median age of 15.5 hours, with a single intratracheal bolus of a bovine surfactant suspension. Arterial oxygenation increased dramatically, and chest radiograms showed improvement after two to four hours. However, a variable degree of deterioration occurred within 24 hours. All of the infants required oxygen therapy for several weeks, and one developed severe bronchopulmonary dysplasia.

Studies have been carried out on the incorporation of32P-labeled α-glycerophosphate (α-G32P) into the lipids of preparations obtained from rat brain cerebral hemispheres. The optimal incorporating system contains Tris and phosphate buffers (pH 7.4), MgCl2, CoA, EDTA, NaF and ATP. The incorporation of α-G32P into monophosphoinositide was stimulated by CDP-choline, CDP-ethanolamine, CDP-glycerol and CTP. These nucleotides depressed the incorporation of α-G32P into phosphatidic acid. Microsomal preparations supported a high incorporation of α-G32P into phosphatidic acid, but the incorporation into monophosphoinositide was low compared with the whole homogenate. Similar observations were made with mitochondrial preparations undergoing oxidative phosphorylation with CoA added to the medium.

Previous investigations conducted in this laboratory showed a number of differences in the cytosine nucleotide requirement for the incorporation of α-glycerophosphate (α-G32P) into the monophosphoinositide of rat brain preparations compared to the pathway described by Paulus and Kennedy, where α-glycerophosphate → phosphatide acid → CDP-diglyceride → monophosphoinositide, and CTP is specifically required. Experiments were carried out with rat brain preparations to determine the nature of the mechanism whereby CDP-choline is as effective as or more effective than CTP in stimulating the incorporation of α-G32P into monophosphoinositide. Isotope dilution experiments in which unlabeled phosphatidic acid and CDP-diglyceride were used, yielded results consistent with the view that both of these compounds are intermediates in the incorporation of a-G32P into monophosphoinositide stimulated by either CTP or CDP-choline. Time-course experiments where cytosine nucleotides were added either at the beginning or after 20 minutes produced a pattern of labeling which could be fitted into the above interpretation, provided that newly formed radioactive molecules of phosphatide acid could be used selectively and CTP in some way inhibits phosphatide acid formation or accumulation. The latter could account for the observation that monophosphoinositide becomes far more actively labeled than phosphatidic acid in the presence of added CTP.

1. Progressive changes were noted in the pool sizes of choline in fetal rabbit lung between 25 and 30 days gestation (term, 31 days) and between 30 days gestation and adult lung. The level of choline in adult lung was double the level in the fetal lung at 25 days gestation. The pool size of choline phosphate decreased 10-fold during this period while the level of CDPcholine decreased by 30%. The phosphatidylcholine content increased 3-fold during development. The major change in the relative pool sizes was a marked decrease in the ratio of choline phosphate to CDPcholine from 26:1 at 25 days gestation to 3.4:1 in adult lung. 2. No differences were detected between the uptake of [14C]choline into slices from fetal lungs at 25 days gestation or slices from adult lung. However, the ability of the adult slices to convert [14C]choline into its derivatives was 30% lower than slices from fetal lung. In addition, whereas fetal slices contained significantly more radioactivity in choline phosphate and CDPcholine, adult slices incorporated significantly more [14C]choline into phosphatidylcholine. Experiments with [3H]choline and 32Pi revealed that the 3H/32P ratio of choline phosphate in fetal or adult slices was identical to the isotopic ratio in phosphatidylcholine, indicating that under the experimental conditions, negligible radioactivity was incorporated by base-exchange. Because of the marked decrease in the pool size of choline phosphate during development, it cannot be concluded that the increase in the incorporation of radioactive choline into phosphatidylcholine is indicative of increased production of phosphatidylcholine by the de novo pathway. The results suggest that if the de novo pathway is responsible for the increase in phosphatidylcholine content, this increase is due to a change in the parameter controlling the flux through the choline phosphate cytidylyltransferase step. The results also indicate that the metabolic flux through choline phosphotransferase is also enhanced during pulmonary development.

1. Administration of estradiol-17 beta to pregnant rabbits at 25 days gestation (term, 31 days) resulted n a significant increase in the incorporation of [14C]-choline, but not [14C]ethanolamine, into the lipids of fetal lung slices. The incorporation of [35S]methionine was not affected. 2. Enzymatic assays conducted in vitro revealed no significant effect on either the activities of several enzyme markers for subcellular organelles, the activities of the enzymes responsible for the production of phosphatidylglycerol and phosphatidylinositol, membrane-bound or aqueously dispersed phosphatidate-dependent phosphatidic acid phosphohydrolase activities or the activities of the auxiliary enzymes responsible for the synthesis of dipalmitoylphosphatidylcholine. 3. The activity of the enzymes involved in the choline pathway for the de novo biosynthesis of phosphatidylcholine were not significantly altered except for a 66% increase in the CTP:cholinephosphate cytidylyltransferase activity assayed in the cytosol. The addition of phosphatidylglycerol stimulated cholinephosphate cytidylyltransferase activity approx. 3-fold. However, in the presence of this lipid, the activities in cytosol from control and treated fetuses were similar, indicating that the increased activity noted in the absence of phosphatidylglycerol was due to an activation of existing cytidylyltransferase activity rather than an increase in total enzyme units. 4. Estrogen treatment of the does was also associated with a marked decrease in the levels of cholinephosphate in fetal lung and significant increases in the levels of CDPcholine and phosphatidylcholine. These alterations in pool size are consistent with an increase in the activity of cholinephosphate cytidyltransferase in vivo. The results suggest that cholinephosphate cytidylyltransferase may catalyse an important rate-determining reaction in the synthesis of phosphatidylcholine in fetal lung. The data also support the view that the reaction catalysed by CDPcholine:diacylglycerol cholinephosphotransferase also has a regulatory role during development.

The role of Adrenocorticotrophin (ACTH), administered in physiological doses (12 micrograms/d), on lung maturation was investigated in the intact ovine fetus at 127-130 days of gestation. ACTH1-24 was administered in a pulsatile or continuous dose for 72 hours. Compared to untreated twins (n = 4) and saline infused fetuses (n = 4), the lungs of the pulsatile-ACTH (n = 10) and continuous-ACTH (n = 4) treated fetuses showed accelerated prepartum maturation by all indices used. Lung distensibility (V40-ml of air per g of wet lung at 40 cm H2O pressure), as determined by pressure-volume curves with air was 1.62 +/- 0.18 vs 0.72 +/- 0.23 and 0.66 +/- 0.12 while the stability (Vo-ml of air per g of wet lung at atmospheric pressure) was 0.33 +/- 0.07 vs 0.10 +/- 0.01 and 0.21 +/- 0.09 for the P-ACTH group vs the control groups (P less than 0.005). In the continuous-ACTH group vs their untreated twins the distensibility was 1.58 +/- 0.10 vs 0.56 +/- 0.11 while the stability was 0.83 +/- 0.20 vs 0.09 +/- 0.01 respectively (less than 0.005). Phosphotidylcholine concentration in lavage fluid increased from 0.05 +/- 0.02 mg/g of lung to 0.24 +/- 0.07 in the pulsed-ACTH group compared to untreated twin fetuses (P less than 0.05). Morphologically the lungs of the treated groups were well aerated with thin walled airsacs. In both treated groups, there was a doubling of the adrenal weight (P less than 0.005). Fetal plasma cortisol basal level increased from less than 5 ng/ml to 143.5 +/- 66.5 ng/ml in the continuous-ACTH group while it only rose to 36.6 +/- 7.5 ng/ml in the pulsed-ACTH group by 72 hours. Superimposed on the rise in basal fetal cortisol, there was an acute increase in cortisol temporally related to each ACTH pulse; the peaks reaching levels indistinguishable from the levels of the continuous-ACTH infusion. It is concluded that the administration of low doses of ACTH markedly accelerate prepartum maturation of the intact ovine lung over 72 hours. The mechanism by which ACTH exerts this powerful maturation effect on the fetal lung remains to be elucidated.

Six preterm infants with severe hyaline membrane disease requiring ventilation were treated, at a median age of 15.5 hours, with a single intratracheal bolus of a bovine surfactant suspension. Arterial oxygenation increased dramatically, and chest radiograms showed improvement after two to four hours. However, a variable degree of deterioration occurred within 24 hours. All of the infants required oxygen therapy for several weeks, and one developed severe bronchopulmonary dysplasia.

With a randomized clinical trial, the possibility was assessed that a tracheal instillation of pulmonary surfactant prior to the first breath might prevent the development of some of the signs of neonatal respiratory distress syndrome. Of the 72 infants in the trial, all born at a gestational age of less than 30 weeks, 39 received 3 or 4 mL of surfactant, prepared from the lipids extracted from calf lung lavage. The treatment resulted in a significantly improved gas exchange during the first 72 hours of life. On the average, the arterial/alveolar PO2 ratio was 0.15 higher for the treated infants, and only about half as much extra oxygen had to be supplied. The respiratory support (peak inspiratory pressure X frequency) could be lowered significantly. Pulmonary interstitial emphysema occurred in 13 of the 33 control infants, but in only three of the 39 treated infants. Six of the control infants died in the neonatal period, but only one treated infant died. It is concluded that surfactant supplementation prior to the first breath is feasible and is of value as protection against the respiratory distress syndrome and the negative effects of hypoxia and ventilatory support.

1. The developmental patterns of the phosphatidic acid phosphohydrolase activities in developing rabbit lung were determined using both aqueously dispersed phosphatidic acid (PAaq) and membrane-bound phosphatidic acid (PAmb) as the substrates. 2. The specific activities and the total activities of the PAmb-dependent phosphohydrolase activities in the microsomes and to a lesser extent in the homogenates increased between 26 and 30 days gestation (term 31), but decreased in the adult. The PAaq-dependent activities demonstrated a smaller increase during late gestation and a decrease in the adult. 3. There was little change in either the Paaq- or the Pamb-dependent activities in the cytosol between 25 and 30 days gestation. The total activities per g lung were increased in the adult. 4. Fractionation of adult cytosol on Bio-Gel A5m revealed PAaq-dependent activities in the void volume (Vo) (50% total), a peak with an apparent molecular mass (Mr) = 150 kdaltons (25% total) and a peak with Mr = 110 kdaltons (25% total). The PAaq-dependent peak with Mr = 150 kdaltons was not detected in the fetal cytosols. 5. Gel filtration revealed PAmb-dependent activity in the Vo (15% total), a major peak with an apparent Mr = 390 kdaltons (44% total) and minor peaks with Mr = 240 kdaltons (16% total) and Mr = 110 kdaltons (24% total). Little change was observed during development. 6. Thermal denaturation studies on he PAmb-dependent activities in the cytosols produced biphasic curves with a rapidly inactivated component and a relatively heat-stable component. The thermal denaturation profiles for the PAmb-dependent activities remained relatively unaltered throughout fetal development. The thermal denaturation profiles of the PAaq-dependent activities in the fetal cytosols were also biphasic. In contrast, the inactivation profiles of the PAaq-dependent activities in adult cytosol were monophasic.

1. 1. The optimal conditions for the incorporation of sn-[ 14 C ] glycerol -3-P into rat brain homogenates has been determined. 2. 2. Under the standard conditions, most of the radioactivity was incorporated into phosphatidic acid, but label was also found in phosphatidyl inositol and the neutral glycerides. 3. 3. The presence of CMP, CDP or CTP (0.2 mM) markedly decreased the incorporation of sn-14C]glycerol-3-P into the total lipids. This depression was due to a striking decrease in the labelling of phosphatidic acid. The incorporation into phosphatidyl inositol was increased by these nucleotides. The incorporation into the glycerides was slightly decreased or not affected. 4. 4. CDP-choline consistently increased the incorporation into the total lipids. 5. 5. These results indicate that the cytidine nucleotides, particularly CTP, can modify the acylation of sn-glycerol-3-P. Since this activity is responsible for the first step in the de novo biosynthesis of diacylglycerolipids, the effect could play an important role in the regulation of phospholipid production for membranes.

1. The regional and subcellular distribution of the incorporation of sn-[14C]glycerol 3-phosphate into rat brain lipids in vitro was investigated and compared with the relative specific activity of various chemical and enzyme markers. The similarity between the subcellular distribution of this incorporation and of NADPH-cytochrome c reductase activity indicated that the synthesis of phosphatidic acid via this route correlated with the presence of endoplasmic reticulum. 2. Experiments in which various amounts of the microsomal fraction were added to fixed amounts of nuclear, myelin, nerve-ending and mitochondrial preparations clearly demonstrated that the endoplasmic-reticulum contamination of these fractions was entirely responsible for the incorporation of sn-[14C]glycerol 3-phosphate. 3. The presence of CMP or CTP inhibited the incorporation of sn-[14C]glycerol 3-phosphate into the whole homogenate. Similar effects were observed with individual fractions, except for the mitochondria. With the mitochondrial fraction the effect of these cytidine nucleotides varied with the preparation, stimulating in some preparations and inhibiting with other preparations. The presence of CDP-choline stimulated the incorporation into the whole homogenate and to a lesser extent into the subcellular fractions. 4. These results indicate that the various organelles of the central nervous system are more dependent on endoplasmic reticulum for the production of glycerolipids de novo than has previously been appreciated.