RESPIRATORY DISTRESS SYNDROME

Structure of lung surfactant

Lipids - 90% of lung surfactant
Dipalmitoylphosphatidylcholine DPPC orLecithin, is functionally the principle
phospholipid and phosphatidyl glycerol.
remainder-phosphotidylinositol,phosphtidylethanolamine,phosphatidylserine
Protein - 10% of lung surfactant
Consists of small proteins- Hydrophobic protein
SP-B and SP-C
Hydrophilic proteins
SP-A and SP-D
SYNTHESIS
Type II pneumocyte cells appear at 20-22wks
By 30-32 weeks sufficient amount of surfactant secreted into cytosol as lamellar
bodies.
These get assembled in alveolar lumen as tubular myelin
ARDS
In adults, severe lung injury can develop in association with sepsis,pneumonia,injury
due to trauma or surgery
It leads to massive influx of neutrophils
Massive pulmonary edema and impairment of surfactant
Neutrophilic proteinases break down surfactant proteins
Therapeutic strategy- surfactant and antiproteinase(recombinant 1 antitrypsin)