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J Appl Physiol 89: 1283-1292, 2000;
8750-7587/00 $5.00
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Vol. 89, Issue 4, 1283-1292, October 2000

Altered airway surfactant phospholipid composition and reduced lung function in asthma

Sarah M. Wright1,*, Peter M. Hockey2,*, Goran Enhorning3, Peter Strong4, Kenneth B. M. Reid4, Stephen T. Holgate2, Ratko Djukanovic2, and Anthony D. Postle1

Departments of 1 Child Health and 2 Medicine, University of Southampton, Southampton SO16 6YD, United Kingdom; 3 Department of Gynecology-Obstetrics, State University of New York at Buffalo, Buffalo, New York 14222-2099; and 4 MRC Immunochemistry Unit, Department of Biochemistry, University of Oxford, Oxford OX1 3QU, United Kingdom

Pulmonary surfactant in bronchoalveolar lavage fluid (BALF) and induced sputum from adults with stable asthma (n = 36) and healthy controls (n = 12) was analyzed for phospholipid and protein compositions and function. Asthmatic subjects were graded as mild, moderate, or severe. Phospholipid compositions of BALF and sputum from control subjects were similar and characteristic of surfactant. For asthmatic subjects, the proportion of dipalmitoyl phosphatidylcholine (16:0/16:0PC), the major phospholipid in surfactant, decreased in sputum (P < 0.05) but not in BALF.1 In BALF, mole percent 16:0/16:0PC correlated with surfactant function measured in a capillary surfactometer, and sputum mole percent 16:0/16:0PC correlated with lung function (forced expiratory volume in 1 s). Neither surfactant protein A nor total protein concentration in either BALF or sputum was altered in asthma. These results suggest altered phospholipid composition and function of airway (sputum) but not alveolar (BALF) surfactant in stable asthma. Such underlying surfactant dysfunction may predispose asthmatic subjects to further surfactant inhibition by proteins or aeroallergens in acute asthma episodes and contribute to airway closure in asthma. Consequently, administration of an appropriate therapeutic surfactant could provide clinical benefit in asthma.

asthma; surfactant; phospholipid; mass spectrometry

* S. M. Wright and P. M. Hockey contributed equally to the experimental work presented in this paper.

1 Phospholipid molecular species are designated as A:n/B:nPX, where A and B are the number of carbon atoms of the fatty acyl groups esterified at sn-1 and sn-2, n is the number of unsaturated double bonds in each fatty acid, and X is the headgroup (choline, glycerol, serine, or inositol). 16:0a/18:1PC is a plasmanyl species containing an ether bond at sn-1.




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