• Clinical and Experimental Pediatrics
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• v.57 no.4
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• pp.157-163
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• 2014

Respiratory distress syndrome (RDS) among preterm infants is typically due to a quantitative deficiency of pulmonary surfactant. Aside from the degree of prematurity, diverse environmental and genetic factors can affect the development of RDS. The variance of the risk of RDS in various races/ethnicities or monozygotic/dizygotic twins has suggested genetic influences on this disorder. So far, several specific mutations in genes encoding surfactant-associated molecules have confirmed this. Specific genetic variants contributing to the regulation of pulmonary development, its structure and function, or the inflammatory response could be candidate risk factors for the development of RDS. This review summarizes the background that suggests the genetic predisposition of RDS, the identified mutations, and candidate genetic polymorphisms of pulmonary surfactant proteins associated with RDS.

• Tuberculosis and Respiratory Diseases
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• v.38 no.3
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• pp.228-235
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• 1991

Pulmonary surfactant is a lipoprotein complex composed primarily of phospholipid and lungspecific apoproteins that reduces surface tension in the alveolus and maintains alveolar stability at low lung volume. Three families of lung-specific apoproteins have been described: SP-A, a glycoprotein with a reduced molecular weight of 28~36 KDa. SP-B a hydrophobic protein with a nonreduced molecular weight of 18 KDa, and SP-C a hydrophobic protein with a non-reduced molecular weight of 5~8 KDa. Surfactant proteins have important roles in regulating surfactant metabolism as well as in determining its physical properties. The synthesis of the active surfactant peptides appears to be modulated by system with considerable complexity, including numerous levels of regulation such as cell-specific, hormonal and developmental controls. Endotoxin appears to alter surfactant protein mRNAs differentially. It is hoped that the elucidation of the factors controlling the synthesis and metabolism of the surfactant proteins will aid in understanding the pathogenesis of hyaline membrane disease and offer new avenues for the therapy and diagnosis of ther pulmonary disorders as well.

• The Korean Journal of Physiology
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• v.28 no.1
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• pp.71-77
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• 1994

In the animal model of acute respiratory distress syndrome (ARDS) induced by N-nitroso-N-methylurethane (NNNMU) the secretory activity of alveolar type H cells during acute alveolar injury was investigated by determining phospholipid and pulmonary surfactant associated proteins in crude surfactant. The mechanism of the secretory change was studied by determination of DNA and RNA levels in the lung tissue. After induction of acute alveolar injury with NNNMU, pulmonary hemorrhage, atelectasis and gross hypertrophy were observed. Seven days after NNNMU treatment the level of total DNA in lung homogenate was increased markedly indicating that a hypertrophy was induced by cellular proliferation. Although the total DNA level increased, the RNA/DNA ratio was gradually decreased after NNNMU treatment. Seven days after NNNMU treatment the RNA/DNA ratio returned to the normal control level. During the acute alveolar injury, phospholipid and surfactant associated proteins were reduced significantly as compared with the control, implying that the secretory activity of alveolar type II cells was altered during acute alveolar injury induced by NNNMU. The protein content in crude surfactant during peak injury(7 days after NNNMU) was decreased significantly but phospholipid/protein ratios were identical in both control and NNNMU treatment groups. SDS-PAGE of proteins in crude pulmonary surfactant showed a decrease in major surfactant associated protein(M.W. 38,000) during acute alveolar injury. The present study may suggest that while alveolar type H cells proliferate markedly, transcription of alveolar type ll cell gene was inhibited by an unknown mechanism such as DNA methylation induced by NNNMU. Such an inhibition of transcriptional activity is thought to be associated with the decreased secretory activity of alveolar type ll cells, which may lead to pulmonary atelectasis and edema during the acute alveolar injury.