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. 1978 Sep;92(3):581–594.

Hyaline membrane disease. Effect of surfactant prophylaxis on lung morphology in premature primates.

E Cutz, G Enhörning, B Robertson, W G Sherwood, D E Hill
PMCID: PMC2018265  PMID: 99046

Abstract

Neonatal lung morphology was evaluated in 12 rhesus monkeys delivered by caesarean section 1 month before term and cared for as human premature neonates. In 6 monkeys, 0.20 to 0.27 ml of natural rabbit surfactant (SA) was instilled intratracheally before the first breath; the other 6 served as controls. Histology and morphometry of the controls' lungs revealed changes typical of hyaline membrane disease (HMD) in human premature infants, whereas the SA-treated lungs showed improved alveolar expansion and only minor lesions typical of HMD. Transmission and scanning electron microscopy of the controls' lungs showed extensive necrosis and desquamation of bronchiolar epithelium, with formation of hyaline membranes; Type I alveolar epithelial cells showed lesions similar to those in bronchioles, but immature Type II cells appeared relatively well preserved. In the lungs of SA-treated animals, the epithelial lining of most airways and alveoli was intact. This first demonstration of the beneficial effect of exogenous SA on lung adaptation in premature primates indicates that prophylaxis with SA might prevent HMD in premature human infants.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bowden D. H., Adamson Y. R. Reparative changes following pulmonary cell injury. Ultrastructural, cytodynamic, and surfactant studies in mice after oxygen exposure. Arch Pathol. 1971 Oct;92(4):279–283. [PubMed] [Google Scholar]
  2. Castleman W. L., Dungworth D. L., Tyler W. S. Intrapulmonary airway morphology in three species of monkeys: a correlated scanning and transmission electron microscopic study. Am J Anat. 1975 Jan;142(1):107–121. doi: 10.1002/aja.1001420108. [DOI] [PubMed] [Google Scholar]
  3. Enhorning G., Robertson B., Milne E., Wagner R. Radiologic evaluation of the premature newborn rabbit after pharyngeal deposition of surfactant. Am J Obstet Gynecol. 1975 Feb 15;121(4):475–480. doi: 10.1016/0002-9378(75)90078-2. [DOI] [PubMed] [Google Scholar]
  4. Enhörning G., Grossman G., Robertson B. Tracheal deposition of surfactant before the first breath. Am Rev Respir Dis. 1973 Jun;107(6):921–927. doi: 10.1164/arrd.1973.107.6.921. [DOI] [PubMed] [Google Scholar]
  5. Enhörning G., Robertson B. Lung expansion in the premature rabbit fetus after tracheal deposition of surfactant. Pediatrics. 1972 Jul;50(1):58–66. [PubMed] [Google Scholar]
  6. Epstein M. F., Farrell P. M. The choline incorporation pathway: primary mechanism for de novo lecithin synthesis in fetal primate lung. Pediatr Res. 1975 Aug;9(8):658–665. doi: 10.1203/00006450-197508000-00009. [DOI] [PubMed] [Google Scholar]
  7. Farrell P. M., Avery M. E. Hyaline membrane disease. Am Rev Respir Dis. 1975 May;111(5):657–688. doi: 10.1164/arrd.1975.111.5.657. [DOI] [PubMed] [Google Scholar]
  8. Gluck L., Kulovich M. V. Fetal lung development. Current concepts. Pediatr Clin North Am. 1973 May;20(2):367–379. doi: 10.1016/s0031-3955(16)32849-8. [DOI] [PubMed] [Google Scholar]
  9. Kotas R. V., Avery M. E. Accelerated appearance of pulmonary surfactant in the fetal rabbit. J Appl Physiol. 1971 Mar;30(3):358–361. doi: 10.1152/jappl.1971.30.3.358. [DOI] [PubMed] [Google Scholar]
  10. Lauweryns J. M. "Hyaline membrane disease" in newborn infants. Macroscopic, radiographic, and light and electron microscopic studies. Hum Pathol. 1970 Jun;1(2):175–204. doi: 10.1016/s0046-8177(70)80033-8. [DOI] [PubMed] [Google Scholar]
  11. Liggins G. C., Howie R. N. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics. 1972 Oct;50(4):515–525. [PubMed] [Google Scholar]
  12. McAdams A. J., Coen R., Kleinman L. I., Tsang R., Sutherland J. The experimental production of hyaline membranes in premature rhesus monkeys. Am J Pathol. 1973 Mar;70(3):277–290. [PMC free article] [PubMed] [Google Scholar]
  13. McDowell E. M., Trump B. F. Histologic fixatives suitable for diagnostic light and electron microscopy. Arch Pathol Lab Med. 1976 Aug;100(8):405–414. [PubMed] [Google Scholar]
  14. Nilsson R., Grossmann G., Robertson B. Lung surfactant and the pathogenesis of neonatal bronchiolar lesions induced by artificial ventilation. Pediatr Res. 1978 Apr;12(4 Pt 1):249–255. doi: 10.1203/00006450-197804000-00001. [DOI] [PubMed] [Google Scholar]
  15. Robertson B. Current and counter-current theories on lung surfactant. Scand J Respir Dis. 1976;57(5):199–207. [PubMed] [Google Scholar]
  16. Robertson B., Enhorning G. The alveolar lining of the premature newborn rabbit after pharyngeal deposition of surfactant. Lab Invest. 1974 Jul;31(1):54–59. [PubMed] [Google Scholar]
  17. Schwieler G. H., Robertson B. Liquid ventilation in immature newborn rabbits. Biol Neonate. 1976;29(5-6):343–353. doi: 10.1159/000240884. [DOI] [PubMed] [Google Scholar]

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