Development of a human lung surfactant, derived from extracted amniotic fluid

Area of Science:

• Biochemistry
• Neonatal Medicine
• Pulmonary Medicine

Background:

• Respiratory distress syndrome (RDS) is a common condition in preterm neonates.
• Animal-derived surfactants, while effective, can cause immunological issues.
• Human-derived surfactants may offer a safer alternative by minimizing immunological reactions.

Purpose of the Study:

• To isolate and characterize surfactant material from human amniotic fluid (HAFS).
• To evaluate the efficacy of HAFS fractions in a fetal rabbit model of RDS.
• To compare HAFS performance against animal-derived surfactant (ovine lung lavage - EOS) and a clinical surfactant (Curosurf).

Main Methods:

• Human amniotic fluid surfactant (HAFS) was extracted and separated into protein and phospholipid fractions using Lipidex 5000 and LH20 chromatography.
• Fractions were tested in a 27-day fetal rabbit model.
• Lung compliance and stability (V5) were measured and compared to EOS and Curosurf.

Main Results:

• HAFS, EOS, and their combined fractions significantly improved lung compliance compared to saline.
• Lung stability (V5) varied among the tested surfactants.
• Lipidex-processed HAFS, especially when enriched with palmitic acid, demonstrated improved stabilizing capacity.

Conclusions:

• Human amniotic fluid surfactant is a viable alternative for RDS treatment.
• Lipidex chromatography followed by palmitic acid enrichment yields the most effective human surfactant extract to date.
• Further development is ongoing for clinical use in preterm neonates.