Effects of intralipid and hydrocortisone upon human fetal lung cell cultures

Organotypic cell culture systems of human fetal lungs of 15, 18, and 26 weeks' gestational age were treated with Intralipid, a phosphatidylcholine-containing lipid mixture, and with hydrocortisone of varying concentrations. The lamellar bodies found in the pneumocytes type II were ultrastructurally identified. Their amount was quantitated by point-counting, a morphometrical method. Intralipid had a stimulating effect upon the surfactant production depending on the concentration admitted. This effect was quantitatively compared to the known effect of hydrocortisone. Intralipid at a concentration of 10(-2%) produced a significant increase of the relative volume of lamellar bodies (P = 0.05) at a gestational age of 18 weeks. This effect is comparable to hydrocortisone treatment at a concentration of 10(-1%) (P = 0.05) and 10(-3%) (P = 0.01). At a gestational age of 26 weeks, Intralipid at a concentration of 10(-1%) (P = 0.01) stimulated lamellar body production. Hydrocortisone had a similar effect at a concentration of 10(-1%) (P = 0.01). Intralipid does not pass the placenta-barrier and is locally applied by amniocentesis. Therefore, complications to the maternal organism and probably to the fetuses are negligible. The application of Intralipid represents an alternative method to accelerate antenatal surfactant production and to improve the rate of survival of preterm infants.