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EDITORIAL FOCUS

Lysophospholipid generation and phosphatidylglycerol depletion in phospholipase A₂-mediated surfactant dysfunction

¹Department of Internal Medicine/Sections of Pulmonary and Critical Care Medicine and ²Molecular Medicine, Departments of ³Microbiology and Immunology and ⁴Biochemistry, Wake Forest University School of Medicine, Winston-Salem, North Carolina

Submitted 19 July 2004 ; accepted in final form 13 October 2004

Pulmonary surfactant's complex mixture of phospholipids and proteins reduces the work of breathing by lowering alveolar surface tension during respiration. One mechanism of surfactant damage appears to be the hydrolysis of phospholipid by phospholipases activated in the inflamed lung. Humans have several candidate secretory phospholipase A₂ (sPLA₂) enzymes in lung cells and infiltrating leukocytes that could damage extracellular surfactant. We considered two mechanisms of surfactant disruption by five human sPLA₂s, including generation of lysophospholipids and the depletion of specific phospholipids. All five sPLA₂s studied ultimately caused surfactant dysfunction. Each enzyme exhibited a different pattern of hydrolysis of surfactant phospholipids. Phosphatidylcholine, the major phospholipid in surfactant and the greatest potential source for generation of lysophospholipids, was susceptible to hydrolysis by group IB, group V, and group X sPLA₂s, but not group IIA or IID. Group IIA hydrolyzed both phosphatidylethanolamine and phosphatidylglycerol, whereas group IID was active against only phosphatidylglycerol. Thus, with groups IB and X, the generation of lysophospholipids corresponded with surfactant dysfunction. However, hydrolysis of and depletion of phosphatidylglycerol had a greater correlation with surfactant dysfunction for groups IIA and IID. Surfactant dysfunction caused by group V sPLA₂ is less clear and may be the combined result of both mechanisms.

lung injury; asthma; surface tension

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