SURFACTANT
PRESENTATION
OUTLINE
➢ Overview of Surfactant
➢ Definition and source of secretion
➢ Structure and Composition
➢ Formation of Surfactant
➢ Requirement for its synthesis
➢ Functions
➢ Clinical correlation
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➢ Overview of Surfactant
❖ Surfactant is a complex mixture of phospholipids (PL) and
proteins (SP) that reduce surface tension at the air-liquid
interface of the alveolus, thus preventing its collapse
during end-exhalation.
❖ It also participates in innate host defense against
inhaled pathogens
❖ When water forms a surface with water, the water molecules
on the surface of the water have strong attraction for
one another. As a result, water surface is always
attempting to contract. This is what holds raindrops
together.
❖ On the inner surfaces of the alveoli the water surface is also
attempting to contract, tending to force air out of the
alveoli through the bronchi causing collapse.
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➢ DEFINITION AND SOURCE OF SECRETION
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➢ Pulmonary Surfactant Structure and Its
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➢ Pulmonary Surfactant Structure and Its
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➢ Pulmonary Surfactant Structure and Its
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➢ Pulmonary Surfactant Structure and Composition
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➢ Pulmonary Surfactant Structure and Its Composition
1. Lipids: 90%
•Dipalmitoylphosphatidylcholine (62%)
•Phosphatidylglycerol (5%)
•Other phospholipids (10%)
•Neutral lipids (13%)
2. Proteins: 8%
•Albumin
•Immunoglobulin A (IgA)
•Apoproteins (SP-A, -B, -C, - D)
3. Carbohydrates: 2%
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➢ Regulation of Synthesis and
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➢ Regulation of Synthesis and
● Surfactant synthesis is regulated by hormones,
● Concentration of protein in the surfactant,
● Stretching of lung and
● Various pharmacological agents.
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A. Hormonal factors
1. Glucocorticoid hormones: Cortisol stimulates surfactant synthesis.
Secretion of glucocorticoids increases
toward term. Number of glucocorticoid receptors in
lungs also increases in third trimester of pregnancy.
2. Thyroxine: Thyroxine promotes surfactant
synthesis. Maternal thyroid deficiency and cretinism
decrease surfactant secretion.
3. Insulin: Insulin facilitates surfactant synthesis. Therefore, diabetes
during pregnancy decreases surfactant secretion
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B. Quantity and quality of proteins in surfactant
Formation of phospholipid film of surfactant is greatly
facilitated by proteins present in the surfactant. Surfactant
proteins are albumin, immunoglobulin (IgA) and apoproteins (surfactant
proteins).
1. There are 4 types of surfactant proteins (SP): SP-
A, SP-B, SP-C, and SP-D. SP-B and SP-C control
synthesis of monomolecular film of phospholipid.
2. SP-A controls reuptake of surfactant by type II cells.
3. The protein content of surfactant depends on concen
tration of protein in the plasma. 13
C. Stretching of lungs
•Hyperinflation of lungs like yawning enhances surfactant synthesis.
Yawning and sighing during infancy are effective stimuli for surfactant synthesis.
D. Pharmacological agents
• β adrenergic agonists enhance surfactant secretion
• Calcium stimulates surfactant secretion.
E. Exercise
Practice of regular physical exercise stimulates surfactant
synthesis in both children and adults.
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➢ Formation of Surfactant
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➢ Synthesis and Secretion
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➢ Functions of
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➢ Functions of
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➢ Functions of
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➢ Mechanism of
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➢ Mechanism of
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➢ Clinical
1. Infant respiratory distress syndrome: After birth, the newborn makes
strong inspiratory effort so that the lungs expand. Surfactant helps in
lung inflation and prevents collapse of expanded lung.
• Lung maturation is incomplete in premature infants.
• Also, hormonal disturbances like diabetes during pregnancy
interfere with lung maturation.
• In such conditions, due to lack of surfactant synthesis, lung expansion
becomes difficult after birth. Breathing becomes extremely labored due
to high surface tension.
It becomes difficult to inflate lungs.
•This is called infant respiratory distress syndrome (IRDS) or
hyaline membrane disease. Pulmonary edema and atelectasis develop due
to high surface tension.
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➢ Clinical
● Administration of phospholipid by inhalation
● Inhalation of synthetic surfactant (or a
surfactant preparation derived from bovine lungs)
● Glucocorticoid therapy (glucocorticoid
promotes surfactant synthesis)
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➢ Clinical
2. Atelectasis following surgery: During deep
breathing, the lungs inflate to a larger volume and new
surfactant molecules spread thoroughly on the alveolar surface, whereas,
during shallow breathing,
the spreading of surfactant is impaired.
● Therefore, patients recovering from anesthesia after
surgery are often encouraged to breathe deeply to enhance
the proper spreading of surfactant on the alveolar
surface.
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➢ Clinical
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➢ Clinical
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References: “To obey is better
1. Guyton and Hall Textbook
of Medical Physiology than sacrifice, and
(Guyton Physiology) 13th to heed is better
Edition
by John E. Hall PhD (Author)
than the fat of
rams.”
2. Medical Physiology for 1 Samuel 15:22
Undergraduate Students 1st
edition (January 1, 2011) –
January 1, 2011
by KHURANA (Author)
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