Influence of Natural Lung Surfactant Inhalations on Clinical Symptoms and Pulmonary Function Parameters in Patients with Bronchial Asthma. Communication 2

E. A. Akulova¹; O. V. Stepanova¹; A. A. Seiliev, PhD²; A. Ed. Shulga²; O. V. Lovacheva, PhD, ScD³; S. A. Lukyanov, PhD¹; K. G. Shapovalov, PhD, ScD¹; V. A. Volchkov, PhD, ScD²; O. A. Rosenberg, PhD, ScD²*

¹Chita State Medical Academy of Ministry of Health, Chita, Russia; ²Russian Research Center of Radiology and Surgery Technologies, St. Petersburg, Russia; ³Central Tuberculosis Research Institute, Moscow, Russia

*Corresponding author: Prof. Oleg Rosenberg, MD, PhD, ScD  Department of Medical Biotechnology of Russian Research Center of Radiology and Surgery Technologies, St. Petersburg,  Russia. E-mail: rozenberg@biosurf.ru

Published: September 16, 2017.  doi: 10.21103/Article7(3)_OA1

Abstract: 

Background: Damage to lung surfactant (LS) enabling the lung local immunity may contribute to the development of bronchial inflammation in patients with bronchial asthma (BA).
Methods and Results: A 70-day course of 21 LS (Surfactant-BL) inhalations at the dose of 25 mg was added to inhaled corticosteroids (ICS) and short/long-acting bronchodilators or combined inhalers in 13 BA patients. After 21 inhalations, many patients reported lower frequency of cough and profuse expectoration, fewer night and day attacks, resolution of wheezing, resolution or lower frequency of bronchospasm episodes under moderate exercise, and termination (1 patient) or double reduction (8 patients out of 13) of the ICS dose. The values of PFPs in patients at Days 250 and 340 did not differ significantly from the values achieved at Day 41. The mean values at Days 250 and 340 were as follows: FVC =86.4±6.43 (%), FEV1=61.4±8.41 (%), FEV1/FVC =66.5±8.87 (%).
Conclusion: LS inhalations improve the condition of patients with BA, allow ICS dose reduction by 2 times, and improve pulmonary function parameters. A total of 70% of patients had quite a long remission of BA symptoms following a 21-inhalation therapy course of the formulation. 

Keywords: 
lung surfactant ● bronchial asthma ● inhaled corticosteroids ● dose ● pulmonary function
References: 

1. Kurashima K, Fujimura M, Matsuda T, Kobayashi T. Surface activity of sputum from acute asthmatic patients. Am J Respir Crit Care Med. 1997;155(4):1254-9.
2. Devendra G, Spragg RG. Lung surfactant in subacute pulmonary disease. Respir Res. 2002; 3:19.
3. van Iwaarden FJ, van Golde LMJ. Pulmonary surfactant and lung defense. In: Robertson B, Taeusch HW, editors. Surfactant therapy for lung disease. Lung biology in health and disease. Vol. 84. New York: Marcel Dekker Inc; 1995:75—84.
4. Rozenberg OA. Pulmonary Surfactants for Acute and Chronic Lung Diseases (Part II). General Reanimatology. 2014;10(5):69-86.[in Russ].
5. Hohlfeld J, Fabel H, Hamm H. The role of pulmonary surfactant in obstructive airways disease. Eur Respir J. 1997;10(2):482-91.
6. Rosenberg OA, Lebedeva ES, Loshakova LV, Shulga AEd, Seiliev AA, Volchkov VA. Influence of Long-Term Inhaled Glucocorticoids on the Lung Surfactant Phospholipid Levels in Rats. International Journal of Biomedicine. 2016; 6(3):167-169.
7. Stepanova OV, Akulova EA, Kochneva AA, Seiliev AA, Shulga AEd, Lovacheva OV, et al. Influence of Natural Lung Surfactant Inhalations on Clinical Symptoms and Pulmonary Function Parameters in Patients with Bronchial Asthma. Communication 1. International Journal of Biomedicine. 2016; 6(4):255-258.
8. Pocket Guide for Asthma Management and Prevention (for Adults and Children Older than 5 Years). A Pocket Guide for Health Professionals. Updated 2016. Available from: http://ginasthma.org/wp-content/uploads/2016/05/WMS-GINA-2016-main-Pocke...
9. Cheng G, Ueda T, Sugiyama K, Toda M, Fukuda T. Compositional and functional changes of pulmonary surfactant in a guinea-pig model of chronic asthma. Respir Med. 2001; 95(3):180–6.
10. Babu KS , Woodcock DA, Smith SE, Staniforth JN, Holgate ST, Conway JH. Inhaled synthetic surfactant abolishes the early allergen-induced response in asthma. Eur Respir J. 2003;21(6):1046–9.
11. Kurashima K, Ogawa H, Ohka T, Fujimura M, Matsuda T, Kobayashi T. A pilot study of surfactant inhalation in the treatment of asthmatic attack. Allergy.1991; 40(2):160-3.
12. Zagorul’ko AK, Nikitina NV, Askari TA, Zagorul’ko AA. Role of the pulmonary surfactant in the pathogenesis of bronchial asthma. Lik Sprava. 2001;(5-6):16-9. [Article in Russian]
13. Rosenberg OA, Kirillov YA, Danilov LN, Loshakova LV, Lebedeva ES, Shylga AE et al. The lung surfactant immune system response to intratracheal administration of “empty” liposomes. J Liposome Research. 1994; 4(1):203-212.
14. Soll R, Ozek E. Multiple versus single doses of exogenous surfactant for the prevention or treatment of neonatal respiratory distress syndrome. Cochrane Database Syst Rev. 2009; 1: CD000141.
15. Gregory TJ, Steinberg KP, Spragg R, Gadek JE, Hyers TM, Longmore WJ et al. Bovine surfactant therapy for patients with acute respiratory distress syndrome. Am. J. Respir. Crit. Care Med. 1997; 155 (4): 1309-1315.
16. Rosenberg OA, Bautin AE, Osovskich VV, Tsibulkin EK, Gavrilin SV., Kozlov IA. When to start surfactant therapy (ST_therapy) of acute lung injury? Abstracts 11th ERS Annual Congress Berlin, Germany. September 22—26, 2001. Eur. Respir. J. 2001; 18 (Suppl 38): P153, 7s.
17. Bautin A, Khubulava G, Kozlov I, Poptzov V, Osovskikh V, Seiliev A et al. Surfactant Therapy for Patients with ARDS after Cardiac Surgery. J.Liposome Research. 2006; 16 (3): 265-272.
18. Gekkieva OV, Bautin AE, Osovskikh VV, Tregubova IV, Seiliev AA, Rosenberg OA. [Preventive Treatment with Surfactant in Thoracic Surgeries Associated with High Risk of Respiratory Failure]. Doctor.Ru. Anesthesiology and Critical Care Medicine (Fast Track). 2016;12(129 Part I):37-42. [Article in Russian].
19. Lovacheva OV, Erokhin VV, Chernichenko NV, Evguschenko GV, Lepekha LN, Rosenberg OA. [Results of use of surfactant in complex therapy of patients with destructive pulmonary tuberculosis. Probl Tuberk Bolezn Legk. 2006;(10):12-7.[Article in Russian].
20. Erokhin VV, Romanova LK. Lung Surfactant System. In: Erokhin VV, Romanova LK, editors. Lung Cell Biology in Health and Pathology. Doctors’ Handbook. Moscow: Medicine; 2000: 167-181.
21. Zhemkov VF, Ivanovsky VB, Zhemkova MV, Seiliev A, Volchkov VA, Rosenberg OA. [The use of natural lung surfactant in combined therapy for lung tuberculosis]. Tuberk Bolezn Legk. 2013;90(2): 018-022. [Article in Russian].

The fully formatted PDF version is available.
Download Article
International Journal of Biomedicine. 2017;7(3):167-170. ©2017 International Medical Research and Development Corporation. All rights reserved.