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Papers In Press, published online ahead of print March 16, 2005
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Department of Pediatrics, Washington University, St. Louis, MO 63110
Corresponding Author: hamvas{at}kids.wustl.edu
We compared kinetic indices of pulmonary surfactant metabolism in premature infants (n=41) with respect to (i) tracer ([1-13C1]acetate, [U-13C6]glucose, [1,2,3,4-13C4]palmitate), (ii) phospholipid pool (total phospholipids or disaturated phospholipids), or (iii) instrumentation (gas chromatography/mass spectrometry (GC/MS) or gas chromatography/combustion/isotope ratio mass spectrometry (GC/C/IRMS)). Tracer incorporation was measured in phospholipids extracted from serial tracheal aspirates after a 24-hour tracer infusion. The fractional catabolic rate (FCR), representing the total fractional turnover from all sources of surfactant production, was independent of tracer. The fractional synthesis rate of surfactant phospholipid from plasma palmitate was significantly higher than that from palmitate synthesized de novo from acetate, and these two sources of palmitate together accounted for only half of total surfactant production in preterm infants. [U-13C6]glucose showed significant recycling of the 13C-label in intermediary metabolism, distinguishable by GC/MS but not by GC/C/IRMS, resulting in a slower apparent FCR when GC/C/IRMS was used. Extracted phospholipid pool did not impact the surfactant metabolic indices. We suggest that FCR should be used as a primary measure of surfactant turnover kinetics, and that tracers labeling both de novo synthesis (acetate and glucose) and preformed pathways (plasma palmitate) can be used to partition the fractional contribution of each pathway to total production.
Revised on February 8, 2005
Accepted on March 3, 2005
Metabolic kinetics of pulmonary surfactant in newborn infants using endogenous stable isotope techniques
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