Surfactant and Varespladib Co-Administration in Stimulated Rat Alveolar Macrophages Culture

Acute lung injury is a life-threating condition characterized by surfactant dysfunction and raised secretory phospholipase A2 (sPLA(2)) activity. Varespladib is a sPLA(2) inhibitor shown to be effective in animal models of acute lung injury. We aimed at investigating the effect of co-administration of surfactant and varespladib on sPLA(2) activity. Alveolar macrophages were cultured and stimulated with lipopolysaccharide and then treated with either varespladib, surfactant, varespladib followed by surfactant or nothing. sPLA(2) activity, free fatty acids, tumour necrosis factor-alpha (TNF-alpha) and protein concentrations were measured in culture supernatants. Treatment with varespladib (p=0.019) and varespladib + surfactant (p=0.013), reduced the enzyme activity by approximately 15\% from the basal level measured in the untreated cultures. Surfactant, varespladib and varespladib + surfactant, respectively decreased free fatty acids by -45\% (p=0.045), 62\% (p=0.009) and -48\% (p=0.015), from the baseline concentration of the untreated cultures. Varespladib and poractant-alpha co-administration reduces sPLA(2) activity and free fatty acids release in cultured rat alveolar macrophages, although a clear drug synergy was not evident. Since co-administration may be useful to reduce inflammation and surfactant inactivation in acute lung injury, further in vivo studies are warranted to verify its clinical usefulness.