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The Role of a High Cholesterol Diet on Surfactant Biophysics during Acute Lung Injury

Pulmonary surfactant is mixture of phospholipid (85%), surfactant proteins (~10%), and neutral lipids, predominately cholesterol (~5%), vital for normal respiratory function. Surfactant's biophysical function is to reduce lung surface tension, especially during exhalation (compression) where surface tensions reach near 0mN/m values, thereby helping to maintain normal pulmonary compliance. However, in acute lung injury, characterized by reduced arterial oxygenation, dysfunction of the surfactant system contributes to impaired respiratory function. Recent studies have shown that supra‐physiological levels of cholesterol in surfactant contributes to impaired surface tension reduction of surfactant from injured lungs. It is unknown if elevated serum cholesterol levels can contribute to elevated cholesterol in surfactant and thereby play a predisposing role in the development of more severe acute lung injury through surfactant biophysical impairment.