Glycolipid accumulation in bronchoalveolar space in adult respiratory distress syndrome.

Surfactant lipids in the alveolar space are believed to play an important role in normal respiratory function. Although the surface-active phospholipids have been extensively studied, the possible role of glycolipids in the surfactant remains to be explored. We have studied the glycolipid composition of cell-free bronchoalveolar lavage from healthy subjects and from adult patients with respiratory distress syndrome. Glycolipids were barely detectable in bronchoalveolar lavage from healthy subjects. However, in adult respiratory distress syndrome, the amount of glycolipid relative to phospholipid was increased by more than twenty times. These lipids, identified as lactosylceramide (galactose-glucose-ceramide) and paragloboside (galactose-N-acetylglucosamine-galactose-glucose-ceramide), may prove to be sensitive markers of lung injury. Since the glycolipids decreased the surface activity of surfactant in vitro, their potential role in the pathogenesis of adult respiratory distress syndrome should be considered.