Surfactant-tolerance evolution of Bacillus clausii protease for enhancing activity and stability by reshaping the substrate access tunnel.

Alkali proteases are crucial in numerous industries, especially in the laundry industry, but their inactivation by surfactants limits their effectiveness. This study employed substrate access tunnel engineering to improve the performance of WT bcPRO in surfactants. By modifying the key residues in the substrate pocket, the best variant N212S showed higher stability and activity in both AES and LAS. Molecular dynamics (MD) simulations provided insights into the enhanced stability and activity. The Asn212Ser mutation weakened the anti-correlation motion, increased the number of hydrogen bonds between amino acid residues, and made the protein structure more compact, contributing to its stability. Additionally, the mutation extended the substrate access tunnel and enabled additional interactions with the substrate, enhancing its catalytic activity in surfactants. This study demonstrates a strategy for reshaping the substrate access tunnel to improve protease stability and activity in surfactant environments, offering a promising protease candidate for the laundry industry.

Immunodetection of Poorly Soluble Substances: Limitations and Their Overcoming.

Immunoassays based on the specific antigen-antibody interactions are efficient tools to detect various compounds and estimate their content. Usually, these assays are implemented in water-saline media with composition close to physiological conditions. However, many substances are insoluble or cannot be molecularly dispersed in such media, which objectively creates problems when interacting in aquatic environments. Thus, obtaining immunoreactants and implementing immunoassays of these substances need special methodological solutions. Hydrophobicity of antigens as well as their limited ability to functionalization and conjugation are often overlooked when developing immunoassays for these compounds. The main key finding is the possibility to influence the behavior of hydrophobic compounds for immunoassays, which requires specific approaches summarized in the review. Using the examples of two groups of compounds-surfactants (alkyl- and bisphenols) and fullerenes, we systematized the existing knowledge and experience in the development of immunoassays. This review addresses the challenges of immunodetection of poorly soluble substances and proposes solutions such as the use of hydrotropes, other solubilization techniques, and alternative receptors (aptamers and molecularly imprinted polymers).

Experimental and theoretical simulations to examine the influence of nonionic surfactant on the corrosion control of mild steel in hydrochloric acid.

The increasing demand for corrosion prevention strategies that are both effective and sustainable is part of the research the background. Nonionic surfactants offer a potential replacement for traditional corrosion inhibitors. These surfactants are well-known for their low toxicity and biodegradability. The research involved conducting experimental tests (such as weight loss, polarization and impedance spectroscopy) and theoretical computations to investigate the role of nonionic surfactant (polyoxyethylene (7) tribenzyl phenyl ether) (PETPE) in controlling the corrosion of mild steel in hydrochloric acid (1.0 M HCl) environment. The results of the study demonstrated that PETPE exhibited significant corrosion inhibition properties for mild steel in HCl solution. The inhibition efficiency of PETPE was found to increase with increasing PETPE concentration. PETPE is an excellent corrosion inhibitor because it significantly reduces the rate of corrosion, as seen by the notable inhibition efficiency result (95.4%) at a relatively low dose of PETPE (100 ppm). Thermodynamic studies were used to discuss the fundamental mechanisms that control PETPE-acid interactions. The adsorption process followed Langmuir adsorption isotherm, indicating a monolayer adsorption of the PETPE on the mild surface. Theoretical computations confirm the strong inhibition behavior of PETPE. The innovative feature of this research is its comprehensive strategy, which integrates experimental studies and theoretical simulations to evaluate the impact of PETPE on the corrosion control of mild steel in hydrochloric acid. The combined effort has the ability to supply valuable knowledge into the mechanisms of corrosion that will lead to the establishment of powerful corrosion control strategies.

Fluorescent Ionic Liquid Aggregates: A Self-Assembled Approach for Pesticide Detection and Catalysis.

The unregulated use of pesticides, industrial discharge of heavy metals, waste, and agricultural runoff may contaminate surface water and groundwater, consequently threatening ecosystems and human health. Thus, the sensitive detection and degradation of pesticides are essential for safety. In this context, herein, we have developed benzimidazolium-based fluorescent surfactant assemblies TA-1/SDS and TA-2/SDBS, which exhibit aggregation-induced emission enhancement in an aqueous medium. The aggregates (TA-1/SDS and TA-2/SDBS) displayed a turn-on emission response upon interaction with carbendazim and azamethiphos with limits of detection 7.5 and 7.8 nM, respectively. The FE-SEM and AFM studies revealed that TA-1/SDS and TA-2/SDBS undergo self-assembly with the addition of AZA and CBZ, resulting in the formation of dendritic structures. In addition to the quantification of AZA and CBZ, TA-1/SDS and TA-2/SDBS have also been evaluated to degrade both pesticides and validated using 31P NMR spectroscopy and LC-MS spectrometry.

Influence of catheter thickness on respiratory physiology during less invasive surfactant administration in extremely preterm infants.

Introduction: Delivering surfactant via thin catheters (minimal-invasive surfactant therapy (MIST); less invasive surfactant administration (LISA)) has become a common procedure. However, the effect of tracheal obstruction caused by catheters of different sizes on tracheal resistance in extremely low gestational age newborns (ELGANs) is unknown. Methods: To investigate the effect of catheters size 3.5, 5 and 6 French on airway resistance in ELGANs of 23-28 weeks gestational age during LISA, we performed calculations based on Hagen-Poiseuille's law and compared these with a clinically and physically more accurate method: computational fluid dynamics (CFD) simulations of respiratory airflow, performed in 3D virtual airway models derived from MRI. Results: The presence of the above catheters decreased the cross-sectional area of the infants' tracheal entrance (the cricoid ring) by 13-53%. Hagen-Poiseuille's law predicted an increase in resistance by 1.5-4.5 times and 1.3-2.6 times in ELGANs born at 23 and 28 weeks, respectively. However, CFD simulations demonstrated an even higher increase in resistance of 3.4-85.1 and 1.1-3.5 times, respectively. The higher calculated resistances were due to the extremely narrow remaining lumen at the glottis and cricoid with the catheter inserted, resulting in a stronger glottal jet and turbulent airflow, which was not predicted by Hagen-Poiseuille. Conclusion: Catheter thickness can greatly increase tracheal resistance during LISA-procedures in ELGANs. Based on these models, it is recommended to use the thinnest catheter possible during LISA in ELGANs to avoid unnecessary increases in airway resistance in infants already experiencing dyspnea due to respiratory distress syndrome.

Photocatalytic Hydrogen Generation in Surfactant-Free, Aqueous Organic Nanoparticle Dispersions.

Hydrogen generation in electrostatically stabilized, aqueous organic nanoparticle dispersions is investigated. For this purpose, organic nanoparticle dispersions are synthesized in water by nanoprecipitation from tetrahydrofuran and stabilized by charging through strong molecular electron acceptors. The dispersions are stable for more than 10 weeks on the shelf and during the photocatalytic process, despite the continuous transfer of charges between the reactants. The hydrogen generation in the electrostatically stabilized dispersions outperforms the hydrogen generation in organic nanoparticle dispersions which contain the common stabilizer sodium dodecyl sulfate.

Sodium houttuyfonate induces bacterial lipopolysaccharide shedding to promote macrophage M1 polarization against acute bacterial lung infection.

Sodium houttuyfonate (SH), derived from the widely utilized natural herb Houttuynia cordata, exhibits an effective therapeutic effect on various diseases, including bacterial and fungal infections, especially the respiratory tract infection. Therefore, the anti-microbial mechanisms of SH may be different from the single-target action mechanism of conventional antibiotics, and further research is needed to clarify this. Firstly, we discovered that SH can effectively intervene in mouse lung infections by reducing bacterial load and acute inflammation response related to pneumonia caused by Pseudomonas aeruginosa. Interestingly, our results confirmed that SH has surface activity and can directly induce changes in the cell wall the shedding of surface lipopolysaccharide (LPS). Additionally, we found that SH-induced shedding of LPS can induce M1 polarization of macrophages in the early stage, leading to the production of corresponding polarization effector molecules. Subsequently, we discovered that SH-induced M1 polarization cells can effectively phagocytose and kill bacterial cells. The protein expression results indicated that SH can enhance the expression of M1 polarization pathway of TLR4/MyD88/NF-κB during the initial phase of macrophage and pathogen interaction. In summary, our results imply that SH could directly induce the shedding of P. aeruginosa LPS in a surfactant-like manner. Afterwards, the SH induced abscisic LPS can initiate the TLR4/MyD88/NF-κB immune pathway to trigger the M1 polarization of macrophages, which might intervene the P. aeruginosa-caused acute lung infection at early stage. Based on these findings, we attempted to coin the term "immune feedback eradication mechanism against pathogen of natural product" to describe this potent antimicrobial mechanism of SH.

Association of SNP-SNP interactions of surfactant protein genes with severity of respiratory syncytial virus infection in children.

The severity of respiratory syncytial virus (RSV) may be linked to host genetic susceptibility. Surfactant protein (SP) genetic variants have been associated with RSV severity, but the impact of single-nucleotide polymorphism (SNP)-SNP interactions remains unexplored. Therefore, we used a novel statistical model to investigate the association of SNP-SNP interactions of SFTP genes with RSV severity in two- and three-interaction models. We analyzed available genotype and clinical data from prospectively enrolled 405 children diagnosed with RSV, categorizing them into moderate or severe RSV groups. Using Wang's statistical model, we studied significant associations of SNP-SNP interactions with RSV severity in a case-control design. We observed, first, association of three interactions with increased risk of severe RSV in a two-SNP model. One intragenic interaction was between SNPs of SFTPA2, and the other two were intergenic, involving SNPs of hydrophilic and hydrophobic SPs alone. We also observed, second, association of 22 interactions with RSV severity in a three-SNP model. Among these, 20 were unique, with 12 and 10 interactions associated with increased or decreased risk of RSV severity, respectively, and included at least one SNP of either SFTPA1 or SFTPA2. All interactions were intergenic except one, among SNPs of SFTPA1. The remaining interactions were either among SNPs of hydrophilic SPs alone (n = 8) or among SNPs of both hydrophilic or hydrophobic SPs (n = 11). Our findings indicate that SNPs of all SFTPs may contribute to genetic susceptibility to RSV severity. However, the predominant involvement of SFTPA1 and/or SFTPA2 SNPs in these interactions underscores their significance in RSV severity.NEW & NOTEWORTHY Although surfactant protein (SP) genetic variants are associated with respiratory syncytial virus (RSV) severity, the impact of single-nucleotide polymorphism (SNP)-SNP interactions of SP genes remained unexplored. Using advanced statistical models, we uncovered 22 SNP-SNP interactions associated with RSV severity, with notable involvement of SFTPA1 and SFTPA2 SNPs. This highlights the comprehensive role of all SPs in genetic susceptibility to RSV severity, shedding light on potential avenues for targeted interventions.

Do Different Amounts of Exogenous Surfactant Differently Influence Cerebrovascular Instability in a Consecutive Group of Preterm Babies? Preliminary Results from a Single-Center Experience.

BACKGROUND: Thirty years ago, the first attempt by Saliba and colleagues was made to reduce the negative effects (hypercarbia) of exogenous surfactant (ES) by slowing its administration. Sixteen years later, we observed the first less invasive surfactant administration (LISA) attempt by Kribs and colleagues. Many studies, since that time, have tried to minimize the invasiveness of ES and subsequent cerebral blood flow perturbations through studies using near-infrared spectroscopy (NIRS). We sought to address this medical challenge by identifying a less problematic modality of ES administration by delivering multiple aliquots of ES instead of a single one, as typically performed. The aim of this study was to test the hypothesis that a different way of administering ES using more aliquots could be a safe alternative that should be assessed in further studies. METHODS: Patients between 26 + 0 and 35 + 6 weeks of gestational age (GA) requiring ES administration were enrolled (April 2023-February 2024). Differently fractioned doses were delivered according to an arbitrary standard dosage (0.3 mL per aliquot in babies < 29 weeks; 0.6 mL in babies ≥ 29 weeks), while NIRS and transcutaneous CO2 (tCO2) monitoring were always performed. ES's effectiveness was assessed based on the reduction in the Oxygen Saturation Index (OSI) after administration. Persistent desaturation, bradycardia, and airway obstruction were defined as adverse effects and used to evaluate safety during ES administration, as well as variability in NIRS-rSO2 values and tCO2. RESULTS: Twenty-four patients were enrolled with a median GA of 29 weeks (IQR 4.5) and BW of 1223 ± 560 g. In addition, 50% of the cohort received fewer than three aliquots, whereas the other 50% received more than three. Monitoring was started before the procedure and continued 30' after the last ES aliquot administration. The variability in NIRS-SpO2 values was significantly higher in the group (p = 0.007) with a lower number of aliquots administered. Similarly, increased NIRS-rSO2 values (p = 0.003) and increased tCO2 levels (p = 0.005) were observed in infants who underwent an ES split after the administration of a low number of aliquots. CONCLUSIONS: Our data obtained from the group with > 3 fractionated doses of ES seem to justify the preparation of a more robust study, as the combination of reduced NIRS variability and reduced tCO2 maximum levels is consistent with more stable cerebral blood flow during the challenging time of ES administration.

The Role of Pulmonary Collectins, Surfactant Protein A (SP-A) and Surfactant Protein D (SP-D) in Cancer.

Surfactant proteins A and D (SP-A and SP-D) belong to the collectin subfamily of C-type oligomeric lectins. They are pattern-recognition molecules (PRMs), able to recognise pathogen- or danger-associated molecular patterns (PAMPs, DAMPs) in the presence of Ca2+ cations. That property enables opsonisation or agglutination of non-self or altered/abnormal self cells and contributes to their clearance. Like other collectins, SP-A and SP-D are characterised by the presence of four distinct domains: a cysteine-rich domain (at the N-terminus), a collagen-like region, an α-helical neck domain and a globular carbohydrate-recognition domain (CRD) (at the C-terminus). Pulmonary surfactant is a lipoprotein complex, preventing alveolar collapse by reducing surface tension at the air-liquid interface. SP-A and SP-D, produced by type II alveolar epithelial cells and Clara cells, are not only pattern-recognition molecules but also contribute to the surfactant structure and homeostasis. Moreover, they are expressed in a variety of extrapulmonary sites where they are involved in local immunity. The term "cancer" includes a variety of diseases: tumours start from uncontrolled growth of abnormal cells in any tissue which may further spread to other sites of the body. Many cancers are incurable, difficult to diagnose and often fatal. This short review summarises anti- and pro-tumorigenic associations of SP-A and SP-D as well as perspectives of their usefulness in cancer diagnosis and therapy.

Surfactant-Based Chemical Washing to Remediate Oil-Contaminated Soil: The State of Knowledge.

As the energy demand increases, there is a significant expansion and utilization of oil resources, resulting in the inevitable occurrence of environmental pollution. Oil has been identified as a prevalent soil contaminant, posing substantial risks to the soil ecosystems. The remediation of soil contaminated with oil is a formidable undertaking. Increasing evidence shows that chemical washing, a remediation technique employing chemical reagents like surfactants to augment the solubilization, desorption, and separation of petroleum hydrocarbons in soil, proves to be an efficacious approach, but the latest advances on this topic have not been systematically reviewed. Here, we present the state of knowledge about the surfactant-based chemical washing to remediate oil-contaminated soil. Using the latest data, the present article systematically summarizes the advancements on ex situ chemical washing of oil pollution and provides a concise summary of the underlying principles. The use of various surfactants in chemical washing and the factors influencing remediation efficiency are highlighted. Based on the current research status and knowledge gaps, future perspectives are proposed to facilitate chemical washing of oil-polluted soil. This review can help recognize the application of chemical washing in the remediation of oil-polluted soil.

Microbubble-laden aerosols improve post-nasal aerosol penetration efficiency in a preterm neonate model.

Nebulized lung surfactant therapy has been a neonatology long-pursued goal. Nevertheless, many clinical trials have yet to show a clear clinical efficacy of nebulized surfactant, which, in part, is due to the technical challenges of delivering aerosols to the lungs of preterm neonates. The study aimed to test microbubbles for improving lung deposition in preterm neonates. An in vitro testing method was developed to replicate the clinical environment; it used a 3D-printed preterm neonate model, connected to a high-flow nasal cannula (HFNC) and a vibrating mesh nebulizer. The flow rate of the HFNC mirrored that used in the clinics (i.e., 4, 6, and 8 L/min). Followingly, the lung penetrations of aerosols with and without microbubbles were compared. The aerodynamic diameter of aerosols with microbubbles (MMAD=1.75 µm) was lower than that of the counterpart (MMAD=2.25 µm). Microbubble-laden aerosols had a significantly higher number of microbubbles that were below 1.0 µm. Microbubble-laden aerosols had dramatically higher lung penetration in the preterm model; lung penetration efficiencies were 30.0, 25.5, and 17.5 % at 4, 6, and 8 L/min, respectively, whereas the lung penetration efficiency for conventionally nebulized aerosols was below 1.25 % in the three flow rates.

Less Invasive Surfactant Administration for Preterm Infants - State of the Art.

BACKGROUND: Less invasive surfactant administration (LISA) has become the preferred method of surfactant administration for spontaneously breathing babies on continuous positive airway pressure (CPAP). SUMMARY: The development of LISA followed the need to combine CPAP and surfactant replacement as mainstay treatment options for respiratory distress syndrome, thereby avoided exposure to positive pressure ventilation. KEY MESSAGES: This review summarises the current knowns and unknowns of LISA including the physiological concept, its relevance for short-term and long-term outcomes and the challenges for practical implementation of LISA as part of a less invasive respiratory care bundle. Further, we provide an update of the evidence on alternatives to LISA, for example, nebulised surfactant administration, pharyngeal deposition of surfactant and delivery via supraglottic airway.

Laryngeal Mask for Minimally-Invasive Surfactant Administration: A Narrative Review.

The cornerstone of treatment for respiratory distress syndrome in preterm infants is surfactant administration, traditionally performed through an invasive procedure involving tracheal intubation and mechanical ventilation. Consequently, there has been a growing interest in exploring less invasive methods of surfactant delivery to mitigate the associated risks. Currently, several techniques are under evaluation, including intratracheal instillation using a thin catheter, aerosolized or nebulized administration, and guided administration by supraglottic airway devices. One such method is surfactant administration through laryngeal or supraglottic airway, which involves placing a laryngeal mask without the need for laryngoscopy and administering surfactant through the device. The simplicity of laryngeal mask insertion could potentially streamline the surfactant delivery process, eliminating the necessity for advanced skills. This narrative review aimed to assess the current evidence in the literature regarding the benefits and risks associated with surfactant administration through a laryngeal supraglottic airway.

Rapid ion pair-based surfactant-assisted liquid-liquid microextraction with solidification of floating organic drop for simultaneous spectrophotometric determination of selected anionic dyes in food samples.

Ion pair-based surfactant-assisted liquid-liquid microextraction with solidification of floating organic drops has been developed to extract Allura red (AR), tartrazine (TAR), and fast green (FG) prior to spectrophotometric determination. Cetyltrimethylammonium bromide (CTAB) was employed as ion-pairing agent to enhance the hydrophobic behavior of anionic dyes. 1-undecanol and ethanol were used as the extraction and dispersion solvents, respectively. The dyes were quantitatively extracted in the presence of KCl (0.15 mol L-1) at pH 4.0. The method exhibits wide linearity (15.0-1500.0 µg L-1 for AR, 35.0-2000.0 µg L-1 for TAR, and 3.0-1200.0 µg L-1 for FG) with preconcentration factors of 19.6, 20.1, and 19.9, respectively. The detection limit was 3.7. 9.5, and 0.83 µg L-1 for AR, TAR, and FG, respectively. The relative standard deviation did not exceed 2.1 %. The procedure was applied for the determination of these dyes in food samples.

Formulation and Evaluation of Butenafine Hydrochloride-Incorporated Solid Lipid Nanoparticles as Novel Excipients for the Treatment of Superficial Fungal Infections.

Objectives: The objective of the present study was to develop natural excipient-based solid lipid nanoparticles (SLN) of butenafine hydrochloride (BUTE) using a modified solvent emulsification technique and to evaluate the competence of aloe vera nanolipidgel in enhancing the penetration of BUTE. Materials and Methods: BUTE-SLNs were prepared using a 23 factorial design to correlate the effect of formulation components on the BUTE-SLN. Particle size, polydispersity index (PDI), zeta potential, entrapment performance, and drug loading were assessed in the formed SLNs. The fabricated BUTE-SLN was evaluated for transmission electron microscopy, fourier transform infrared spectroscopy, differential scanning calorimetry, and X-ray diffraction study studies and revealed the encapsulation of BUTE in lipid in the amorphous state. BUTE-SLN-based aloe vera gel was formulated and evaluated compared with the marketed product with respect to primary skin irritation, hydration, skin permeation, and antifungal activity. Results: The BUTE-SLN aloe vera gel, optimized for its formulation, features excellent slip properties and controlled drug release. DSC and XRD studies confirm its amorphous nature with effective drug entrapment. The gel provides enhanced skin deposition, improved antifungal activity, and reduced irritation. This makes it a cost-effective and innovative alternative to traditional dosage forms. BUTE-SLN promisingly showed no irritation, higher hydrating potential, slow and sustained release, and enhanced antifungal activity. With an aim to target deeper skin strata, minimize the side effects of drugs and symptomatic impact of fungal infection, and shorten the duration of therapy, BUTE-SLN was successfully prepared. The mean particle size and PDI were 261.25 ± 2.38 nm and 0.268 ± 0.01, respectively. Conclusion: BUTE-SLN gel offers improved topical delivery of BUTE with significantly higher compatibility and antifungal activity than the marketed formulation.

Magnitude of Obesity Alone does not Alter the Alveolar Lipidome.

Obesity may lead to pulmonary dysfunction through complex and incompletely understood cellular and biochemical effects. Altered lung lipid metabolism has been identified as a potential mechanism of lung dysfunction in obesity. While murine models of obesity demonstrate changes in pulmonary surfactant phospholipid composition and function, data in humans are lacking. We measured untargeted shotgun lipidomes in two bronchoalveolar lavages (BAL) from apical and anteromedial pulmonary subsegments of 14 adult subjects (7 males and 7 females) with body mass indexes ranging from 24.3 to 50.9 kg/m2. The lipidome composition was characterized at the class, species, and fatty acyl / alkyl level using total lipid molecular ion signal intensities normalized to BAL protein concentration and epithelial lining fluid volumes. Multivariate analyses were conducted to identify potential changes with increasing BMI. The alveolar lipidomes contained the expected composition of surfactant associated phospholipids, sphingolipids, and sterols in addition to cardiolipin and intracellular signaling lipid species. No significant differences in lipidomes were detected between the two BAL regions. Though a small number of lipid species were associated with BMI in multivariate analyses, no robust differences in lipidome composition or specific lipid species were identified over the range of body habitus. The magnitude of obesity alone does not substantially alter the alveolar lipidome in patients without lung disease. Differences in lung function in patients with obesity and no lung disease are unlikely related to changes in alveolar lipid composition.

The effect of temperature and breathing pattern on the surface activity of ground squirrel pulmonary surfactant.

This study investigates how hibernation affects the surface activity of pulmonary surfactant with respect to temperature and breathing pattern. Surfactant was isolated from a hibernating species, the 13-lined ground squirrel, and a homeotherm, rabbit, and analyzed for biophysical properties on a constrained sessile drop surfactometer. The results showed that surfactant from ground squirrels reduced surface tension better at low temperatures, including when mimicking episodic breathing, as compared to rabbit surfactant. In addition, low temperature adaptation was also observed using only the hydrophobic components of surfactant from ground squirrels. Overall, the data supports the conclusion that ground squirrel surfactant has adapted to maintain surface activity during low temperature episodic breathing patterns, and that temperature adaptation is maintained with the hydrophobic components of the surfactant.

Pulmonary surfactant and prostaglandin E2 in airway smooth muscle relaxation of human and male guinea pigs.

Pulmonary surfactant serves as a barrier to respiratory epithelium but can also regulate airway smooth muscle (ASM) tone. Surfactant (SF) relaxes contracted ASM, similar to ß2-agonists, anticholinergics, nitric oxide, and prostanoids. The exact mechanism of surfactant relaxation and whether surfactant relaxes hyperresponsive ASM remains unknown. Based on previous research, relaxation requires an intact epithelium and prostanoid synthesis. We sought to examine the mechanisms by which surfactant causes ASM relaxation. Organ bath measurements of isometric tension of ASM of guinea pigs in response to exogenous surfactant revealed that surfactant reduces tension of healthy and hyperresponsive tracheal tissue. The relaxant effect of surfactant was reduced if prostanoid synthesis was inhibited and/or if prostaglandin E2-related EP2 receptors were antagonized. Atomic force microscopy revealed that human ASM cells stiffen during contraction and soften during relaxation. Surfactant softened ASM cells, similarly to the known bronchodilator prostaglandin E2 (PGE2) and the cell softening was abolished when EP4 receptors for PGE2 were antagonized. Elevated levels of PGE2 were found in cultures of normal human bronchial epithelial cells exposed to pulmonary surfactant. We conclude that prostaglandin E2 and its EP2 and EP4 receptors are likely involved in the relaxant effect of pulmonary surfactant in airways.

Practical Way to Use Supraglottic Airway Device.

We read a review of case reports published on Current Pediatric Reviews 2024 about the use of I-gel® in neonatal complicated intubation, and we decided to write a commentary on the benefits and limitations of using supraglottic airways in neonatal age, with a specific focus on Igel [1]. The use of supraglottic airway devices in neonatal ages is limited to particular conditions, but further research is showing the utility of these devices as the first choice in neonatal resuscitation or airway stabilization. Our commentary highlights the broader practical applications of I-gel and reinforces its role as a valuable tool in neonatal resuscitation.