Acute respiratory distress syndrome (ARDS) is a pulmonary disease with a 40% mortality rate that effects over 300,000 people in the US each year. It is also common for patients with the COVID-19 virus to develop ARDS, both while infected with the virus, as well as delayed onset. The underlying causes of the disease are not well understood, but we believe that ARDS may be explained by changes to the interfacial properties of the lung surfactant (LS) that occur during lung inflammation. A joint confocal microscope/capillary pressure microtensiometer has been developed to study the interfacial properties of LS and elucidate the underlying cause of ARDS by visualizing the interface during bubble expansion and compression.<br/>We present studies of the interfacial static and dynamic properties of simple model lung surfactants as well as clinical replacement surfactants relevant to ARDS. We focus on the effects of chemical species such as lysolipids that arise from inflammation in the lung on LS morphology and function. With the new tool we have developed, we are not only able to measure dynamic adsorption behavior, equilibrium surface tensions, and interfacial rheology, but create three-dimensional visualizations of the interface while these processes occur. This allows us to link morphological changes such as phase transition and monolayer collapse on the interface to the changing interfacial properties. This additionally allows us to visualize interfacial structures being destroyed and properties of the LS being disrupted as contaminating materials are introduced, an indication of a possible underlying cause of ARDS.

Confocal microscopy imaging of microtensiometer for dynamic lung surfactant interfaces

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