The impact of cannabis smoke on the performance of pulmonary surfactant under physiologically relevant conditions

The lung permits gaseous exchange between the body and atmosphere. The principal interchange site is the alveolar space, which is bathed in a lipid-protein blend called pulmonary surfactant. This material minimises the surface tension and maintains airway patency. Pulmonary surfactant is the initial contacting site for orally inhaled products and environmental toxins. Langmuir monolayer technology can be applied to model the alveolar space. A recent development in this field is the lung biosimulator. The aim of this study was to investigate the influence of cannabis smoke on the activity of the lung surfactant replacement product, Curosurf®. Here, the lung biosimulator facilitated controlled operating conditions of 37C, elevated humidity and accepted fluid hydrodynamics. Initially, 50mg cannabis material was pyrolysed and the smoke collected. For complete pyrolysis, a regimen involving 4 puffs, 50ml volume, 3 second puff duration and a 30-second interval was applied. Quantification for cannabis smoke was conducted via gas chromatography – mass spectroscopy, with a mean concentration of 1% 9 tetrahydrocannabinol (THC) determined. Cannabis smoke aliquots were transferred to the lung biosimulator and 10 minutes allowed for interaction. Expansion – contraction cycles were then initiated to mimic tidal breathing. Baseline data confirmed that Curosurf® works effectively, under physiologically relevant conditions. High surface pressures (e.g. 70mN/m) were attained on full compression. Exposure to cannabis smoke from two independent batches increased the compressibility term and reduced the Langmuir isocycle maximum surface pressure by approximately 20%; interbatch variation was detected. Cannabis smoke impaired the ability of Curosurf® to lower the surface tension term. This was ascribed to the penetration of the planar, hydrophobic drug into the two-dimensional film and destructive interaction with polar functionalities. The net effect would be increased work of breathing for the individual.