Regulation of lung surfactant phospholipid synthesis and metabolism

► Normal lung surfactant phosphatidylcholine homeostasis is tightly regulated. ► Regulated steps include synthesis, molecular selection, intracellular transport, secretion, reuptake and recycling. ► Aberrant regulation is involved in many surfactant pathologies. ► Dynamic lipidomic analyses using stable isotopes provide novel insights into the underlying mechanisms. ► Lung phospholipid synthesis and turnover are integrated with extra-pulmonary whole body phospholipid metabolism.