Pulmonary surfactant: functions, abnormalities and therapeutic options

Area of Science:

• Pulmonary Medicine
• Biophysics
• Biochemistry

Background:

• Surfactant replacement therapy (SRT) emerged 20 years ago from animal studies, proving effective for infant respiratory distress syndrome.
• SRT is now a standard treatment for neonates, with recent research deepening understanding of surfactant's roles.
• Surfactant-associated proteins are crucial for surface tension reduction and pulmonary defense mechanisms.

Purpose of the Study:

• To review the surfactant system's complexity, biophysics, physiology, and biochemistry.
• To discuss exogenous surfactant preparation development and clinical applications.
• To explore pathophysiological mechanisms affecting surfactant function in lung diseases.

Main Methods:

• Literature review of clinical trials and experimental studies on surfactant therapy.
• Analysis of the functional roles of surfactant components, particularly proteins.
• Discussion of therapeutic mechanisms and clinical targets for surfactant replacement.

Main Results:

• SRT efficacy is confirmed for infant respiratory distress syndrome.
• Growing evidence supports SRT for adult conditions like acute respiratory distress syndrome (ARDS), pneumonia, and COPD.
• Surfactant proteins are vital for lung mechanics and host defense.

Conclusions:

• Surfactant therapy has evolved from neonatal care to broader respiratory disease applications.
• Understanding surfactant biophysics, physiology, and biochemistry is key to optimizing therapeutic strategies.
• Further research into exogenous surfactant development and clinical targeting is warranted for diverse lung pathologies.