Aerosolized lucinactant: a potential alternative to intratracheal surfactant replacement therapy.
BACKGROUND
Surfactant replacement therapy (SRT) has been demonstrated to be both safe and highly effective in the treatment of preterm infants with respiratory distress syndrome (RDS). However, administration of the various available suspensions has required endotracheal intubation and its inherent risks. Delivery of aerosolized SRT would be a laudable goal.


OBJECTIVE
To review the chemistry, pharmacodynamics, clinical efficacy and safety of aerosolized lucinactant for the prevention/treatment of RDS in the preterm infant.


METHODS
Laboratory and clinical experience with aerosolized lucinactant are reviewed.


CONCLUSIONS
Laboratory studies confirm the ability of lucinactant to withstand the aerosolization process and to maintain its biological activity. A small clinical pilot trial demonstrated safety and feasibility and provided a signal to suggest proof of concept and the justification for a larger Phase III trial.
Donn
Steven M
SM
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Michigan Health System, F5790 C.S. Mott Children's Hospital, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109-0254, USA. smdonnmd@med.umich.edu
Sinha
Sunil K
SK
D000280:Administration, Inhalation; D000336:Aerosols; D045422:Continuous Positive Airway Pressure; D004338:Drug Combinations; D005233:Fatty Alcohols / Q000008:administration & dosage* / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D010715:Phosphatidylglycerols / Q000008:administration & dosage* / Q000627:therapeutic use*; D011506:Proteins / Q000008:administration & dosage* / Q000627:therapeutic use*; D011663:Pulmonary Surfactants / Q000008:administration & dosage* / Q000627:therapeutic use*; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy*
D000336:Aerosols; D004338:Drug Combinations; D005233:Fatty Alcohols; D010715:Phosphatidylglycerols; D011506:Proteins; D011663:Pulmonary Surfactants; C502722:lucinactant