Old and new uses of surfactant.
Exogenous surfactant has been the primary life-saving therapy for respiratory distress syndrome (RDS) of preterm infants for many years. More recently, early surfactant treatment administered less invasively by transient endotracheal intubation and combined to nasal ventilation has been shown to further improve neonatal outcome by reducing the need of mechanical ventilation. In addition to RDS, other neonatal and pediatric respiratory disorders characterized by surfactant inactivation or dysfunction, such as pulmonary hemorrhage, aspiration pneumonia, and viral lower respiratory tract infection, might also be amenable to surfactant replacement therapy. However, the nature of lung injury and the influence of co-morbidities may reduce the efficacy of surfactant in these conditions. Currently under investigation are new synthetic surfactant formulations which may be more effective and resistant to inactivation than natural ones and could be produced at a lower cost. The use of surfactants to deliver drugs directly to the lung also seems to be a promising technique worthy of study.
Gizzi
Camilla
C
Division of Neonatology, S. Giovanni Calibita Hospital, Fatebenfratelli, Isola Tiberina, Rome, Italy.
Papoff
Paola
P
Barbàra
Caterina Silvia
CS
Cangiano
Giulia
G
Midulla
Fabio
F
Moretti
Corrado
C
D058492:Drug Repositioning; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000209:etiology; D015931:Intensive Care, Neonatal / Q000379:methods*; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy; D012140:Respiratory Tract Diseases / Q000188:drug therapy / Q000209:etiology
D011663:Pulmonary Surfactants