A recipe for a good clinical pulmonary surfactant

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Pérez Gil, Jesús (2022) A recipe for a good clinical pulmonary surfactant. Biomedical journal, 45 (4). pp. 615-628. ISSN 2319-4170

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Official URL: https://doi.org/10.1016/j.bj.2022.03.001



Abstract

The lives of thousands premature babies have been saved along the last thirty years thanks to the establishment and consolidation of pulmonary surfactant replacement therapies (SRT). It took some time to close the gap between the identification of the biophysical and molecular causes of the high mortality associated with respiratory distress syndrome in very premature babies and the development of a proper therapy. Closing the gap required the elucidation of some key questions defining the structure–function relationships in surfactant as well as the particular role of the different molecular components assembled into the surfactant system. On the other hand, the application of SRT as part of treatments targeting other devastating respiratory pathologies, in babies and adults, is depending on further extensive research still required before enough amounts of good humanized clinical surfactants will be available. This review summarizes our current concepts on the compositional and structural determinants defining pulmonary surfactant activity, the principles behind the development of efficient natural animal-derived or recombinant or synthetic therapeutic surfactants, as well as a the most promising lines of research that are already opening new perspectives in the application of tailored surfactant therapies to treat important yet unresolved respiratory pathologies.

Resumen (otros idiomas)

Esta revisión, escrita a petición de la Sociedad Europea de Medicina Neonatal, una de las entidades organizadoras de la International Week on Surfactant Research (https://www.mcascientificevents.eu/surfactantresearch/), celebrada el pasado diciembre 2020, detalla los principios básicos detrás del desarrollo de la terapia de suplementación con surfactante exógeno que se aplica hoy de forma extendida en los recién nacidos muy prematuros. La experiencia de más de 25 años de investigación en este campo del laboratorio del Prof. Pérez Gil se ha proyectado hacia una descripción accesible de los mecanismos moleculares y las relaciones estructura-función en el sistema surfactante pulmonar, su alteración en situaciones patológicas, y su restauración mediante la administración de preparaciones terapéuticas. También se revisa la potencial aplicación de las terapias del surfactante en diferentes patologías respiratorias de niños y adultos así como las perspectivas futuras en el desarrollo de nuevos surfactantes terapéuticos.

Item Type:Article
Uncontrolled Keywords:Surfactant replacement therapy; Air–liquid interface; Respiratory distress syndrome; ARDSLipid–protein interactions; DPPC
Subjects:Medical sciences > Medicine > Pneumology
Medical sciences > Biology > Biochemistry
ID Code:74860
Deposited On:29 Sep 2022 15:01
Last Modified:30 Sep 2022 07:21

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