Restoring pulmonary surfactant membranes and films at the respiratory surface

• Published in: Biochimica et biophysica acta. Biomembranes 2017-09, Vol.1859 (9), p.1725-1739
• Main Authors: Echaide, Mercedes, Autilio, Chiara, Arroyo, Raquel, Perez-Gil, Jesus
• Format: Article
• Language: English
• Subjects: Air-liquid interface; Animals; ARDS; Exogenous surfactant therapy; Humans; Lung - chemistry; Meconium aspiration sindrome; Meconium Aspiration Syndrome - drug therapy; Meconium Aspiration Syndrome - etiology; NRDS; Pulmonary Surfactants - pharmacology; Pulmonary Surfactants - therapeutic use; Respiratory Distress Syndrome, Adult - drug therapy; Respiratory Distress Syndrome, Adult - etiology; Respiratory Distress Syndrome, Newborn - drug therapy; Respiratory Distress Syndrome, Newborn - etiology; Respiratory mechanics
• ISSN: 0005-2736; 1879-2642
• DOI: 10.1016/j.bbamem.2017.03.015

Pulmonary surfactant is a complex of lipids and proteins assembled and secreted by the alveolar epithelium into the thin layer of fluid coating the respiratory surface of lungs. There, surfactant forms interfacial films at the air-water interface, reducing dramatically surface tension and thus stabilizing the air-exposed interface to prevent alveolar collapse along respiratory mechanics. The absence or deficiency of surfactant produces severe lung pathologies. This review describes some of the most important surfactant-related pathologies, which are a cause of high morbidity and mortality in neonates and adults. The review also updates current therapeutic approaches pursuing restoration of surfactant operative films in diseased lungs, mainly through supplementation with exogenous clinical surfactant preparations. This article is part of a Special Issue entitled: Membrane Lipid Therapy: Drugs Targeting Biomembranes edited by Pablo V. Escribá. [Display omitted] •Exogenous surfactant supplementation has saved thousands of lives of preterm neonates.•Development of humanized clinical surfactants is a main motivation for current research.•Meconium aspiration syndrome associates with inactivation of surfactant at different levels.•Surfactant therapy in MAS or ARDS depends on production of enhanced inhibition-resistant surfactants.