Treatment With Exogenous Lung Surfactant

Abstract

The presented literature review examines the structure of the endogenous pulmonary surfactant, as well as the use of exogenous surfactant (Curosurf®) in various pathological conditions of the respiratory system. The endogenous lung surfactant is a lipoprotein complex that is synthesized by type II alveolar cells. It supports the breathing process and is a major component of the lung's immune defenses. In clinical practice, about 80% of premature infants develop respiratory distress syndrome (RDS). This condition requires intrabronchial administration of poractant alfa (Curosurf®), which results in reduced respiratory stress and increased survival. Apart from RDS, lung surfactants are also used in the treatment of asthma. Various mechanisms have been identified by which the surfactant is important for the pathophysiological course of the disease. Synthetic and natural surfactants that suppress the immune response can be used to treat asthma. For example, Alveofact®, Survanta® and Exosurf® lead to concentration-dependent suppression of lymphocyte function and proliferation, and Curosurf® also inhibits neutrophil activation. It also reduces the production of superoxide anions and the release of proinflammatory mediators from monocytes. Curosurf® is also relevant for Covid 19 associated pneumonia. It is believed that its intrabronchial administration will lead to improved blood oxygenation levels. Also, administration of surfactant would reduce pulmonary edema and improve the excessive inflammatory response found in autopsies of patients with COVID-19.