Respiratory distress syndrome (RDS) is a multifactorial developmental disease caused by lung immaturity and presenting as high-permeability lung edema ("hyaline membrane disease"). It is characterized by a transient deficiency of alveolar surfactant during the first week of life. During the first few days of life, the alveolar surfactant pool size increases up to that in the controls. The allelic variants of the genes encoding the surfactant proteins (SP) SP-A1, SP-A2, SP-B, and SP-C have been associated with RDS. The main SP-A haplotype, interactively with the SP-B Ile131Thr polymorphism and with constitutional and environmental factors, influence the risk. Case reports on mutations with partially functional SP-B have been published. The genetic susceptibility factors depend on the degree of prematurity at birth, consistent with sequential differentiation of the lung and gestation-dependent differences in clinical presentation. The preferentially type 2 cell expressed genes involved in critical functions (such as ATP-binding cassette transporter, ABCA3), those involved in susceptibility to acute lung damage, and those with known susceptibility to other severe lung diseases (such as G protein-coupled receptor for asthma susceptibility, GPR154 alias GPRA) will possibly serve as candidate genes in future studies. RDS associated with near-term and term births may have a different genetic predisposition and pathogenesis compared to RDS after very preterm birth. As we learn more about the molecular consequences of allelic variation, new therapies based on a new generation of surfactant diagnostics and individualized therapies may follow.

Genetic basis of respiratory distress syndrome.

Background: In a recent study utilizing a saline-lavaged adult rabbit model, we described a significant improvement in systemic oxygenation and pulmonary shunt after the instillation of a novel synthetic peptide-containing surfactant, Synsurf. Respiratory distress syndrome in the preterm lamb more closely resembles that of the human infant, as their blood gas, pH values, and lung mechanics deteriorate dramatically from birth despite ventilator support. Moreover, premature lambs have lungs which are mechanically unstable, with the advantage of being able to measure multiple variables over extended periods. Our objective in this study was to investigate if Synsurf leads to improved systemic oxygenation, lung mechanics, and histology in comparison to the commercially available porcine-derived lung surfactant Curosurf ® when administered before first breath in a preterm lamb model. Materials and methods: A Cesarean section was performed under general anesthesia on 18 time-dated pregnant Dohne Merino ewes at 129–130 days gestation. The premature lambs were delivered and ventilated with an expiratory tidal volume of 6–8 mL/kg for the first 30 minutes and thereafter at 8–10 mL/kg. In a randomized controlled trial, the two surfactants tested were Synsurf and Curosurf ® , both at a dose of 100 mg/kg phospholipids

/pdf/surfactant-treatment-before-first-breath-for-respiratory-1s95h7y441.pdf

Surfactant treatment before first breath for respiratory distress syndrome in preterm lambs: comparison of a peptide-containing synthetic lung surfactant with porcine-derived surfactant.

Pulmonary surfactant (PS) is a complex mixture of lipids and proteins that forms a monomolecular film at the lung-air interface. It serves dual purposes: (i) lowers the surface tension; and (ii) participates in innate immune defense of the lung. Surface tension lowering property of PS is achieved by forming a surface film (monolayer) which is highly enriched in dipalmitoylphosphatidylcholine. Among the four surfactant proteins (SP), SP-A and SP-D are hydrophilic, SP-B and SPC are hydrophobic and are also biocompatible in all the mammalians. This article gives a brief account of the history of research on PS, anatomy of lung, alveolar metabolism, composition and methodologies adopted for in vitro evaluation of the PS.The possible molecular mechanism of film formation (adsorption), and of film adaptation to surface changes (phase transitions) during the process of respiration have been described in detail. Major disorders of the surfactant system related with its clinical consequence, and the potentials of surfactant therapy in the treatment of some of these disorders have been discussed.A brief account of the evolutionary development of pulmonary surfactants has also been presented.

/pdf/composition-structure-and-biophysical-functions-of-pulmonary-4p4uuue77q.pdf

Composition, Structure and Biophysical Functions of Pulmonary Surfactants: Their Deficiency and Strategy for Remedy

Introduction: The comparative efficacy of pulmonary surfactant in the treatment of respiratory distress syndrome in preterm infants remains unclear. We aimed to evaluate the effectiveness of different pulmonary surfactant in the treatment of respiratory distress syndrome in preterm infants and to provide an evidence-based reference for clinical use. Material and methods: MEDLINE, Embase, The Cochrane Library, and Clinical Trials databases were electronically searched from inception to January 2019. Two reviewers independently screened literature and extracted data, and then R and RevMan 5.3 software packages were used to perform network meta-analysis. Results: The relative risk of respiratory distress syndrome in preterm infants associated with six different pulmonary surfactant was analysed, including beractant (Survanta), surfactant A  (Alveofact), calfactant (Infasurf), poractant (Curosurf), lucinactant (Surfaxin), and colfosceril (Exosurf). Patients with the following drugs appeared to have significantly reduced mortality of respiratory distress syndrome compare with beractant: surfactant A  (OR = 0.53, 95% CI: 0.31–0.90), calfactant (OR = 0.91, 95% CI: 0.85–0.97), poractant (OR = 0.72, 95% CI: 0.67–0.77), lucinactant (OR = 0.80, 95% CI: 0.71– 0.90), and colfosceril (OR = 0.93, 95% CI: 0.87–0.99). The SUCRA (surface under the cumulative ranking) values for each of the drugs were: beractant (8.9%), surfactant A (93.8%), calfactant (40.3%), poractant (65.4%), lucinactant (59.8%), and colfosceril (31.6%). Conclusions: Compared with beractant, other pulmonary surfactants are more effective to reduce the mortality of respiratory distress syndrome in preterm infants. Surfactant A  drugs appeared to have the best efficacy in reducing mortality of respiratory distress syndrome in preterm infants.

https://www.archivesofmedicalscience.com/pdf-124153-59573?filename=Comparative efficacy of.pdf

Comparative efficacy of pulmonary surfactant in respiratory distress syndrome in preterm infants: a Bayesian network meta-analysis

The miscibility of Langmuir monolayers of egg yolk lecithin (eggPC) with n-hexadecanoic acid (PA), 1-hexadecanol (HD), and their equimolar mixture (PA/HD) was investigated thermodynamically and morphologically. Surface pressure (π )-molecular area (A) and surface potential (ΔV )-A i sotherms for the binary and ternary systems were measured, employing the Wilhelmy method and the ionizing 241 Am electrode method, respectively. From the thermodynamic perspective, eggPC was partially miscible with PA, HD, and PA/HD within the monolayer state, in terms of an excess Gibbs free energy of mixing calculated from the π -A isotherms and a two-dimensional phase diagram based on a monolayer collapse pressure. This was also directly supported by phase behavior observations using luorescence microscopy (FM). EggPC formed a typical liquid-expanded (LE) monolayer, and the others formed liquid-condensed (LC) monolayers. The FM images exhibited miscible modes at middle molar fractions of PA, HD, and PA/ HD, and immiscible patterns at large molar fractions for all the systems examined. A new inding in the present study was that the eggPC/PA, eggPC/HD, and eggPC/(PA/HD) systems exhibited partial miscibility, although the systems were made of both LE (eggPC) and LC monolayers (the others). This miscibility is considered to be attributable to the molecular species comprising eggPC.

/pdf/miscibility-of-egg-yolk-lecithin-with-palmitic-acid-and-3dqsna8n2p.pdf

Miscibility of Egg Yolk Lecithin with Palmitic Acid and Hexadecanol at the Air-Water Interface

A Multicenter, Randomized, Masked, Comparison Trial of Lucinactant, Colfosceril Palmitate, and Beractant for the Prevention of Respiratory Distress Syndrome Among Very Preterm Infants

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

S.M. Donn

Author Tools

Chat about Author

Papers

A Multicenter, Randomized, Masked, Comparison Trial of Lucinactant, Colfosceril Palmitate, and Beractant for the Prevention of Respiratory Distress Syndrome Among Very Preterm Infants