Surfactant biology and clinical application

Alterations of surfactant composition or levels have been found in nearly every form of lung disease including chronic, acute, infectious, inflammatory, obstructive, and interstitial lung diseases. It is well established that surfactant content and composition are altered in acute respiratory disease syndrome (ARDS). Several recent pilot studies in adults and children have examined the efficacy of surfactant therapy in ARDS. Some evidence supports the measurement of surfactant protein levels as markers for predicting the onset and outcome of ARDS and perhaps providing a window for early treatment of patients at risk to develop ARDS., Continued investigation into the role of surfactant in the immune regulation of the lung may also provide additional information to support the efficacy of surfactant replacement in lung disease. This article discusses surfactant biology, alterations of surfactant in disease, and potential clinical applications.