ABSTRACT
The composition and activity of clinical exogenous surfactants currently in use to treat respiratory disease and injury are discussed in this chapter. Several exogenous surfactants used earlier in research on surfactant therapy in infants are also noted. In addition to detailing current surfactant preparations, new exogenous surfactants under active clinical investigation are described and potential additional approaches for future drug development are identified. Although clinical exogenous surfactants of high activity are currently available, most contain material from animal lungs. Active avenues of development for new clinical exogenous surfactants include the use of recombinant human sequence apoproteins or hydrophobic peptides combined with synthetic lipids. In addition, future synthetic surfactants could be formulated to contain novel components such as phospholipid analog molecules resistant to inflammation-induced enzymatic degradation. Some current clinical exogenous surfactants could also potentially be improved in activity by adding specific apoprotein or peptide components as discussed in this chapter.
