ABSTRACT

This book focuses on the basic science of endogenous and exogenous lung surfactants and its translation to clinical lung surfactant therapies. Initial chapters provide an introduction to surface tension, surfactants, surface films, phospholipid structure and biophysics, and experimental methods and materials used in studying lung surfactants. Following chapters cover the discovery of lung surfactant, the theoretical basis of its pulmonary activity, its functional composition and molecular biophysics, and the mechanisms by which it can become dysfunctional in lung disease and injury. The direct connection between the biophysical properties and physiological actions of lung surfactants is detailed, and biophysical-physiological correlations of lung surfactant activity and inhibition are provided. The final third of the book emphasizes applications involving surfactant replacement therapy for the neonatal respiratory distress syndrome (RDS), acute lung injury, and the acute respiratory distress syndrome (ARDS). Animal models of surfactant deficiency and acute lung injury are summarized, and their use in developing exogenous surfactant therapy for RDS and ARDS are illustrated in a variety of examples. The history and current status of clinical surfactant therapy for RDS and ARDS are then discussed in detail, along with current and future exogenous surfactants and their composition and activity. The necessary integration of basic and clinical research on lung surfactants is emphasized throughout coverage here. The style of presentation is designed for physicians and scientists with varying backgrounds in interfacial phenomena and biophysics. Each chapter (other than this Introduction) has an initial Overview and a final Summary covering main points and perspectives. Some chapter text is also printed in smaller type to designate supplementary material or explanation. The body of each chapter contains extensive literature citations, which are compiled in alphabetical order at the end of the book along with a glossary of common terms and abbreviations.