A small review on surfactant replacement therapy for neonates with respiratory distress syndrome

Since the early 1980s, surfactant replacement therapy (SRT) has revolutionized the treatment of neonatal respiratory distress syndrome (RDS) in premature infants, effectively addressing the surfactant deficiency associated with underdeveloped lungs. Surfactant therapy reduces alveolar surface tension, preventing lung collapse and optimizing gas exchange. Natural surfactants derived from animal sources have demonstrated superior efficacy over early protein-free synthetic surfactants, which are no longer widely available. Recent advancements include new-generation synthetic surfactants containing protein analogs that are undergoing clinical evaluation. The clinical administration of surfactants has shifted from standard endotracheal tube instillation to slightly invasive modes using thin catheters, falling the need for mechanical ventilation and related risks. Main components of surfactants, including dipalmitoylphosphatidylcholine (DPPC) and surfactant proteins (SP-A, SP-B, SP-C, SP-D), are crucial to its biophysical and immunological functions. Understanding the interaction between surfactant protein and surfactant is important for treatment of RDS. So in this mini review we have discussed about DPPC and surfactant protein interaction