Lal Mithilesh K, Sinha Sunil K
The James Cook University Hospital, Marton Road, Middlesbrough.
Ther Adv Respir Dis. 2008 Oct;2(5):339-44. doi: 10.1177/1753465808097113. Epub 2008 Sep 18.
Respiratory distress syndrome (RDS) is a leading cause of mortality and morbidity in preterm infants. Surfactant replacement therapy has been widely used to prevent and treat RDS in these newborns and has now become a standard of care. First-generation synthetic surfactants such as Exosurf did not contain any surfactant protein. This disadvantage was overcome with animal-derived surfactant preparations which contain specific proteins but has the limitation of being derived from animal sources. This has led to development of newer synthetic surfactants such as lucinactant (Surfaxin, Discovery Laboratories, Philadelphia) which contains the protein B mimic synthetic peptide, sinapultide. Recent phase 3 clinical trials with Surfaxin show promising results with similar efficacy as animal derived surfactants and yet avoiding the disadvantage associated with animal products. The purpose of this paper is to summarise results of recent clinical trials of Surfaxin use in newborns with RDS.
呼吸窘迫综合征(RDS)是早产儿死亡和发病的主要原因。表面活性剂替代疗法已被广泛用于预防和治疗这些新生儿的RDS,现已成为一种标准治疗方法。第一代合成表面活性剂,如Exosurf,不含任何表面活性剂蛋白。动物源性表面活性剂制剂克服了这一缺点,其含有特定蛋白质,但存在来源于动物的局限性。这促使了更新型合成表面活性剂的开发,如卢西纳坦(Surfaxin,发现实验室,费城),其含有蛋白质B模拟合成肽西纳普利肽。最近使用Surfaxin的3期临床试验显示出有前景的结果,其疗效与动物源性表面活性剂相似,同时避免了与动物产品相关的缺点。本文的目的是总结近期使用Surfaxin治疗新生儿RDS的临床试验结果。