Wright J R, Clements J A
Am Rev Respir Dis. 1987 Aug;136(2):426-44. doi: 10.1164/ajrccm/136.2.426.
Despite the grave difficulties that beset researchers who are trying to isolate and characterize the various intracellular and extracellular forms of lung surfactant; despite the serious ambiguities of interpretation of experimental data caused by the multicomponent nature of the surfactant; despite the inaccessibility for diagnostic purposes of this material, which functions deep in the lungs; despite the fact that incisive methods of protein chemistry and molecular biology have only recently been brought to bear on lung surfactant; despite all these problems, our knowledge and understanding of lung surfactant are rapidly increasing. We know now that it is a dynamic system with many parts, and that the reserves of these are normally not large and are recycled. We believe that tight metabolic control must exist to maintain these reserves, and we already have experimental techniques to raise or lower the reserves. Heroic methods of surfactant substitution are now being tested in patients whose deficiency or risk thereof is sufficiently desperate, and the results of these clinical trials, if they are carefully documented with lung function data, will add a new dimension to our knowledge of surfactant dynamics. We may expect in the future that more subtle alterations in surfactant function will become detectable and more sophisticated methods to manipulate the system will be invented. Essential to these will be a deeper understanding of surfactant forms, pathways, kinetics, and controls. Fortunately, research on surfactant structure, metabolism, and turnover intrigues many investigators. They, we may hope, will soon provide the necessary information.
尽管试图分离和鉴定肺表面活性物质各种细胞内和细胞外形式的研究人员面临着重重困难；尽管由于表面活性物质的多组分性质导致实验数据的解释存在严重模糊性；尽管这种在肺部深处发挥作用的物质因诊断目的难以获取；尽管蛋白质化学和分子生物学的精确方法直到最近才应用于肺表面活性物质研究；尽管存在所有这些问题，我们对肺表面活性物质的认识和理解仍在迅速增加。我们现在知道它是一个由许多部分组成的动态系统，而且这些部分的储备通常不大且会循环利用。我们相信必须存在严格的代谢控制来维持这些储备，并且我们已经有了提高或降低储备的实验技术。目前正在对那些表面活性物质缺乏或有足够高缺乏风险的患者进行大胆的表面活性物质替代方法测试，如果这些临床试验结果能与肺功能数据仔细记录在一起，将为我们对表面活性物质动力学的认识增添新的维度。我们可以期待未来能够检测到表面活性物质功能更细微的变化，并且会发明出更复杂的方法来操控这个系统。对这些而言，更深入地了解表面活性物质的形式、途径、动力学和调控至关重要。幸运的是，关于表面活性物质结构、代谢和更新的研究引起了许多研究者的兴趣。我们希望他们很快能提供必要的信息。
