Cattel Francesco, Giordano Susanna, Bertiond Cecilia, Lupia Tommaso, Corcione Silvia, Scaldaferri Matilde, Angelone Lorenzo, De Rosa Francesco Giuseppe
S.C. Farmacia Ospedaliera -A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
Department of Medical Sciences, Infectious Diseases, University of Turin, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
Respir Physiol Neurobiol. 2021 Jun;288:103645. doi: 10.1016/j.resp.2021.103645. Epub 2021 Feb 28.
Several pre-clinical and clinical trials show that exogenous pulmonary surfactant has clinical efficacy in inflammatory lung diseases, especially ARDS. By infecting type II alveolar cells, COVID-19 interferes with the production and secretion of the pulmonary surfactant and therefore causes an increase in surface tension, which in turn can lead to alveolar collapse. The use of the pulmonary surfactant seems to be promising as an additional therapy for the treatment of ARDS. COVID-19 causes lung damage and ARDS, so beneficial effects of surfactant therapy in COVID-19-associated ARDS patients are conceivable, especially when applied early in the treatment strategy against pulmonary failure. Because of the robust anti-inflammatory and lung protective efficacy and the current urgent need for lung-supportive therapy, the exogenous pulmonary surfactant could be a valid supportive treatment of COVID-19 pneumonia patients in intensive care units in addition to the current standard of ARDS treatment.
多项临床前和临床试验表明，外源性肺表面活性物质在炎症性肺部疾病，尤其是急性呼吸窘迫综合征（ARDS）中具有临床疗效。新型冠状病毒肺炎（COVID-19）通过感染II型肺泡细胞，干扰肺表面活性物质的产生和分泌，从而导致表面张力增加，进而可导致肺泡塌陷。肺表面活性物质作为治疗ARDS的一种辅助疗法似乎很有前景。COVID-19会导致肺损伤和ARDS，因此可以想象表面活性物质疗法对COVID-19相关ARDS患者会有有益效果，尤其是在针对肺衰竭的治疗策略中尽早应用时。由于其强大的抗炎和肺保护功效以及当前对肺支持治疗的迫切需求，除了目前ARDS治疗的标准方法外，外源性肺表面活性物质可能是重症监护病房中COVID-19肺炎患者有效的支持性治疗方法。
