[Molecular aspects of pulmonary surfactant in neonatal respiratory distress syndrome and surfactant replacement therapy].

A success in surfactant therapy for neonatal respiratory distress syndrome in Japan in 1980 has led to the introduction of scientific randomized controlled trials on the one hand, and a great interest in the constituents of the exogenous surfactant on the other. It contains 2% hydrophobic surfactant proteins B and C that are now known to be critical components in surface-active properties of lung surfactant. The application of molecular biology has fostered rapid progress in the elucidation of the structure, function and metabolism of the surfactant. The introduction of surfactant therapy has had a major impact on neonatal mortality and morbidity. Although various surfactant preparations are already in the market and a new generation of totally synthetic surfactant is under clinical evaluation, further studies are required to address the issue regarding optimization of surfactant therapy.