Exogenous pulmonary surfactant: A review focused on adjunctive therapy for severe acute respiratory syndrome coronavirus 2 including SP-A and SP-D as added clinical marker

Ghati, Amit; Dam, Paulami; Tasdemir, Didar; Katı, Ahmet; Sellami, Hanen; Sezgin, Gülten Can; Ildız, Nilay; Franco, Octávio Luiz; Mandal, Amit Kumar; Öçsoy, İsmail

doi:10.1016/j.cocis.2020.101413

Cited by 46 publications

(58 citation statements)

References 31 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, pulmonary surfactant is involved in the barrier and protective function of the lungs, affecting innate and adaptive local immunity [ 4 ]. The exogenous surfactant exhibits anti-inflammatory properties and reduces the production of tumor necrosis factor-alpha, interleukin (IL)-1, IL-6, and, thus, it may efficiently contribute toward the repair of damaged alveoli in SARS-CoV-2-associated ARDS [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…This virus preferentially molests the alveolar type II cells and subsequently causes apoptosis, cellular damage, and altered production of the pulmonary surfactant [ 1 , 2 ]. Dysregulated function of the surfactant may result in alveolar collapse and inflammation, augmented capillary permeability, edema, and microvascular thrombosis [ 2 , 3 ]. In the past, the treatment strategy using the exogenous surfactant did not show the full therapeutic efficacy in the context of adult ARDS [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Beneficial effects of inhaled surfactant in patients with COVID-19-associated acute respiratory distress syndrome

Avdeev

Trushenko

Чикина

et al. 2021

Respiratory Medicine

View full text Add to dashboard Cite

Background We have investigated the use of nebulized surfactant as a potential therapeutic option for the patients with coronavirus disease 2019 (COVID-19)-associated acute respiratory distress syndrome (ARDS) undergoing non-invasive ventilation. Methods The patients were divided into 2 groups: surfactant (n = 33) and control (n = 32). The subjects in the surfactant group received the inhaled surfactant at daily dose of 150–300 mg. The oxygenation parameters and several clinical outcomes were analyzed. Results On the 5 day of therapy, PaO 2 /FiO 2 improved significantly in the surfactant group compared to the control group (184 (155–212) mmHg vs 150 (91–173) mmHg, p = 0.02). The inhaled surfactant significantly reduced the need for transfer of patients to intensive care units (24.2% vs 46.9%, p = 0.05) and invasive mechanical ventilation (18.2% vs 40.6%, p = 0.04). Even more, the nebulized surfactant shortened the length of non-invasive ventilation (7 (3–13) days vs 11 (5–22) days, p = 0.02) and time spent in hospital (18 (16–27) days vs 26 (21–31) days, p = 0.003) in patients suffering from COVID-19-linked ARDS. Conclusions Our preliminary data provided indications that inhaled surfactant therapy may represent a promising option for patients with COVID-19-associated ARDS. However, larger clinical trials are crucially needed.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Beneficial effects of inhaled surfactant in patients with COVID-19-associated acute respiratory distress syndrome

Avdeev

Trushenko

Чикина

et al. 2021

Respiratory Medicine

View full text Add to dashboard Cite

show abstract

“…In such a situation, all physiological functions (including the defensive ones) associated with the dynamic surface active properties of PS at the ALI are destroyed. When the innate PS is inactivated, the supplementation of exogenous PS is a vital strategy needed to recover the pulmonary functions but also to provide enough surfactant to produce the postulated physicochemical activity against SARS-CoV-2 [ 95 , 98 ]. Several clinical trials are undertaken currently to test the applicability of the exogenous surfactants in the treatment of COVID-19 [ 99 ].…”

Section: Particles On the Surface Of The Respiratory System: Role Of mentioning

confidence: 99%

Inhaled aerosols: Their role in COVID-19 transmission, including biophysical interactions in the lungs

Sosnowski¹

2021

Current Opinion in Colloid & Interface Science

View full text Add to dashboard Cite

The high rate of spreading of COVID-19 is attributed to airborne particles exhaled by infected but often asymptomatic individuals. In this review the role of aerosols in SARS-CoV-2 coronavirus transmission is discussed from the bio-physical perspective. The essential properties of the coronavirus virus transported inside aerosol droplets, their successive inhalation, and size-dependent deposition in the respiratory system are highlighted. The importance of face covers (respirators and masks) in the reduction of aerosol spreading is analyzed. Finally, the discussion of the physicochemical phenomena upon coronavirus enter to surface of lung liquids (bronchial mucus and pulmonary surfactant) is presented with a focus on a possible role of interfacial phenomena in pulmonary alveoli. Information given in this review should be important in understanding the essential biophysical conditions of COVID-19 infection via aerosol route as a prerequisite for effective strategies of respiratory tract protection and, possibly, indications for future treatments of the disease.

show abstract

“…the host immune response by releasing inflammatory mediators that act upon the alveoli resident macrophages (106). Activated macrophages release cytokines IL-1, IL-6, and TNF-a, which activate chemotactic immune cells circulating in the bloodstream.…”

Section: Host Immune Response and Development Of Severe Pneumoniamentioning

confidence: 99%

Modulation of Host Immune Response Is an Alternative Strategy to Combat SARS-CoV-2 Pathogenesis

et al. 2021

View full text Add to dashboard Cite

The novel SARS-CoV-2virus that caused the disease COVID-19 is currently a pandemic worldwide. The virus requires an alveolar type-2 pneumocyte in the host to initiate its life cycle. The viral S1 spike protein helps in the attachment of the virus on toACE-2 receptors present on type-2 pneumocytes, and the S2 spike protein helps in the fusion of the viral membrane with the host membrane. Fusion of the SARS-CoV-2virus and host membrane is followed by entry of viral RNA into the host cells which is directly translated into the replicase-transcriptase complex (RTC) following viral RNA and structural protein syntheses. As the virus replicates within type-2 pneumocytes, the host immune system is activated and alveolar macrophages start secreting cytokines and chemokines, acting as an inflammatory mediator, and chemotactic neutrophils, monocytes, natural NK cells, and CD8+ T cells initiate the local phagocytosis of infected cells. It is not the virus that kills COVID-19 patients; instead, the aberrant host immune response kills them. Modifying the response from the host immune system could reduce the high mortality due to SARS-CoV-2 infection. The present study examines the viral life cycle intype-2 pneumocytes and resultant host immune response along with possible therapeutic targets.

show abstract

Exogenous pulmonary surfactant: A review focused on adjunctive therapy for severe acute respiratory syndrome coronavirus 2 including SP-A and SP-D as added clinical marker

Cited by 46 publications

References 31 publications

Beneficial effects of inhaled surfactant in patients with COVID-19-associated acute respiratory distress syndrome

Beneficial effects of inhaled surfactant in patients with COVID-19-associated acute respiratory distress syndrome

Inhaled aerosols: Their role in COVID-19 transmission, including biophysical interactions in the lungs

Modulation of Host Immune Response Is an Alternative Strategy to Combat SARS-CoV-2 Pathogenesis

Contact Info

Product

Resources

About