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State-of-the-Art Surfactant in Biomedical Application: A Commemorative Issue in Honor...
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State-of-the-Art Surfactant in Biomedical Application: A Commemorative Issue in Honor of Prof. Tetsuro Fujiwara

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Drug Discovery, Development and Delivery".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 2988

Special Issue Editor

Dr. Fumihiko Namba

E-Mail Website
Guest Editor
Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe 3508550, Japan
Interests: bronchopulmonary dysplasia; patent ductus arteriosus; preterm infants
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Von Neergaard first suggested the presence of pulmonary surfactant based on experiments with a pig's lung in 1929. After that, essential contributions to understanding pulmonary surfactants and their importance in lung stability and mechanics of respiration came in the 1950s. In 1959, Avery and Mead discovered that a lack of surfactant is the cause of respiratory distress syndrome (RDS), leading to the studies of pulmonary surfactant from the 1980s on to treat and prevent RDS in preterm infants. In 1980, Tetsuro Fujiwara from Japan was the first who publish the results of a successful trial of surfactant treatment for RDS, and numerous trials confirmed the effectiveness of surfactants in improving mortality, the need for ventilation, and short-term outcomes and a significant impact on residual morbidity of preterm infants. As a result, surfactant therapy has become the standard therapy of RDS and is deemed one of the most effective and safe medicines in neonatology. However, after 40 years since the introduction of surfactant replacement therapy for the treatment of RDS, neonatologists have still been seeking to improve its efficacy and short- and long-term pulmonary outcomes by diagnosing RDS early and precisely, introducing novel synthetic surfactant and non-invasive alternative methods for surfactant replacement therapy, and so on.

In this Commemorative Special Issue, we intend to present an overview of the state of the art of this exciting story, including the significant recent advances and the latest research and milestones in research on pulmonary surfactants. For this Special Issue, we welcome the submission of original high-quality research and review articles focused on (i) diagnostic tools for surfactant deficiency, (ii) in vivo and in vitro models, (iii) molecular mechanisms underlying the abnormal surfactant metabolism and function in the lung and other organs, and (iv) novel therapeutic strategies for surfactant replacement therapy.

Dr. Fumihiko Namba
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (3 papers)

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11 pages, 1192 KiB  
Article
Application of Video Laryngoscopy for Minimally Invasive Surfactant Therapy: A Retrospective Comparative Cohort Study
by Tamara Jahmani, Michael R. Miller, Orlando da Silva and Soume Bhattacharya
Biomedicines 2024, 12(3), 618; https://doi.org/10.3390/biomedicines12030618 - 9 Mar 2024
Viewed by 610
Abstract
Minimally invasive surfactant therapy (MIST) has emerged as a preferred method of surfactant delivery. Pioneers of this technique have described the use of direct laryngoscopy (DL) for MIST. With the increasing application of video laryngoscopy (VL) for neonatal airway management, it is speculated [...] Read more.
Minimally invasive surfactant therapy (MIST) has emerged as a preferred method of surfactant delivery. Pioneers of this technique have described the use of direct laryngoscopy (DL) for MIST. With the increasing application of video laryngoscopy (VL) for neonatal airway management, it is speculated that MIST techniques can be adapted for use with VL. Objective: To compare procedural success, operator ease of use, and complication of MIST using VL vs. MIST using DL. Methods: This was a retrospective, observational cohort study conducted at a tertiary-level neonatal intensive care unit after obtaining ethical approval. We included neonates who received MIST between 1 October 2020 and 31 October 2022. Baseline demographic characteristics, along with procedural data, were collected. Primary outcome measures included the overall procedural success rate, the need for multiple attempts, and the total number of attempts. Secondary outcome measures included the occurrence of adverse events, the need for a second dose of surfactant, and the need for intubation within 7 days of the procedure. Means and SDs, independent t-tests, frequencies, and chi-square were used as appropriate. p-values < 0.05 were considered statistically significant. Results: Of the 79 neonates included, 37 neonates received MIST via VL, while 42 received MIST via DL. The median gestational age was lower in the VL group at 29.0 weeks vs. 30.5 weeks (p = 0.011) in the DL group. The median birthweight in the VL group was 1260 g, IQR (1080, 1690), which was significantly lower than the DL group, which was 1575 g, IQR (1220, 2251), p = 0.028. Purpose-built catheter use was higher in the DL group. The overall procedural success was similar between groups. The need for multiple attempts was lower with VL in comparison to DL [4 (11%) vs. 13 (31%); p = 0.034)] at the univariate level but not significant at multivariate analysis (p = 0.131). Procedural complications, the need for a second dose of surfactant, the need for mechanical ventilation post-MIST, and operator ease of use were similar. User comments emphasized the value of VL in providing real-time visual information to confirm catheter placement and guide operators/trainees. Conclusion: Overall, in our cohort, despite VL being a more recently adapted technology used more in smaller, sicker, and more premature neonates, procedural success, complications, and operator ease of use for MIST using VL and DL were comparable. Our findings show the successful application of VL for MIST and suggest procedural advantages that might facilitate universal adoption. Full article
(This article belongs to the Special Issue State-of-the-Art Surfactant in Biomedical Application: A Commemorative Issue in Honor of Prof. Tetsuro Fujiwara)
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22 pages, 11601 KiB  
Article
Structure and Function of Canine SP-C Mimic Proteins in Synthetic Surfactant Lipid Dispersions
by Frans J. Walther and Alan J. Waring
Biomedicines 2024, 12(1), 163; https://doi.org/10.3390/biomedicines12010163 - 12 Jan 2024
Viewed by 792
Abstract
Lung surfactant is a mixture of lipids and proteins and is essential for air breathing in mammals. The hydrophobic surfactant proteins B and C (SP-B and SP-C) assist in reducing surface tension in the lung alveoli by organizing the surfactant lipids. SP-B deficiency [...] Read more.
Lung surfactant is a mixture of lipids and proteins and is essential for air breathing in mammals. The hydrophobic surfactant proteins B and C (SP-B and SP-C) assist in reducing surface tension in the lung alveoli by organizing the surfactant lipids. SP-B deficiency is life-threatening, and a lack of SP-C can lead to progressive interstitial lung disease. B-YL (41 amino acids) is a highly surface-active, sulfur-free peptide mimic of SP-B (79 amino acids) in which the four cysteine residues are replaced by tyrosine. Mammalian SP-C (35 amino acids) contains two cysteine-linked palmitoyl groups at positions 5 and 6 in the N-terminal region that override the β-sheet propensities of the native sequence. Canine SP-C (34 amino acids) is exceptional because it has only one palmitoylated cysteine residue at position 4 and a phenylalanine at position 5. We developed canine SP-C constructs in which the palmitoylated cysteine residue at position 4 is replaced by phenylalanine (SP-Cff) or serine (SP-Csf) and a glutamic acid-lysine ion-lock was placed at sequence positions 20–24 of the hydrophobic helical domain to enhance its alpha helical propensity. AI modeling, molecular dynamics, circular dichroism spectroscopy, Fourier Transform InfraRed spectroscopy, and electron spin resonance studies showed that the secondary structure of canine SP-Cff ion-lock peptide was like that of native SP-C, suggesting that substitution of phenylalanine for cysteine has no apparent effect on the secondary structure of the peptide. Captive bubble surfactometry demonstrated higher surface activity for canine SP-Cff ion-lock peptide in combination with B-YL in surfactant lipids than with canine SP-Csf ion-lock peptide. These studies demonstrate the potential of canine SP-Cff ion-lock peptide to enhance the functionality of the SP-B peptide mimic B-YL in synthetic surfactant lipids. Full article
(This article belongs to the Special Issue State-of-the-Art Surfactant in Biomedical Application: A Commemorative Issue in Honor of Prof. Tetsuro Fujiwara)
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3 pages, 153 KiB  
Commentary
Dr. Tetsuro Fujiwara—My Memories from the Early Days of Dr. Fujiwara’s Research
by Alan H. Jobe
Biomedicines 2024, 12(1), 218; https://doi.org/10.3390/biomedicines12010218 - 18 Jan 2024
Viewed by 688
Abstract
This brief commentary honors Dr. Tesuro Fujiwara, the first person to treat infants with respiratory distress syndrome by instilling surfactant into their trachea. In the 1960s, mortality from RDS, which could only be treated with oxygen, was about 50 percent. Based on the [...] Read more.
This brief commentary honors Dr. Tesuro Fujiwara, the first person to treat infants with respiratory distress syndrome by instilling surfactant into their trachea. In the 1960s, mortality from RDS, which could only be treated with oxygen, was about 50 percent. Based on the physiology Fujiwara learned that lung immaturity could be treated with doses of surfactant from animals in sheep models. He then made a surfactant from cow lungs called Servanta and treated 10 infants with RDS, who all had a large improvement in oxygenation. Other new therapies, such as continuous positive airway pressure and newer infant ventilators—in combination with surfactant therapy have decreased infant mortality to less than 1% from RDS in the most recent US infant death statistics. Full article
(This article belongs to the Special Issue State-of-the-Art Surfactant in Biomedical Application: A Commemorative Issue in Honor of Prof. Tetsuro Fujiwara)
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