Calfactant

Abstract

Surfactant administration has proven remarkably effective in the prevention and treatment of infantile respiratory distress syndrome (IRDS) and may also be beneficial in other forms of acute lung injury. Several surfactant products are available commercially along with others in various phases of development and clinical trials. While all of these products share an ability to lower surface tension in vitro, there are substantial compositional differences that appear to affect their in vivo efficacy. At present, the 'modified natural' surfactants containing the hydrophobic surfactant proteins SP-B and SP-C appear most effective. Calfactant may have a particular advantage because of its relatively high content of SP-B and its lack of contamination with non-surfactant lipids and proteins.

A Multicenter, Randomized, Masked, Comparison Trial of Lucinactant, Colfosceril Palmitate, and Beractant for the Prevention of Respiratory Distress Syndrome Among Very Preterm Infants

“…The results of this study are consistent with those of earlier trials that compared synthetic surfactants lacking SPs with animal-derived surfactants containing variable quantities of SP-B and SP-C. 3,30,31 Of those studies, only the trial by Hudak et al 30 used a prophylactic approach. In those studies, infants treated with animal-derived surfactants experienced more rapid improvement in oxygenation and lung compliance.…”

“…3,32,33 The superiority of animal-derived surfactants over non-protein-containing synthetic surfactants seemed consistent with the importance of SP-B, but animalderived surfactants also contain SP-C, which might have contributed importantly to the observed benefits. 31 Several experimental lines of evidence have supported a more important role for SP-B over SP-C in the effectiveness of exogenous surfactants. SP-B promotes the rapid absorption and stabilization of phospholipids at the air-liquid interface and accounts for the sustained low surface-tension activity after dynamic compression.…”

Post hoc analysis of calfactant use in immunocompromised children with acute lung injury: Impact and feasibility of further clinical trials*

“…Calfactant (Infasurf produced by ONY, Amherst, NY) is a modified natural lung surfactant approved by the Food and Drug Administration for infantile respiratory distress syndrome (12). It has a ratio of phospholipids to apoprotein surfactant protein (SP)-B similar to that of natural bovine surfactant (13). Additionally, its activity seems to equal that of natural surfactant (14) and it is resistant to inhibition by lysophospholipids and proteins associated with lung injury (15).…”

Discovery of novel S. aureus autolysins and molecular engineering to enhance bacteriolytic activity

“…S3). S. aureus is also a major causative agent of acute pneumonias, prompting us to test the activity of the chimeric enzymes in the clinical grade lung surfactant Infasurf, which is widely used in lung surfactant replacement therapy for infants suffering from respiratory distress syndrome (Willson 2001). In PBS suspensions containing up to 60% lung surfactant, SsaALP-LBD retained full activity, while LytO-LBD exhibited a trend toward higher activity with increasing lung surfactant (Fig 5d).…”