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The role of pulmonary surfactant in airway obstruction and its influence on airway reopening - review

Kuraszkiewicz B.

Biocybernetics and Biomedical Engineering

2006

Vol. 26, no. 2

75-83

Our knowledge about the role of pulmonary surfactant in obstructive airways disease is stiII limited, but there is convincing evidence that pulmonary surfactant plays a role in keeping the airways open. Whereas lung damage with dysfunction of alveolar surfactant is of importance in various respiratory diseases, such as ARDS (adult respiratory distress syndrome) or pneumonia, alveolar surfactant dysfunction does not seem to play a major role in obstructive airways disease. On the contrary, surfactant impairment in the airways as a secondary consequence of airway inflammation might have a major impact on the small airway function. Thus, dysfunction of surfactant in the airways might be a contributory factor to airway obstruction and increased airway resistance in obstructive lung disease. In last years, direct and indirect evidence has emerged for surfactant as a factor in the regulation of airway calibers. Surfactant may be of a greater importance in the airways than it has previously been recognized. This review will discuss those aspects of the airway mechanics that are closely related to the function of pulmonary surfactant. Some of the mechanisms discussed may be of secondary rather than primary importance in obstructive airways disease.