Pulmonary protein surfactant therapy has been seminal in the improved survival of premature neonates. However, a significant proportion of premature neonates born less than 28 weeks gestation, develop neonatal chronic lung disease. Premature neonatal lungs have not developed the surfactant stores essential for breathing and require surfactant as a replacement therapy. Unfortunately, current commercial surfactant therapies contain only surfactant proteins SP-B and C lack the essential anti-inflammatory innate immune proteins SP-A and SP-D.
Fifteen million babies are born prematurely every year. Approximately 50% of premature infants born at less than 28 weeks gestation develop chronic lung disease characterized by a dependency on oxygen at 36 weeks gestational age.
These children may develop lung inflammation and require long-term home oxygen therapy for up to 4-5 years, potentially leading to permanent adverse respiratory and neurodevelopmental outcomes. Oxygen therapy may also damage the delicate lung tissue of the premature neonate. Importantly, commercial surfactant formulations which lack the natural anti-inflammatory proteins (SP-A and SP-D) do not protect against this damage There are currently no effective treatments for neonatal chronic lung disease (nCLD)