Dr. Tore Curstedt co-invented Curosurf, drug that helped to treat Neonatal Respiratory Distress Syndrome [NRDS / IRDS] in 4 million babies worldwide. What is the problem with lung maturation in prematurely born babies?
– Dr. Curstedt, you invented a drug called Curosurf that helps to save lives, millions of babies around the world now. Would you please briefly describe what is the problem that your drug so successfully treats?
– Premature babies don’t have a component called surfactant, and if they don’t have surfactant, they cannot breathe. Because this surfactant lines the alveoli, the alveoli don’t collapse during expiration and the drug makes it easier for alveoli to expand during inspiration. And if the babies can survive two, three days, they will start to produce their own surfactant.
– So the key is these first several days of life?
– The key is the two, three, four first days of life, and usually you have to give this exogenous surfactant once, twice, or perhaps three times. Not more than that. The half-life time for this material is one day, one to two days.
– So the drug that you co-invented only needs to be given once, twice or three times to a prematurely born baby, and that makes all the difference in saving the baby’s life.
– Yes. Perhaps 40% of the babies need the drug only once, and perhaps the other 40 to 60%, need the drug two or three times.
– And how does the drug work?
– The drug will diminish the surface tension in the lungs and it will line the alveoli, and it will increase the possibility for the alveoli to open up. The surfactant, that will decrease the surface tension in the alveoli and it will line the alveoli. And during inspiration, it makes it much easier to open up lungs. And it will also prevent the alveoli to collapse during expiration.
– So when you give this drug to the baby, to prematurely born baby, then it prevents the collapse of the alveoli and that’s the hallmark of the respiratory distress syndrome.
– Yes, also to prevent the collapse, but also make it easier to open up so you can have oxygen into the lungs and oxygen taken up by the blood.
– It’s a very seemingly simple action, but nevertheless it’s such a dramatic effect and before Curosurf, the drug you invented, become available, babies died because the oxygen just couldn’t get to their tissues.
– Yeah, because they couldn’t take up oxygen, and in that case, you have this premature baby, which are blue babies, they can’t take up the oxygen and they can’t use the oxygen, they have no oxygen to use for their metabolism. And if you give the surfactant, you can see in a couple of minutes that the blue baby will be pink baby.
– So it’s a very easily observed and fast effect
– It’s very fast, in a couple of minutes. Two, three, four minutes.
– So you invented the drug that can be given just once, twice, or three times to a prematurely born baby and it changes the life.
– It changes the life and it will get them to survive. Of course, it was already known before that you have the surface active material called surfactant. And Dr. Mary Avery had shown in the late 1950s that premature babies had a lack of endogenous surfactant. So you have the connection with surface active material, and lack of surface active material in premature babies. But this was known in the late 1950s, but you can also see that in 1963, President Kennedy and his wife got a premature child. He was born in week 34.
– [Anton] So it was not that premature…
– No it’s not, it’s a little premature.
– [Anton] Six weeks before term.
– Six weeks…
– And the weight was 2.1 kilogram, so a big baby. And he died of respiratory distress syndrome. And that even if they know about surfactant, that it was impossible to give the babies exogenous surfactant at that time and that was 1963
– And they were treated at one of the best US hospitals in Boston.
– Yes, it was. It was the president’s child, of course.
– At the best hospital.
– The best hospital, the best treatment at that time
– And somewhere, thousands of miles away, a young researcher, Dr. Tore Curstedt, started to work on how to fix that problem.
– Yes, I and my colleague, Dr. Bengt Robertson, we had started. And of course it was also in other places of the world, they also started with surfactant research.