Role of Surfactant for the Treatment of Alveolar Cells against Coronavirus (Covid-19)

Main Article Content

Sony Ahmed
Md. Shamim Akter
Kallol Roy
Md. Shafiul Islam


Coronavirus disease (COVID-19) is an infectious disease caused by the newly discovered coronavirus. Coronavirus affects human lung tissues. Covid-19 should be infection of the lungs, the virus infects alveolar cells resulting in reduced production of pulmonary surfactant. Pulmonary surfactant is a complex of lipids and proteins that line the alveolar epithelial surface and stabilize it during respiration. The surfactant helps to reduce the surface tension on alveoli. The surface-active components of the alveoli are a complex mixture of specific lipids, proteins and carbohydrates, which is produced in the lungs by type II alveolar epithelial cells. As a result, the lungs continue to collapse, reducing its own volume, but the collapse is prevented by the muscles of inspiration, which instead increase its volume. Covid-19 allows the surfactant to maintain the correct amount of surfactant during the acute phase of infection during lung infection and allows time to resume and allow individual surfactant production for type II cells. Surfactant degradation or inactivation may contribute to increased susceptibility to pneumonia and increased susceptibility to infection. Surfactant deficiency in patients with acute respiratory syndrome in adults and surfactant administration may be a useful therapy against Covid-19.

Surfactant therapy, Covid-19, respiratory distress syndrome, alveolar cells, surface tension.

Article Details

How to Cite
Ahmed, S., Akter, M. S., Roy, K., & Islam, M. S. (2020). Role of Surfactant for the Treatment of Alveolar Cells against Coronavirus (Covid-19). Annual Research & Review in Biology, 35(6), 34-39.
Minireview Article


Louisiana State University Health Sciences Center. ACE inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19; 2020.

Ajaykumar B. Coronavirus complications: How does Covid-19 affect your lungs? Narayana Health; 2020.

Hansen JE, Ampaya EP, Bryant GH. The branching pattern of airways and air spaces of a single human terminal bronchiole. Journal of Applied Physiology. 1975;38:983-989.

Saladin K. Human anatomy 3rd Ed. McGraw-Hill. 2011;641-643.

Weinberger, Steven, Cockrill. Principles of pulmonary medicine Seventh Ed. Elsevier. 2019;126-129.

Ross, Michael H, Pawlina. Histology A Text and Atlas Sixth Edition; 2011.

Fehrenbach H. Alveolar epithelial type II cell defender of the alveolus revisited. Respir Res. 2001;2:33-46.

International Union of Pure and Applied Chemistry IUPAC Gold Book, Surfactant Surface Active Agent. Last Revised.

Edwin JA, Veldhuizen, Henk P. Haagsman. Role of pulmonary surfactant components in surface film formation and dynamics. Biochimica et Biophysica Acta BBA Biomembranes. 2000;1467:255-270.

Young, Barbara. Wheater's functional histology: A text and colour atlas. O'Dowd, Geraldine, Woodford, Phillip (Sixth Ed.). Philadelphia, PA. pp. Ch.; 2014.

Perlman S. Another decade, another coronavirus. N Engl J Med.; 2020.

Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet; 2020.

Alveoli and the breathing process. Retrieved 2013-10-30.

King RJ, Clements JA. Surface active materials from dog lung. Method of isolation. Am J. Physiol. 1972;223:707-14.

King RJ, Clements JA. Surface active materials from dog lung: Composition and physiological correlations. Am J Physiol. 1972;223:715-26.

Kulovich MV, Hallman M, Gluck L. The lung profile: Normal pregnancy. Am J Obstet Gynecol. 1979;135:57-63.

Hallman M, Spragg R, Harrell JH, Moser KM, Gluck L. Evidence of lung surfactant abnormality in respiratory failure. J Clin Invest. 1982;70:673-83.

Liau OF, Barrett CR, Loomis AL, Cernansky G, Ryan SF. Diphosphatidylglycerol in experimental acute alveolar injury in the dog. J Lipid Res. 1984;25:678-83.

Raju TNK, Vidyasagar O, Bhat R. Double-blind controlled trial of single-dose treatment with bovine surfactant in severe hyaline membrane disease. Lancet. 1987;651-5.

Suzuki Y, Kogishi K, Fujita Y, Kina T, Nishikawa S. A monoclonal antibody to the 15,000 dalton protein associated with porcine pulmonary surfactant. Exp Lung Res. 1986;1l:61-73.

Whitsett JA, Ohning BL, Ross G. Hydrophobic surfactant-associated protein in whole lung surfactant and its importance for biophysical activity in lung surfactant extracts used for replacement therapy. Pediatr Res. 1986;20:460-7.

Said SI, Avery ME, Davis RK, Banerjee CM, EI-Gohary M. Pulmonary surface activity in induced pulmonary edema. J Clin Invest. 1965;44:458-64.

Ikegami M, Jobe A, Glatz T. Surface activity following natural surfactant treatment in premature lambs. J Appl Physiol. 1981;51:306-12.

Ikegami M, Jacobs H, Jobe A. Surfactant function in respiratory distress syndrome. J Pediatr. 1983;102:443-7.

Jacobs H, Jobe A, Ikegami M, Glatz T, Jones S, Barajas L. Premature lambs rescued from respiratory failure with natural surfactant: Clinical and biophysical correlates. Pediatr Res. 1982;16:424-9.

Robertson B. Pathology and pathophysiology of neonatal surfactant deficiency in pulmonary surfactant. In: Robertson B, Van Golde LMG, Batenburg JJ, Eds. Pulmonary surfactant. Amsterdam: Elsevier Science Publishers. 1984;383-418.

Nilsson R, Grossmann G, Robertson B. Lung surfactant and the pathogenesis of neonatal bronchiolar lesions induced by artificial ventilation. Pediatr Res. 1978;12: 249-55.

Nilsson R, Grossmann G, Robertson B. Pathogenesis of neonatal lung lesions induced by artificial ventilation: Evidence against the role of barotrauma. Respiration. 1980;40:218-25.

Christian A, Devaux, Jean-Marc R, Philippe C. New insight on the antiviral effects of chloroquine against Coronavirus what to expect for COVID-19. International Journal of Antimicrobial Agents; 2020.

Jobe A, Ikegami M. Surfactant for the treatment of respiratory distress syndrome. The American Review of Respiratory Disease. 1987;136:1256-75.