Bengt A. Robertson | |
---|---|
Born | Stockholm, Sweden | 14 September 1935
Died | 7 December 2008 73) | (aged
Education | Karolinska Institute |
Known for | Corusurf |
Scientific career | |
Thesis | The intrapulmonary arterial pattern in normal infancy and in transposition of the great arteries (1968) |
Bengt A. Robertson was a Swedish physician and perinatal pathologist. Robertson was primarily known for the development of the synthetic lung surfactant known as Corusurf that brought relief to very small babies suffering from infant respiratory distress syndrome (RDS). [1] [2] [3] From 1974 to 2000 he was the director of the division for experimental perinatal pathology in the department of women and child Health at the Karolinska Institute.
In 1996 he was awarded the King Faisal International Prize in Medicine together with Tetsurō Fujiwara for contributions to the understanding of neonatal medicine. [4] [5]
Robertson was born and grew up in Stockholm. As a child he attended the Södra Latins Gymnasium in the Södermalm area of Stockholm, leaving in 1953. [1] Having decided to become a physician, Robertson attended the Karolinska Institute, a medical university and graduated Master of Science in Medicine (Swedish: Läkarexamen) in 1960. [5] Robertson followed the MD with a Doctor of Philosophy degree and was awarded a doctorate in 1968. His thesis was titled: "The intrapulmonary arterial pattern in normal infancy and in transposition of the great arteries". [5]
Robertson was married to Gertie Grossmann, a pediatric surgeon who collaborated with him on surfactant research. [1] Bengt had four children from a previous marriage, consisting one daughter and three sons. [1]
From 1974 to 2000 he was director of the department of Experimental Perinatal Pathology at the Karolinska Institute. [6] From 1994 to 1997, Robertson was also director of the department of pediatric pathology at Karolinska University Hospital. [1] In 2002, Robertson was promoted to a adjunct professor in Perinatal Pathology at the Karolinska Institute. [1]
In 1959, Mary Avery and Jere Mede conducted a trial at the department of physiology at Harvard University in Boston, that showed that respiratory distress syndrome (RDS) was due to surfactant deficiency. [7] Two trials followed that used synthetic Dipalmitoylphosphatidylcholine surfactant. The surfactant treatment was delivered as a mist via a nebulizer but the trials showed mixed results. Robillard stated it seemed worthy of further investigation. [8] The second study by Jacqueline Chu and her colleagues John Clements, Marshall Klaus and Bill Tooley in Singapore, [9] implied that the underlying cause of RDS was low blood flow instead instead of a deficiency of surfactant. [10]
In 1972, Bengt and Enhörning conducted two trials to discover the reasons for the failure of nebulised synthetic surfactant. They described that when natural surfactant was installed directly into the trachea of premature rabbits, normal lung expansion was achieved, and the animals survived. [11] [12] The discovery that the treatment effect was dependent on the surfactant preparation containing natural surfactant proteins and that the surfactant was administered as a bolus dose directly into the trachea, was a fine discovery, i.e. to be effective the treatment needed to be nebulised directly into the lungs of preterm infants, [2] which resulted in the enhanced expansion of the lungs by air. [12]
When Robertson was a visiting scientist of the department of pathology at Toronto University between 1977-1979, he met obstetrician Göran Enhörning who was based at the Toronto Western Hospital. Enhörning, like Robertson was from Stockholm and would become his principal collaborator. [13]
In the autumn of 1984, Bengt became the leader of a group of neonatologist and surfactant researchers, known as "The Collaborative European Multicenter Study Group", who were formed to test Curosurf in the first large international multicentre clinical trial. [2]
Robertson received many honours throughout his life. In 1996, he was first recognised when he was awarded the King Faisal International Prize. [5] Two years later in 1998, Robertson along with Tore Curstedt was awarded the Hilda and Alfred Eriksson Prize by the Royal Swedish Academy of Sciences. [14] In 2002, he was awarded the Erich Saling Maternité Prize given by the European Association of Perinatal Medicine. [15] This was followed in 2004 with the awarding of the Lars Werkö Prize by the Swedish Heart Lung Foundation along with Tore Curstedt. [16]
Pulmonary alveolar proteinosis (PAP) is a rare lung disorder characterized by an abnormal accumulation of surfactant-derived lipoprotein compounds within the alveoli of the lung. The accumulated substances interfere with the normal gas exchange and expansion of the lungs, ultimately leading to difficulty breathing and a predisposition to developing lung infections. The causes of PAP may be grouped into primary, secondary, and congenital causes, although the most common cause is a primary autoimmune condition in an individual.
Infant respiratory distress syndrome (IRDS), also known as surfactant deficiency disorder (SDD), and previously called hyaline membrane disease (HMD), is a syndrome in premature infants caused by developmental insufficiency of pulmonary surfactant production and structural immaturity in the lungs. It can also be a consequence of neonatal infection and can result from a genetic problem with the production of surfactant-associated proteins.
Transient tachypnea of the newborn is a respiratory problem that can be seen in the newborn shortly after delivery. It is caused by retained fetal lung fluid due to impaired clearance mechanisms. It is the most common cause of respiratory distress in term neonates. It consists of a period of tachypnea. Usually, this condition resolves over 24–72 hours. Treatment is supportive and may include supplemental oxygen and antibiotics. The chest x-ray shows hyperinflation of the lungs including prominent pulmonary vascular markings, flattening of the diaphragm, and fluid in the horizontal fissure of the right lung.
Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn. It is a hospital-based specialty and is usually practised in neonatal intensive care units (NICUs). The principal patients of neonatologists are newborn infants who are ill or require special medical care due to prematurity, low birth weight, intrauterine growth restriction, congenital malformations, sepsis, pulmonary hypoplasia, or birth asphyxia.
Pulmonary surfactant is a surface-active complex of phospholipids and proteins formed by type II alveolar cells. The proteins and lipids that make up the surfactant have both hydrophilic and hydrophobic regions. By adsorbing to the air-water interface of alveoli, with hydrophilic head groups in the water and the hydrophobic tails facing towards the air, the main lipid component of surfactant, dipalmitoylphosphatidylcholine (DPPC), reduces surface tension.
Dipalmitoylphosphatidylcholine (DPPC) is a phospholipid (and a lecithin) consisting of two C16 palmitic acid groups attached to a phosphatidylcholine head-group.
Mary Ellen Avery, also known as Mel, was an American pediatrician. In the 1950s, Avery's pioneering research efforts helped lead to the discovery of the main cause of respiratory distress syndrome (RDS) in premature babies: her identification of surfactant led to the development of replacement therapy for premature infants and has been credited with saving over 830,000 lives. Her childhood, mentors, drive, and education inspired Avery to be the visionary that she was. In 1991 President George H.W. Bush conferred the National Medal of Science on Avery for her work on RDS.
Ola Didrik Saugstad is a Norwegian pediatrician, neonatologist and neuroscientist noted for his research on resuscitation of newborn children and his contribution to reduce child mortality. He is a Research Professor at Oslo University Hospital and Professor of Neonatology at Northwestern University's Feinberg School of Medicine in Chicago. He is Professor Emeritus of Pediatrics at the University of Oslo and was Director of the Department of Pediatric Research at Oslo University Hospital from 1991 to 2017.
Surfactant protein C (SP-C), is one of the pulmonary surfactant proteins. In humans this is encoded by the SFTPC gene.
Lucinactant is a liquid medication used to treat infant respiratory distress syndrome. It is a pulmonary surfactant for infants who lack enough natural surfactant in their lungs. Whereas earlier medicines of the class, such as beractant, calfactant (Infasurf), and poractant (Curosurf), are derived from animals, lucinactant is synthetic. It was approved for use in the United States by the U.S. Food and Drug Administration (FDA) on March 6, 2012.
Dr. Karthik Nagesh is a neonatologist in India. He has been practicing neonatal intensive care since 1992 at the Manipal Hospital in Bangalore. He is well known in India for his pioneering work in intensive care for sick neonates especially, Surfactant Therapy and ventilation for sick babies with respiratory distress. He is currently the Chairman of the Manipal Advanced Children's Center and Chairman and HOD of Neonatology and Neonatal ICUs at the Manipal Hospitals Group as well as an adjunct professor of paediatrics, KMC at Manipal University.
Poractant alfa is a pulmonary surfactant sold under the brand name Curosurf by Chiesi Farmaceutici. Poractant alfa is an extract of natural porcine lung surfactant. As with other surfactants, marked improvement on oxygenation may occur within minutes of the administration of poractant alfa. The new generic form of surfactant is Varasurf developed in PersisGen Co. and commercialized by ArnaGen Pharmad. It has fully comparable quality profile with Curosurf.
Beractant, also known by the trade name of Survanta, is a modified bovine pulmonary surfactant containing bovine lung extract, to which synthetic DPPC, tripalmitin and palmitic acid are added. The composition provides 25 mg/mL phospholipids, 0.5 to 1.75 mg/mL triglycerides, 1.4 to 3.5 mg/mL free fatty acids, and <1.0 mg/mL total surfactant proteins. As an intratracheal suspension, it can be used for the prevention and treatment of neonatal respiratory distress syndrome. Survanta is manufactured by Abbvie.
Surfactant therapy is the medical administration of exogenous surfactant. Surfactants used in this manner are typically instilled directly into the trachea. When a baby comes out of the womb and the lungs are not developed yet, they require administration of surfactant in order to process oxygen and survive. This condition that the baby has is called newborn respiratory distress syndrome, and it is treatable. Surfactant coat the smallest parts of the lungs called the alveoli and helps for oxygen to go in and for carbon dioxide to go out. How surfactant does this is by not allowing the alveoli to collapse and to retain their inflated shape when the baby exhales.
Henrik Verder is a pediatrician and the inventor of the INSURE and LISA methods combined with nasal CPAP. In 1989 he used this pioneering method to successfully treat the first premature infant with severe RDS. Verder is a significant researcher within the field of paediatrics, with more than 50 publications and over 500 citations.
Chiesi Farmaceutici S.p.A. is an Italian family controlled global pharmaceutical company based in Parma, Emilia-Romagna. Chiesi has 31 affiliates in the world, nearly 6,500 total employees and provides medicines to patients in 100 nations. Chiesi currently has revenues of 3 billion euros. According to 2020 official data from the European Patent Office (EPO), Chiesi Group, with 42 patents filed, is confirmed as the first Italian Pharmaceutical Company and third among Italian Companies across all sectors for filing the highest number of patents.
Anne Greenough is a British neonatologist and is most notable for research into clinical and academic neonatology through work relating to the origins, markers and management of chronic lung disease following preterm birth. Greenough is Professor of Neonatology and Clinical Respiratory Physiology at King's College London.
Christian P. Speer is a German pediatrician and Professor of Pediatrics specialized in neonatology at the Julius Maximilian University of Würzburg. Speer is known for his scientific and educational contributions in neonatal medicine.
Henry Lewis Halliday was a British-Irish paediatrician and neonatologist. In 2021, Halliday was awarded the James Spence Medal for research into neonatology, for coordinating two of the largest neonatal multicentre trials for prevention and treatment of a number of neonatal respiratory illnesses and for a breakthrough in the development of a new lung surfactant that brought relief to very small babies suffering from infant respiratory distress syndrome (RDS).
Tore Curstedt is a Swedish physician. Curstedt is primarily known for the development of the synthetic lung surfactant known as Corusurf along with Bengt Robertson.