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KI research saves children around the world

A success story. There is really no other way to describe the development of Curosurf, a drug used in the treatment of preterm babies. To date, 3.2 million babies have been treated and 600,000 to 800,000 neonates the world over have been saved and spared the complications associated with premature birth.

The story begins in the 1980s in a laboratory at Karolinska Institutet, where Tore Curstedt and the late professor Bengt Robertson developed a treatment that would come to revolutionise neonatal care. “We were both trained at Karolinska Institutet. Bengt Robertson’s speciality was measuring how the introduction of surfactants (compounds that lower surface tension) affected the survival of preterm animals. I myself had started researching fats called phospholipids. By combining our research, we managed to develop a substance that could be used in humans.”

Tore Curstedt explains that in preterm babies, the lungs are undeveloped and lack surfactant, a compound of proteins and phospholipids that normally coats the inside of the alveoli. When the lungs mature, it is produced automatically, but until this happens, these tiny air sacks have difficulty expanding on inhalation and collapse on exhalation, causing a life-threatening condition called respiratory distress syndrome.

Curosurf, named after its inventors (CUrstedt-RObertson-SURFactant) is a drug derived from pig lungs that helps the alveoli to ventilate properly. “We started our research on rabbit fetuses, and then one day in 1983, a doctor from St Göran’s hospital called and said that they had a very sick newborn boy who wasn’t going to survive,” recalls Dr Curstedt. “Would it be possible to test the drug on him? Naturally we were taking a risk, but within minutes, his blue pallor had been replaced by a rosy glow. And he survived.”

Both researchers then applied for a licence and additional funding to begin clinical trials, which they conducted in several European countries in early 1985. “Through the close collaboration between Karolinska Institutet and Karolinska University Hospital, we treated thousands of children during those trials,” he says.

“In the first study, half of the children received surfactant, while the rest were given the conventional treatment. Shortly after the study began, the results were so striking that it would have been unethical not to treat them all with surfactant. The main reason for our success was the interaction between basic research and the clinic.”

Today, Dr Curstedt is working with Karolinska Institutet’s researcher Jan Johansson to produce a synthetic surfactant. “We have a synthetic material that’s been tested in England, Germany and the Czech Republic, and a larger trial is underway in the United States.