Premature Babies' Lungs Saved With This Scientist's Discovery

The miracles of medicine are rarely spontaneous. In fact, more often than not, they unfold over years of painstaking trial and error. Such was the case with Fujiwara's development of a replacement surfactant. John Clements had identified surfactant in the laboratory in 1957, and Mary Ellen Avery had shown it was the underlying cause of respiratory distress syndrome (RDS) – a lung disorder seen in premature babies who haven’t had time to develop “surfactant”.  Surfactant keeps the lungs inflated.  But, it wasn't until 1980 that Fujiwara took the next giant step. He had labored for years, as had others, to develop a replacement surfactant for premature infants. There had been some success in treating rabbits, but progress with humans was slow. One group had tried to deliver a replacement surfactant using an aerosol, but their efforts failed. Fujiwara found a way. He developed a liquid surfactant that he propelled directly into the lungs of the infants by way of a tube. It was the breakthrough everyone had been looking for. Fujiwara's liquid replacement ushered in a new era in which it was possible to fight the battle against RDS - and win.

 

Fujiwara was determined. He had spent years researching surfactants and, though there was still a great deal to learn, he had an idea. He was confident that the surfactant in the lungs of cows contained all the critical components that helped protect lungs - at least cow's lungs. Though we most often associate research with white coats and laboratories, there are at times less decorous tasks that also come into play. Fujiwara, after all, had to get his cow lungs somewhere. So, he became a frequent visitor to the local slaughterhouses. They always had a fresh supply of cow lungs, which the young researcher could take back to his laboratory, then again don his impeccably white lab coat.

Fujiwara wanted to find out if he could use this same naturally occurring surfactant to treat humans. So, he gathered the surfactant from cow's lungs, washed it and mixed it in a solution. He then administered the solution directly into the windpipes of the sick infants. This ingenious technique, known as intratracheal injection, is today a common method of drug delivery. Fujiwara next gently moved the tiny babies around to help the fluid spread within their lungs and cover the entire lining. The results were stunning. Within minutes the infants were able to breathe more freely and, within a few short hours, their skin showed the bright pink hue of a healthy young baby. Fujiwara's discovery set off a whirlwind of activity, including clinical trials throughout the world. But, it would still take time. Finally, after a full ten years of clinical trials, liquid replacement surfactants were approved for clinical use. Fujiwara's journey was long but, thanks to his tenacity, hundreds of thousands of premature infants have received the gift of life. 

Lives Saved:  Over 4,000,000

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Snippets
JFK lost a child to RDS
President John F. Kennedy and his wife Jackie's child, Patrick, born in 1963, had respiratory distress syndrome (RDS). With the best of care, he died 39 hours after birth.  This spurred more research on surfactants. But it would be the 1980s before good substitute surfactants were developed.

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Letter from Tetsuro Fujiwara to Mary Ellen Avery
How can I ever thank you for your visiting us here in Akita – such an inconvenient small town far from Tokyo…My colleague, Maeta…should be proud of what they did – traveling with the world-important lady and her niece over 400 miles in a rainy day...I also want to thank you for your book with your beautiful signature on it. It is a beautiful book…

I also thank you for your suggestion of the name of our surfactant – Fuji-surf. What a beautiful name it is!

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Key Contributors
Mary Ellen Avery
John Clements
Tetsuro Fujiwara

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