30 Years of Surfactant Research - From Basic Science to New Clinical Treatments for the Preterm Infant

the results of subsequent clinical trials of surfactant treatment performed during the last 30 years. The first clinical trial with a synthetic surfactant, composed of analogues of both hydrophobic surfactant proteins and phospholipids and developed in collaboration between the Karolinska Institutet and Chiesi Farmaceutici, was described by Christian Speer from Würzburg [1] . The presentation by Mats Blennow from Stockholm was about surfactant and noninvasive ventilation [5] . His conclusion was that there is mounting evidence that early continuous positive airway pressure from birth is feasible and safe even in very preterm infants and that a strategy for surfactant administration should be part of a noninvasive ventilation approach. This view is reflected in the latest European guidelines for the management of respiratory distress syndrome (RDS) [6] . Aaron Hamvas from Chicago discussed the benefits of high-throughput sequencing technology in order to identify the microbiota in various microenvironments of the human body [7, 8] . He summarized data from elegant studies that suggested a microbial influence on the development of neonatal respiratory disease and he also highlighted many of the gaps that remain in understanding the function of the respiratory microbiome. Bronchopulmonary dysplasia (BPD) was once described as primarily the result of postnatal injury from The 30th International Workshop on Surfactant Replacement took place in Stockholm from June 5–6, 2015. This annual meeting has been held in different places all over Europe but now returns to the Karolinska Institutet where research by Bengt Robertson and Tore Curstedt on Curosurf®, a porcine surfactant, began in 1980 [1] . The meeting was held in the Aula Medica at Karolinska Institutet in the lecture hall where the Nobel Lectures in Physiology or Medicine are given. The Workshop started with the 7th Bengt Robertson Memorial Lecture given by Eric Shinwell from Tsfat, Israel. His lecture was entitled ‘The Risky Business of Prediction’ in which he highlighted the difficulties in caring for infants born close to the limits of viability and the problems in predicting an individual infant’s outcome and long-term future using population statistics – indeed a risky business [2] . As this was the 30th Anniversary of the first International Surfactant Workshop held in Amsterdam in 1986, Tore Curstedt from Stockholm described the history of the development of Curosurf and the first treatment of a preterm infant with this surfactant in the 1980s [1, 3] . Henry Halliday from Belfast spoke about the first randomized controlled trial of Curosurf which began early in 1985 [4] and was the first to show that surfactant treatment could reduce neonatal mortality. He also reviewed Published online: June 5, 2015