1994 Albert Lasker Clinical Medical Research Award

Surfactant therapy for premature infants

The contributions of John A. Clements to the field of pulmonary biology stand alone. His discovery of lung surfactant and subsequent work that created an artificial version of this vital substance have saved literally thousands of lives of premature infants and is widely regarded as the most important discovery in pulmonary physiology in the last 50 years.

As a pioneer in surfactant research, Dr. Clements's early studies are a classic and superb example of the direct relevance of fundamental medical research to human health, and are particularly impressive in that the odyssey from the laboratory to clinical application was carried out by a single research group under his direction at the University of California, San Francisco.

Dr. Clements's groundbreaking work in respiratory distress syndrome (RDS) in premature infants began 40 years ago, when the existence of such a substance was unknown. Of those premature infants who developed RDS, virtually all died despite efforts to save them by ventilators and other mechanical approaches. It was he who first defined the soapy, detergent-like surface active material called surfactant in lungs in detailed biochemical and biophysical terms, and solved the mystery of how such a substance performed during the expansion and contraction of the alveolus. It was Dr. Clements and his colleagues who proposed the theory of alveolar stabilization by surfactant and developed assays for its principal components, and who devised a test for predicting fetal development in vitro.

But the most dramatic and far-reaching contribution was his development of an artificial surfactant now used in more than 50 countries to save the lives of premature infants at risk of RDS. In the United States alone, the use of surfactant has been credited with a 6 percent overall reduction in infant mortality and with a remarkable 50 percent reduction in the number of infant deaths from RDS.

To John A. Clements, for his brilliant studies defining and describing the role of pulmonary surfactant and in developing a life-saving artificial surfactant now used in premature infants around the world, this 1994 Albert Lasker Clinical Medical Research Award is given.