Lung surfactant (LS) is a membrane-based lipid-protein complex that lines the alveoli, reducing the surface tension at the air-liquid interface and thus minimizing the work of breathing. Besides this function, LS is also the first physical barrier between the outside air and the systemic circulation, therefore playing a key role in the defense against harmful particles and microorganisms.

Viral respiratory tract infections (RTIs), and especially acute lower RTIs, are one of the leading causes of morbidity and mortality worldwide. LS participates in the network of interactions between viruses and the immune system to prevent or lessen the effects of the infection, but it is also altered by these pathogens, which can potentially impair its function.

The aim of this review is to provide an integrated multidisciplinary overview toward understanding the interplay between respiratory viruses and LS and its health impact on the respiratory system. The review is centered on the antiviral mechanisms of both LS proteins and lipids, and their different interactions that lead to varying outcomes. Finally, a summary of the clinical application of surfactant in the scene of lung viral infection is disclosed, including state-of-the-art approaches of the therapeutic use of surfactant components.

肺表面活性剂（LS）是一种基于膜的脂质蛋白复合物，排列在肺泡上，降低气液界面的表面张力，从而最大限度地减少呼吸功。除了这一功能之外，LS还是外部空气和体循环之间的第一道物理屏障，因此在防御有害颗粒和微生物方面发挥着关键作用。

病毒性呼吸道感染 (RTI)，尤其是急性下呼吸道感染，是全世界发病和死亡的主要原因之一。LS 参与病毒和免疫系统之间的相互作用网络，以预防或减轻感染的影响，但它也会被这些病原体改变，这可能会损害其功能。

本综述的目的是提供综合的多学科概述，以了解呼吸道病毒和 LS 之间的相互作用及其对呼吸系统健康的影响。该综述的重点是 LS 蛋白和脂质的抗病毒机制，以及它们导致不同结果的不同相互作用。最后，总结了表面活性剂在肺部病毒感染领域的临床应用，包括表面活性剂成分治疗用途的最新方法。