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Both animal and artificial surfactants are available on the market. Natural surfactants include bovine, porcine, or human amniotic fluid preparations. The latter is no longer used due to high costs and insufficient availability.
Natural surfactants have surfactant-associated proteins and thus may have better spreading and lung defence properties. Surfactant containing proteins is more effective than artificial surfactant which lacks these surfactant proteins. On the other hand, foreign proteins in natural surfactant can be antigenic.