S-1226, or S1226, is a mixture of

carbon dioxide Carbon dioxide is a chemical compound with the chemical formula . It is made up of molecules that each have one carbon atom covalent bond, covalently double bonded to two oxygen atoms. It is found in a gas state at room temperature and at norma ...

-enriched air and nebulized perflubron being developed as a novel

bronchodilator A bronchodilator or broncholytic (although the latter occasionally includes secretory inhibition as well) is a substance that dilates the bronchi and bronchioles, decreasing resistance in the respiratory airway and increasing airflow to the lun ...

for use in

respiratory diseases Respiratory diseases, or lung diseases, are pathology, pathological conditions affecting the organs and tissues that make gas exchange difficult in Breathing, air-breathing animals. They include conditions of the respiratory tract including the t ...

such as

asthma Asthma is a common long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wh ...

cystic fibrosis Cystic fibrosis (CF) is a genetic disorder inherited in an autosomal recessive manner that impairs the normal clearance of Sputum, mucus from the lungs, which facilitates the colonization and infection of the lungs by bacteria, notably ''Staphy ...

, and

COVID-19 Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the coronavirus SARS-CoV-2. In January 2020, the disease spread worldwide, resulting in the COVID-19 pandemic. The symptoms of COVID‑19 can vary but often include fever ...

by SolAeroMed. Unlike typical bronchodilators such as β₂-adrenergic agonists and

antimuscarinics A muscarinic acetylcholine receptor antagonist, also simply known as a muscarinic antagonist or as an antimuscarinic agent, is a type of anticholinergic drug that blocks the activity of the muscarinic acetylcholine receptors (mAChRs). The muscarin ...

, S-1226 does not act on receptors in the airways. Instead, it combines the bronchodilator activity of

gaseous Gas is a state of matter that has neither a fixed volume nor a fixed shape and is a compressible fluid. A ''pure gas'' is made up of individual atoms (e.g. a noble gas like neon) or molecules of either a single type of atom ( elements such as ...

carbon dioxide with the

mucolytic Mucoactive agents are a class of pharmacologic agents that include expectorants, mucolytics, mucoregulators, and mucokinetics that can affect the volume, viscosity, transportation, and composition of mucus or sputum. They often aid in clearing ...

properties of the synthetic surfactant perflubron to relax the smooth musculature of the airways, clear excess

mucus Mucus (, ) is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both Serous fluid, serous and muc ...

, and reduce

inflammation Inflammation (from ) is part of the biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. The five cardinal signs are heat, pain, redness, swelling, and loss of function (Latin ''calor'', '' ...

. Thus, S-1226 represents a novel class of bronchodilators that could alleviate certain problems of existing therapeutics, such as the buildup of tolerance to their effects and their inefficient penetration of airway mucus.

Clinical studies

Asthma

S-1226 has completed

phase Phase or phases may refer to: Science *State of matter, or phase, one of the distinct forms in which matter can exist *Phase (matter), a region of space throughout which all physical properties are essentially uniform *Phase space, a mathematica ...

I and II clinical trials for the treatment of acute asthma exacerbations caused by exposure to

allergens An allergen is an otherwise harmless substance that triggers an allergic reaction in sensitive individuals by stimulating an immune response. In technical terms, an allergen is an antigen that is capable of stimulating a type-I hypersensitivi ...

Phase I

The phase I randomized double-blind placebo-controlled trial designed to assess the safety of S-1226 compared 3 different formulations of S-1226 containing varying

concentrations In chemistry, concentration is the Abundance (chemistry), abundance of a constituent divided by the total volume of a mixture. Several types of mathematical description can be distinguished: ''mass concentration (chemistry), mass concentration'', ...

of carbon dioxide (4%, 8%, and 12%) to a

placebo A placebo ( ) can be roughly defined as a sham medical treatment. Common placebos include inert tablets (like sugar pills), inert injections (like saline), sham surgery, and other procedures. Placebos are used in randomized clinical trials ...

. No serious

adverse events In pharmaceuticals, an adverse event (AE) is any unexpected or harmful medical occurrence that happens to a patient during medical treatment or a clinical trial. Unlike direct side effects, an adverse event does not necessarily mean the medicatio ...

were reported, though S-1226 caused a greater number of related adverse events than did the placebo. These events were attributed by the investigators to the carbon dioxide constituent of S-1226.

Phase II

The phase II randomized double-blind placebo-controlled cross-over trial was designed to further assess the safety and to provide preliminary evidence of efficacy of S-1226 in treating acute asthma exacerbations caused by exposure to allergens. The 8% carbon dioxide formulation of S-1226 was used in this study due to its favourable efficacy in animal studies and favourable safety in the phase I trial. The trial enrolled 12 patients with mild allergic asthma who were randomised to either receive S-1226 (8% carbon dioxide) or placebo. After the first treatment period and a washout period of 14 days, the group initially randomised to S-1226 received placebo, and vice versa in the second treatment period. No serious adverse events were reported. The placebo group experienced a gradual lowering of peripheral blood oxygenation levels, while the S-1226 intervention group did not. The S-1226 intervention group regained their initial FEV₁ (the

volume Volume is a measure of regions in three-dimensional space. It is often quantified numerically using SI derived units (such as the cubic metre and litre) or by various imperial or US customary units (such as the gallon, quart, cubic inch) ...

of air a person can forcibly

exhale Exhalation (or expiration) is the flow of the breath out of an organism. In animals, it is the movement of air from the lungs out of the airways, to the external environment during breathing. This happens due to elastic properties of the lungs ...

in 1 second) more rapidly than the placebo group following allergen exposure.

Cystic fibrosis

As of December 2023, SolAeroMed were recruiting patients with cystic fibrosis for a phase II trial of S-1226.

References

{{reflist Bronchodilators Experimental drugs