LAUSR

Objectives: Lung infections with multiresistant pathogens are a major problem among patients suffering from cystic fibrosis (CF). N-chlorotaurine (NCT) is a long-lived oxidant generated in activated cells of the innate immune system, namely neutrophilic and eosinophilic granulocytes and monocytes. NCT acts as an antiseptic agent that can be synthesised chemically and showed good tolerability when inhaled via a nebulizer (1). NCT demonstrated rapid in vivo activity against SARS-CoV-2, influenza A viruses, and RSV as well as for C. albicans, E. dermatitidis, P. aeruginosa and MRSA (2,3). Methods: We evaluated 10 patients with CF who inhaled 5 ml of 1% NCT via a nebulizer twice daily. Results: All 10 patients tolerated the inhalation well. The duration of inhalation was between 4 weeks and 3 years. Targeted pathogens were S. apiospermum, A. xylosoxidans, P. aeruginosa, MRSA and SARS-CoV-2. Patients improved clinically after starting to inhale 1% NCT (Sputum production, sputum color, exacerbation rate, need for intravenous antibiotics, expectoration). Conclusions: NCT is a safe, well-tolerated, endogenous, inhaled substance with broad-spectrum activity against pathogens supported by anti-inflammatory properties. It might be a significant step forward for treatment of multiresistant bacteria and fungi. In addition, NCT has a high activity against COVID-19 and other viral infections of the lower airways. References 1. Arnitz R, et al. Tolerability of inhaled N-chlorotaurine in humans: a double-blind randomized phase I clinical study. Ther Adv Respir Dis. 2018 Jan 1;12:175346661877895. 2. Lackner M et al. N-chlorotaurine, a novel inhaled virucidal antiseptic is highly active against respiratory viruses including SARS-CoV-2 (COVID-19), November 2020, DOI:10.21203/rs.3.rs-118665/v1, License CC BY 4.0. 3. Gruber M et al. Bactericidal and Fungicidal Activity of N-Chlorotaurine Is Enhanced in Cystic Fibrosis Sputum Medium. Antimicrob Agents Chemother 2017 May;61(5):AAC.02527-16.