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Muco-penetrating approaches that have made it to the clinic include PEGylated adrenomedullin (NCT04417036, phase II of BAY1097761 for acute respiratory distress syndrome), amikacin liposomes (FDA-approved for mycobacterium infections therapy) and ciprofloxacin liposomes (NCT02104245, phase III of ciprofloxacin liposomes for non-cystic fibrosis bronchiectasis), all showing better penetration and retention in the airways during delivery (Table 3)

Avoid repeated freeze-thaw cycles

Synthesizing a single molecule that can perform all three actions requires highly advanced solid-phase peptide synthesis (SPPS) techniques and double the purification steps of simpler peptides like semaglutide

Medications like antihistamines and nasal sprays may temporarily relieve symptoms, but they don't address the root cause