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ALX1 is an inhaled nitric oxide (NO)-releasing prodrug developed for the treatment of muco-obstructive chronic lung diseases, such as non-cystic fibrosis bronchiectasis (NCFB) and chronic obstructive pulmonary disease (COPD). The formulation consists of a diazeniumdiolate prodrug dissolved in an aqueous phosphate buffer, designed for delivery via nebulization. Upon reaching the bronchial mucosa, the prodrug undergoes hydrolysis at physiological pH to release free nitric oxide into the airway surface liquid and mucus layer. This localized delivery mechanism aims to provide sustained antimicrobial and anti-inflammatory effects while minimizing the systemic toxicities, such as methemoglobinemia and hypotension, typically associated with high-dose inhaled nitric oxide gas. ALX1 has demonstrated activity against respiratory pathogens, including *Pseudomonas aeruginosa*, and is being evaluated for its ability to reduce lung inflammation and improve pulmonary function.
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