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This combination consists of RESP301, a nitric oxide (NO)-generating inhaled solution, together with four first-line oral anti-tuberculosis drugs: isoniazid, rifampin, pyrazinamide, and ethambutol. RESP301 delivers inhaled NO directly to the respiratory tract, exerting direct antimicrobial activity (antiviral and antibacterial) and enhancing host defenses. Isoniazid inhibits mycolic acid synthesis in Mycobacterium tuberculosis. Rifampin blocks bacterial RNA polymerase. Pyrazinamide is bactericidal against replicating and dormant mycobacteria. Ethambutol impairs cell wall synthesis by inhibiting arabinosyl transferases. This combination is under clinical investigation for the treatment of pulmonary tuberculosis, with RESP301 adding a novel, inhaled mechanism to standard oral TB therapy[1][2][4].
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