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Solnatide is a synthetic peptide drug currently in clinical development for the treatment of acute lung injury (ALI), acute respiratory distress syndrome (ARDS), pulmonary edema—including that associated with COVID-19—and other conditions involving pulmonary permeability edema. It is administered as an inhaled dry powder or aerosol formulation. Solnatide mimics the lectin-like domain of tumor necrosis factor alpha (TNF-α) and consists of 17 amino acids with an intramolecular disulfide bond. Its primary mechanism involves direct activation of the epithelial sodium channel (ENaC), which enhances alveolar fluid clearance and restores capillary barrier function by promoting sodium uptake and water removal from the lungs. Solnatide also inhibits hypoxia-induced reactive oxygen species production and protein kinase C alpha activation, further supporting endothelial and epithelial barrier integrity without pro-inflammatory effects. The drug has received orphan drug designation for several indications including primary graft dysfunction following lung transplantation and pseudohypoaldosteronism type 1B[2][3][4][5][6].
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