Sargramostim

Sargramostim, also called Leukine®, is a recombinant (artificially created by combinding DNA from different sources) form of human Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF). It is produced by Partner Therapeutics. 

GM-CSF is naturally produced in the human body and functions on various aspects of the immune system in health and illness. It is particularly important in the development and maturation of a key innate immune cell in the lung called the Alveolar Macrophage. It also serves an important role during infection and inflammation, heping to mobilise aspects of the immune response. 

In the same way that GM-CSF has many functions, so too does Sargramostim. It is an FDA-approved treatment given as an injection to boost immune defense after bone marrow transplant, however we are interested in its use as an inhaled medication to improve to the lung's immune defenses. This has been the recent subject of research interest with evidence showing that GM-CSF administration can prevent and improve outcomes from bacterial infections, especially following Influenza, and can even improve the lung's ability to absorb oxygen during critical illness caused by COVID-19. 

Vibrating Mesh Nebuliser

A nebuliser is a device which can transform a liquid, including medications, into a fine mist called an aerosol. In healthcare, this is used to deliver medications throughout the lungs, commonly seen in conditions such as Asthma or COPD. There are many different kinds of nebulisers, including Jet Nebulisers which use oxygen or air to aerosolise the liquid. For our study we are using what is called a Vibrating Mesh Nebuliser, the Aerogen Solo. This has a number of advantages over traditional jet nebulisers. Firstly, it can be used by healthy individuals and as an attachment for individuals who are critically ill on a ventilator. It is virtually silent, and does not require additional oxygen to function (it creates an aerosol from the liquid by using a rapidly vibrating mesh plate to create even sized droplets. It has also been shown to be very effective at distributing the intervention evenly across the lung.