Taipan Technology April 1997

Turning a breathing fluid into liquid gold This company wants to put liquid in your lungs and artificial blood in your veins In the movie The Abyss, Navy SEALS diving underwater filled their lungs with an oxygenated liquid to stay alive. The theory was that liquid in the lungs of a submerged person is more effective in supplying the body with oxygen than from an air tank. The idea isn't new. The concept of "liquid ventilation" was developed in the 1920s, when researchers attempting to eradicate the effects of war gas poisoning found that the lungs could tolerate washings with large quantities of saline solution. But it wasn't until the 1990s that researchers developed an effective and truly applicable "lung liquid" for medical purposes. Alliance Pharmaceutical's oxygen-carrying drug - called LiquiVent - is an intrapulmonary liquid administered directly into the lungs to open up collapsed air sacs (alveoli) and assist in gas exchange. The drug is so effective in supplying damaged and diseased lungs with oxygen, the FDA has granted LiquiVent Subpart E ("fast track") status - a designation reserved for drugs being developed to treat life-threatening or severely debilitating conditions. Breathe in, breathe out Each year over 150,000 people are hospitalized with acute respiratory failure - a condition that can result from infections, traumatic shock, severe burns, inhalation of toxic substances, or other causes. Of those, nearly 70% die from the condition. Most at risk are the elderly and newborns - especially premature babies. Because premature infants have inadequately formed lungs, their respiratory systems have a difficult time exchanging gases-taking in oxygen and expelling poisonous carbon monoxide. The results can be fatal. Out of all the pediatric patients with acute respiratory failure in 1996, 62% died. Aqua-lung, my friend ... LiquiVent aids premature infants with breathing by doing the gas exchange automatically. Plus the liquid stimulates the development of premature lungs (as if the baby was still forming in amniotic fluid). Made from perfluorocarbons (more specifically, perflubron), LiquiVent is an unique, inert, and colorless fluid that has the appearance and consistency of water. It has a relatively high density (1.9 g/mL), a low surface tension, and is immiscible in aqueous solutions. Perflubron is minimally absorbed across the alveolus and is eliminated from the lungs by evaporation. Liquid ventilation with LiquiVent is generally performed by one of two techniques: 1 "total" liquid ventilation, in which the lungs are completely filled with the solution and ventilated using a "liquid ventilator" 2 "partial" liquid ventilation (or "near drowning"), which requires partial filling of the lungs with LiquiVent and ventilation with gas using a conventional gas mechanical ventilator. Currently, LiquiVent is in pivotal Phase II/III studies with children (up to 17 years old), as well as Phase II studies with adults and premature infants. So far, results have been positive. LiquiVent was well-tolerated by patients, and reinflated collapsed air sacs, improved lung oxygenation, and improved lung mechanics. It also appears to remove debris from the lungs, reducing inflammation, and imaging the lungs to assist in the diagnosis of airway blockages or pathologies. But that's not all ... In February 1997, Taipan editors told you how Chinese gangs were becoming "modern-day vampires" ... kidnapping peasants and draining their blood to sell to hospitals. Alliance's other product - an artificial blood - will make blood donation - voluntary or involuntary - obsolete. Co-developed with Johnson & Johnson, Alliance's Oxygent is an intravascular oxygen carrier that acts as a temporary "blood substitute" to reduce or eliminate the need for donor blood transfusions during surgery for the more than 3 million surgical patients who need donor blood each year. Blood brothers Unlike donor blood, Oxygent cannot transmit infectious diseases such as AIDS and hepatitis. It's compatible with all blood types ... it has a shelf-life in excess of one year ... and it can be sterilized. Oxygent is expected to be used during acute blood loss surgeries in conjunction with autologous blood techniques (conserving the patient's own blood) to provide temporary enhancement of oxygen delivery. Phase I and IIa human studies demonstrated that Oxygent can deliver oxygen to body tissues. And critical Phase IIb studies are being conducted on surgical patients-with a major focus on cardiopulmonary bypass patients. Fill 'er up Even though many of Alliance's developmental drugs are in Phase I and II studies, the company is getting attention from the big boys-Hoechst Marion Roussel and Johnson & Johnson. For more information on LiquiVent and Oxygent, contact Alliance Pharmaceutical Corp. at 3040 Science Park Road, San Diego, CA 92121; tel. (619)558-4300; fax (619)558-5161.