Inhalers are a vital element for people with asthma. And it was a 13-year-old girl, whose father ran a pharmaceutical company, who gave the kickoff that led to its development in the US in the 1950s.
“Dad, why can’t they put my asthma medicine in a spray can, like they do with hairspray?”
This was the candid question that Susie Mason, a 13-year-old American girl with severe asthma, asked her father in the 1950s.
Fortunately for Susie — and hundreds of thousands of people with this respiratory condition — her father, George Maison, was president of a pharmaceutical company (Riker Laboratories).
And the research he commissioned in 1956 three scientists to satisfy their daughter’s wish resulted in the modern inhaler, a device used around the world to deliver controlled doses of an asthma drug directly to the lungs, with the push of a button.
According to the World Health Organization, asthma is the most common non-contagious disease in children.
It is estimated that more than 300 million of people suffer from asthma in the world.
Cigarettes and nebulizers as “old perfume bottles”
Susie’s restlessness was far from whimsical. At the time, the most widely used method of delivering the drug to patients was a glass bottle with a rubber spray bottle, much like an old-fashioned perfume bottle.
In that container “you put the bronchodilator drug, which you probably had to keep in the fridge,” explains Stephen Stein, a researcher and disciple of Charlie Thiel, the only living member of the team that invented the inhaler.
While it did get the drug into the lungs, the dose it delivered was not uniform.
“It was a very cumbersome process. But in addition, the nebulizer was very delicate. It could be broken. It was an option, but not a great option, ”he adds.
For all its flaws, it was a step up from another popular method of treating asthma at the time: cigarette.
Today it may seem almost like a joke, but back then, the cigarette prepared for asthma was an accepted way to treat this condition.
“Smoking is very toxic because it is a very efficient method of getting things into the lungs,” Stein says.
“Precisely because they can do it, it was used to administer substances that had atropine (a substance that was used to treat asthma ”.
Therapeutic aerosol treatments have a long history dating back to Ancient Egypt, A few ago 3,500 years.
According to a 2010 study by researchers at the University of Exeter in the United Kingdom, Egyptian documents compiled around 1550 BC, reveal that “treatments for respiratory problems included not only the consumption of a variety of preparations with plant, animal and mineral products, but also the administration of active substances (…) directly to the lungs through inhalation”.
“We know it was this way from a papyrus scroll found next to a mummy,” Stein explains.
“The therapy that I was describing mentions the use of crazy grass (Hyoscyamus niger), to breathe the vapors of that plant when it burns ”.
“And it turns out that this plant contains atropine, a substance that is still used in certain inhaler products today.”
The objective of the Riker laboratory researchers was to create a device that would allow the lungs to be carried more quantity of drug and form faster.
To do this, they began by testing powerful gaseous propellants that, in successive experiments, proved difficult to handle and contain.
In his 90s, Charlie Thiel still remembers what happened when they tested the sealing of inhalers by immersing them in a source of hot water.
“All (200 inhalers) exploded at the same time. A jet of water covered the entire roof, ”says Thiel.
The team continued to experiment with other formulations of the drug in sturdy Coca-Cola bottles, and that’s how Thiel discovered a formula that worked.
“If you mix drug particles into propellants, they tend to stick together against the wall and don’t disperse well,” Stein explains.
“Thiel discovered that if he used the Surfactant Span 85 (Sorbitan trioleate), the formula dispersed very well and its particles were projected in small aerosols that could reach the lungs ”.
This finding made it possible that it was not necessary to add ethanol or alcohol to the formula to transform it into an aerosol.
The process – from the idea to the product development – took just one year.
“Patients loved it (to the inhaler), ”Thiel recalls. “It was so much more comfortable for them!”
Thiel was never interested in fame but in the impact the product had on patients.
In a recording he made with his disciple, he recalls an encounter that still moves him today.
In it he recounts a meeting in 1995 with an Australian doctor, an elderly man who suffered from asthma.
“He gave me a bear hug and said, ‘Charlie, if it weren’t for your invention, I’d be dead.’ It just blew me away. “
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