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In BlGGT, replacement of this arginine with another positively charged residue lysine (R109K) resulted in significant enhancement of activity (Bindal et al., 2017), whereas in EcGGT (R114K) and BsGGT (R113K), similar mutation resulted in 93 and 22% residual activities, respectively (Minami et al., 2003a

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Specifically, while inhaled gentamicin and inhaled colistin have demonstrated potential, clinical trials involving inhaled tobramycin, aztreonam, and ciprofloxacin (both dry powder and liposomal formulations) have failed to achieve the predefined study endpoints ( Retrospective studies on Pseudomonas aeruginosa have reported initial eradication rates of bronchiectasis via various regimens, including oral, inhaled, and intravenous antibiotics, ranging from 52% to 80%

This route allows for systemic distribution of the secretome's components, which can be beneficial for addressing widespread inflammation and potentially exerting effects beyond the lungs