Nebulized RNS60 for the Treatment of Amyotrophic Lateral Sclerosis

Inclusion Criteria: * Probable, probable-laboratory supported, or definite ALS, either sporadic or familial according to modified El Escorial criteria * Disease duration \< 3 years * Age 18 to 80 * Able to provide informed consent and to comply with study procedures * Subjects must not have taken riluzole for at least 30 days, or be on a stable dose of riluzole for at least 30 days, prior to screening (riluzole-naïve participants are permitted in the study) * Women must not be lactating or able to become pregnant (e.g. post menopausal, surgically sterile, or using adequate birth control) for the duration of the study, and for 3 months after study completion * Men should practice contraception for the duration of the study and for 3 months after completion Exclusion Criteria: * Diagnosis of a motor neuron disease other than ALS (e.g., primary lateral sclerosis, progressive muscular atrophy, progressive bulbar palsy) * Clinically significant unstable medical condition (other than ALS) that would pose a risk to the participant if they were to participate in the study or that would impact survival or functional disability in the next 12 months * Abnormal liver function defined as aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) \> 3 times the upper limit of the normal * Renal insufficiency (Glomerular Filtration Rate \< 60) * Active pulmonary disease * Prior poor compliance with an inhalation device * The presence of unstable psychiatric disease, cognitive impairment, or dementia that would impair ability of the participant to provide informed consent, according to judgment by the principal investigator. * History of human immunodeficiency virus (HIV) infection, clinically significant chronic hepatitis, or other active infection. * Active participation in another ALS clinical trial within 30 days of the Screening Visit * Other experimental treatments or anti-inflammatory/immunomodulatory medications used in the preceding 3 months