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10-nitro-oleic acid is a synthetic nitroalkene derivative of oleic acid characterized as a long-chain nitro-fatty acid small molecule, developed as a first-in-class electrophilic fatty acid for the treatment of fibrotic and chronic inflammatory diseases[3][5]. Its mechanism of action is primarily the induction of Nrf2-dependent antioxidant gene expression, inhibition of TLR4/NF-κB signaling, and regulation of key immune cell functions, including suppression of proinflammatory cytokine production in macrophages and T cells[1][5][3]. CXA-10 modulates immune response by inhibiting calcineurin-dependent NFAT signaling in T lymphocytes, and it affects other pathways relevant to inflammation, redox regulation, and metabolic dysfunction[5][1][3]. Developed as an oral formulation, it has demonstrated effects on metabolic parameters such as serum leptin, cholesterol, and triglycerides in obese subjects[3]. The drug was primarily developed by Complexa for chronic kidney and pulmonary indications, and has been investigated in clinical trials for focal segmental glomerulosclerosis, pulmonary arterial hypertension, and other diseases[3].
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