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ACREOS is a first-in-class, oral, small molecule therapy being developed by Metabolica Health (formerly Metabolica Drug Discovery) for the treatment of type 2 diabetes, obesity, and nonalcoholic fatty liver disease (NAFLD) / nonalcoholic steatohepatitis (NASH). Derived from the gut microbiome metabolite 4-cresol, ACREOS is designed to target the biological root of metabolic dysfunction by promoting pancreatic β-cell regeneration and protection, restoring endogenous insulin production, and reprogramming systemic metabolism. Mechanistically, the active compound 4-cresol binds to and modulates key kinases, including ribosomal protein S6 kinase A3 (RPS6KA3/RSK2), tyrosine kinase non-receptor 1 (TNK1), and eukaryotic translation initiation factor 2-alpha kinase 4 (EIF2AK4/GCN2), while downregulating dual specificity tyrosine-phosphorylation-regulated kinase 1A (DYRK1A) downstream. ACREOS is currently in preclinical development.
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