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Annexin A1 (ANXA1) is a 37 kDa calcium-dependent phospholipid-binding protein that serves as a critical endogenous mediator in the resolution of inflammation. It belongs to the annexin superfamily and is primarily known for its ability to inhibit cytosolic phospholipase A2 (cPLA2), thereby preventing the release of arachidonic acid and the subsequent production of pro-inflammatory eicosanoids such as prostaglandins and leukotrienes. Annexin A1 also acts as a high-affinity agonist for the Formyl peptide receptor 2 (FPR2/ALX), a G protein-coupled receptor that triggers pro-resolving signaling pathways, including the inhibition of neutrophil migration and the promotion of macrophage-mediated phagocytosis of apoptotic cells (efferocytosis). In the context of sickle cell disease (SCD), research has demonstrated that a lack of Annexin A1 is associated with astrocyte dysfunction and white matter injury; consequently, recombinant Annexin A1 is being investigated as a potential therapeutic agent to prevent or treat ischemic stroke and cerebral infarction in SCD patients.
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