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Anti-P-selectin monoclonal antibodies represent a therapeutic class of biologics designed to inhibit P-selectin (CD62P), a cell adhesion receptor expressed on the surface of activated vascular endothelial cells and platelets. The primary mechanism of action involves blocking the interaction between P-selectin and P-selectin glycoprotein ligand-1 (PSGL-1), which is found on the surface of leukocytes and other blood cells. This blockade prevents the rolling and subsequent adhesion of cells to the endothelium, a process critical to the pathogenesis of vaso-occlusive crises (VOCs) in sickle cell disease and various inflammatory or ischemic conditions. Crizanlizumab (Adakveo) is the first-in-class humanized monoclonal antibody approved for reducing the frequency of VOCs in sickle cell disease. Other agents in this class, such as inclacumab, have been investigated for cardiovascular protection and sickle cell disease management. Preclinical research also suggests potential applications in treating lupus nephritis by ameliorating renal hypoxia and tubulointerstitial lesions.
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