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ASM-024 is a small synthetic homopiperazinium compound developed primarily for the treatment of airway inflammatory diseases such as asthma and chronic obstructive pulmonary disease (COPD). It acts as both a bronchodilator and anti-inflammatory agent. Mechanistically, ASM-024 is a modulator of cholinergic receptor function with dual activity at nicotinic acetylcholine receptors (nAChRs) and muscarinic receptors. It functions as an antagonist at α3β4 and α7 nAChR subtypes but can act as a "silent agonist" at the α7 nAChR in the presence of positive allosteric modulators, leading to anti-inflammatory effects via signal transduction pathways independent of ion channel activation. Additionally, it antagonizes M1, M2, and M3 muscarinic receptors. Preclinical studies have shown that ASM-024 reduces airway resistance and relaxes tracheal/bronchial smooth muscle in animal models. The drug does not cross the blood-brain barrier and has demonstrated good safety when administered by inhalation[1][5][6][7][8].
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