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AZD1613 is a human monoclonal antibody developed by AstraZeneca that targets pregnancy-associated plasma protein A (PAPPA, also known as pappalysin-1). PAPPA is a metalloproteinase that is upregulated in the cyst-lining epithelium of patients with autosomal dominant polycystic kidney disease (ADPKD). By cleaving insulin-like growth factor binding proteins (IGFBPs), particularly IGFBP-4, PAPPA increases local insulin-like growth factor 1 (IGF-1) bioavailability, which drives cyst expansion and renal function decline. AZD1613 inhibits PAPPA-mediated proteolysis of IGFBPs, thereby suppressing downstream IGF-1 signaling and reducing cyst growth. It is currently in Phase I clinical development for the treatment of ADPKD.
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