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CreTAC-1 is a charge-reversal proteolysis-targeting chimera (CreTAC) designed for the tissue-specific degradation of the Stimulator of Interferon Genes (STING) protein. It is engineered using a pH-responsive polymer platform that maintains electroneutrality at physiological pH (7.4) to minimize systemic toxicity but undergoes protonation and charge inversion in the acidic microenvironment of rheumatoid arthritis joints (pH ~6.5). This transition facilitates a significant increase in joint accumulation, cellular uptake, and cytoplasmic affinity for STING. By promoting the degradation of STING variants, CreTAC-1 effectively suppresses synovitis and bone erosion in preclinical models of collagen-induced arthritis without the hematological toxicity associated with conventional treatments like methotrexate.
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