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CS-6253 is a synthetic peptide drug derived from the C-terminal domain of apolipoprotein E (apoE), designed as an agonist of ATP-binding cassette transporter A1 (ABCA1). It mimics the function of apoA-I, promoting ABCA1-mediated cholesterol efflux and the formation of nascent high-density lipoprotein (HDL) particles. This mechanism enhances reverse cholesterol transport and induces microparticle release in an ABCA1-dependent manner. Preclinical studies show that CS-6253 can correct lipidation defects associated with ApoE4, reduce amyloid-beta accumulation, and improve synaptic function in Alzheimer's disease models. The drug is administered intravenously and is under development primarily for Alzheimer's disease, with additional preclinical investigation for atherosclerosis and type 2 diabetes mellitus. The primary developer is Artery Therapeutics, with contributions from Tel Aviv University and University of California at Berkeley[2][4][6][7][8].
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