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ES-62 is a phosphorylcholine-containing 62 kDa glycoprotein secreted by the filarial nematode Acanthocheilonema viteae. It is a biologic immunomodulator with potent anti-inflammatory activity. Mechanistically, ES-62 primarily subverts TLR4 (Toll-like receptor 4) signaling to downregulate MyD88-dependent inflammatory responses, suppress pathological Th17 polarization, promote regulatory B cells (IL-10+ Bregs), and restore regulatory/effector immune cell balance. ES-62 can disrupt T-cell receptor signaling (via pathways involving PLD, PKC, PI3K, Ras–Erk MAPK), downregulate Th1 and Th17 responses, and normalise the gut microbiota. These effects have been demonstrated in preclinical mouse models across a range of immune and metabolic pathologies, including rheumatoid arthritis, systemic lupus erythematosus, allergic asthma, and metabolic dysfunction associated with ageing. ES-62 is administered subcutaneously in preclinical studies and is not currently approved for human use.
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