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ho9R is a poly-arginine cell-penetrating peptide (CPP) consisting of nine D-arginine residues. It has been extensively investigated as a neuroprotective agent for the treatment of ischemic stroke, traumatic brain injury, and other neurological disorders. The peptide exerts its therapeutic effects by modulating ion channels to reduce excitotoxic calcium influx into neurons; specifically, it acts as a non-competitive antagonist of N-methyl-D-aspartate (NMDA) receptors and inhibits voltage-gated calcium channels (VGCCs). Additionally, ho9R has been shown to stabilize mitochondrial membranes, reduce the production of reactive oxygen species, and inhibit pro-apoptotic signaling pathways. The use of D-arginine residues instead of the naturally occurring L-arginine (as in the R9 peptide) provides ho9R with significantly greater resistance to proteolytic degradation, thereby enhancing its stability and duration of action in vivo. While ho9R demonstrated potent neuroprotective efficacy in preclinical models, much of the clinical development focus by its primary developers has shifted toward longer poly-arginine variants such as R18 (also known as ARG-007).
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