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Isthmin-1 is a secreted protein and adipokine, recently identified as a bioactive polypeptide hormone involved in multiple physiological and pathological processes, including metabolism, angiogenesis, and inflammation. Mechanistically, isthmin-1 activates the PI3K–AKT signaling pathway—independently of the insulin and insulin-like growth factor (IGF) receptors—to promote glucose uptake in adipocytes, suppress hepatic lipid synthesis, improve glucose tolerance, and ameliorate hepatic steatosis in preclinical models. Isthmin-1 also plays roles in vascular permeability, apoptosis, inhibition of endothelial cell proliferation (via αvβ5 integrin), and modulates airway inflammation through stimulation of adiponectin via the GRP78 receptor. Recombinant isthmin-1 (rISM1) has demonstrated promise as a potential therapeutic agent for type 2 diabetes, fatty liver disease, and allergic airway inflammation in animal models[1][3][5][6][2][7][9].
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