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K-604 is a potent and selective small molecule inhibitor of acyl-coenzyme A:cholesterol acyltransferase 1 (ACAT-1, also known as SOAT1), with an IC50 of approximately 0.45 μM for ACAT-1 and much lower activity against ACAT-2[1][4][6]. It reduces cholesterol esterification in macrophages and has been shown to decrease foam cell formation, which is relevant to atherosclerosis[1]. More recently, it has been investigated as a drug candidate for the treatment of Alzheimer's disease and glioblastoma due to its ability to inhibit ACAT-1 in the brain; however, it exhibits poor solubility in neutral water and low permeability across the blood–brain barrier when administered orally. Intranasal administration has been explored as an alternative delivery route for central nervous system indications[8]. The compound was developed through solubility-driven structural optimization strategies.
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