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L-902,688 is a potent, selective, and orally active small molecule agonist of the prostaglandin E2 receptor EP4, with a Ki of 0.38 nM and an EC50 of 0.6 nM[4]. It binds to the orthosteric site of EP4 and activates downstream signaling pathways, including the cAMP/PKA and peroxisome proliferator-activated receptor gamma (PPARγ), leading to anti-proliferative and anti-migratory effects on pulmonary arterial smooth muscle cells[1][4][5]. L-902,688 has demonstrated efficacy in preclinical models for reducing pulmonary arterial hypertension (PAH) and ischemic brain injury by modulating vascular remodeling and inflammation[1][3].
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