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Larsucosterol is an endogenous sulfated oxysterol and a small molecule epigenetic modulator under development for the treatment of alcohol-associated hepatitis (AH) and other serious conditions. It acts primarily as an inhibitor of DNA methyltransferases (DNMT1, DNMT3a, DNMT3b), thereby reducing DNA hypermethylation and modulating gene expression involved in cell signaling pathways related to stress response, cell death/survival, inflammation, and lipid biosynthesis. This mechanism may lead to improved cell survival and reduced inflammation in acute organ injury settings. Larsucosterol has received FDA Fast Track and Breakthrough Therapy designations for AH due to its potential to address a high unmet medical need[2][4][5]. It is being developed by DURECT Corporation with both intravenous and oral formulations studied in clinical trials[4][6].
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