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An LRG1 antagonist is a therapeutic agent designed to inhibit the activity of leucine-rich alpha-2-glycoprotein 1 (LRG1). LRG1 is a secreted glycoprotein implicated in pathological angiogenesis, vascular dysfunction, and fibrosis. It is upregulated in diseased tissues, where it promotes aberrant blood vessel growth and vascular leakage by modulating the transforming growth factor-beta (TGF-β) signaling pathway, specifically shifting it toward the pathogenic ALK1/Smad1/5/8 pathway. By blocking LRG1, these antagonists aim to normalize the vasculature, reduce fibrosis, and restore normal tissue homeostasis. LRG1 antagonists, such as the monoclonal antibody magacizumab (developed by University College London) and STX-002 (developed by Senya Therapeutics), are being investigated for the treatment of neovascular age-related macular degeneration (AMD), diabetic retinopathy, diabetic kidney disease (DKD), and various solid tumors, where they may also enhance the delivery and efficacy of co-administered chemotherapies and immunotherapies.
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