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MI-676 is a novel, selective human constitutive androstane receptor (CAR) agonist under preclinical development for the treatment of metabolism-associated steatotic liver disease (MASLD). It acts as a hepatoprotective agent by protecting hepatocytes from palmitate-induced endoplasmic reticulum (ER) stress and lipotoxic apoptosis. Mechanistically, MI-676 suppresses SREBP-driven lipogenesis and ER stress, while concurrently activating pro-survival pathways including the GADD45B-Src-PP2A-MDM2-XIAP and CAR-AKT-MDM2 axes, ultimately leading to p53 suppression. It selectively induces CYP2B6 without transactivating CYP3A4, confirming its specificity for human CAR.
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