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Recombinant D-dopachrome tautomerase (rD-DT), also known as recombinant macrophage migration inhibitory factor-2 (rMIF-2), is a recombinant version of the endogenous cytokine and enzyme D-dopachrome tautomerase. D-DT is a structural and functional homolog of macrophage migration inhibitory factor (MIF) but lacks the pseudo-ELR motif, potentially offering a more selective tissue-protective profile without inducing CXCR2-mediated inflammatory leukocyte infiltration. rD-DT acts as an agonist of the CD74 receptor complex (often in association with CD44) and the chemokine receptors CXCR4 and ACKR3 (CXCR7), triggering downstream signaling pathways such as the CaMKK2/AMPK and MAPK/ERK cascades. Preclinical studies have demonstrated that administration of rD-DT exerts protective and anti-fibrotic effects in animal models of kidney fibrosis (such as unilateral ureteral obstruction), cardioprotection in myocardial ischemia-reperfusion injury, and metabolic improvements in obesity and glucose intolerance.
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