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S100A4 monoclonal antibodies represent a therapeutic class of biologics designed to neutralize the extracellular S100A4 protein, a member of the S100 family of calcium-binding proteins also known as metastasin-1 or fibroblast-specific protein 1 (FSP1). S100A4 acts as a damage-associated molecular pattern (DAMP) that promotes tissue fibrosis and chronic inflammation by interacting with receptors such as TLR4 and RAGE, and by modulating the TGF-β signaling pathway. The most clinically advanced candidate is CAL101, a humanized IgG4 monoclonal antibody developed by Calsis Biotherapeutics, currently in Phase II trials for idiopathic pulmonary fibrosis (IPF). Other developments include EXTH-122, a bispecific antibody targeting S100A4 and the transferrin receptor (TFR) to enable blood-brain barrier crossing for the treatment of glioblastoma.
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