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TAT-V12Rac1 is a cell-permeable, constitutively active recombinant fusion protein designed to stabilize the endothelial barrier. It consists of the HIV-1 Trans-Activator of Transcription (TAT) protein transduction domain fused to a mutant form of the small GTPase Rac1, specifically the G12V variant which remains in a permanent GTP-bound, active state. By delivering active Rac1 directly into the cytoplasm, the drug promotes the polymerization of cortical F-actin, strengthening the endothelial actin fence at the cell periphery. This mechanism prevents the formation of membrane pores and vascular leakage caused by bacterial toxins or internalization, such as that seen in Pseudomonas aeruginosa infections. It is primarily being investigated as a therapeutic for sepsis-associated acute lung injury (ALI) and Gram-negative bacteremia.
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