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THR-184 is a synthetic oligopeptide developed as a small peptide mimetic that acts primarily as an agonist of bone morphogenetic protein (BMP) signaling and a potent antagonist of transforming growth factor beta (TGFβ) signaling. It targets BMP receptors, particularly bone morphogenetic protein receptor type I and II, leading to phosphorylation of Smad proteins and modulation of cellular pathways involved in inflammation, apoptosis, fibrosis, and epithelial-to-mesenchymal transition (EMT). The drug was designed for the prevention and treatment of acute kidney injury (AKI), especially in patients at risk due to cardiac surgery. Preclinical studies demonstrated its ability to reduce the severity of AKI in animal models by inhibiting inflammation and fibrosis. Clinical trials showed that it was safe and well tolerated but did not significantly reduce the incidence or severity of AKI compared with placebo in high-risk cardiac surgery patients[1][3][5][6][10].
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