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TM5275 is an orally bioavailable, selective small-molecule inhibitor of plasminogen activator inhibitor-1 (PAI-1, encoded by the SERPINE1 gene). Developed by Tohoku University and Renascience, TM5275 binds to the s4A position of the PAI-1 molecule, preventing its interaction with tissue plasminogen activator (tPA) and urokinase-type plasminogen activator (uPA), thereby preserving active tPA and enhancing fibrinolysis. It also inhibits the interaction between PAI-1 and low-density lipoprotein receptor-related protein 1 (LRP1). Preclinical studies have demonstrated its therapeutic potential as an antithrombotic agent without prolonging bleeding time, as well as its anti-fibrotic and anti-inflammatory effects in models of chronic pancreatitis, liver fibrosis (NASH), lung fibrosis, and diabetic nephropathy.
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