V4C-232

V4C-232 is a first-in-class synthetic small molecule antagonist of the vasopressin V2 receptor (V2R), derived from a peptide found in the venom of the green mamba snake. Developed by V4Cure, a spin-off of the French Alternative Energies and Atomic Energy Commission (CEA), the compound is designed to treat volume overload conditions and cystic diseases. By reversibly binding to V2R, V4C-232 inhibits the action of vasopressin, leading to increased elimination of free water in the urine (aquaresis) and suppression of cell proliferation and cyst growth. Its primary clinical focus is the treatment of refractory ascites in patients with liver cirrhosis, with secondary development for Autosomal Dominant Polycystic Kidney Disease (ADPKD) and Autosomal Recessive Polycystic Kidney Disease (ARPKD).