Alpha-1-acid glycoprotein 2 (ORM2)

Alpha-1-acid glycoprotein 2 (ORM2) is a major acute-phase plasma protein synthesized predominantly by the liver, with roles in the immune response and drug transport. Structurally, it is a highly glycosylated member of the lipocalin family, forming a beta-barrel fold capable of binding hydrophobic ligands, including several classes of therapeutic drugs. ORM2 levels rise sharply in response to inflammation, trauma, or infection, where it acts as a systemic immunomodulator by suppressing excessive immune activity and helping to maintain vascular stability. ORM2's drug-binding properties influence the pharmacokinetics and efficacy of many medications, making it a critical factor in precision dosing. Clinically, ORM2 serves as a biomarker for inflammation, liver function, and cancer progression, but its expression and glycosylation can complicate pharmacological management and may contribute to immune escape in cancer or increase infection risk in chronic disease[1][3][4][5].

Other names

Orosomucoid 2AGP2AGP 2OMD 2AGP-BAGP-B'orosomucoid-2alpha-1-acid glycoprotein, type 2

Drugs bind ORM2, which affects their plasma binding, bioavailability, distribution, and clearance; ORM2 can sequester drugs and alter therapeutic effect, especially during inflammation