Evidence map›Paper›PMID 41701900›Full record

ArticleJCI insight2026

A potent inhibitor of PAI-1, MDI-2517, mitigates disease severity in a preclinical systemic sclerosis model.

Enming J Su, Pei-Suen Tsou, Mark Warnock, Natalya Subbotina, Kris Mann, Sirapa Vichaikul, Alyssa Rosek, Lisa Leung, Xianying Xing, Enze Xing and 9 more

Abstract read
In one paragraph

Article in JCI insight, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Enming J SuDivision of Cardiovascular Medicine, Department of Internal Medicine.
Pei-Suen TsouScleroderma Program, Division of Rheumatology, Department of Internal Medicine.
Mark WarnockDivision of Cardiovascular Medicine, Department of Internal Medicine.
Natalya SubbotinaDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine.
Kris MannDivision of Cardiovascular Medicine, Department of Internal Medicine.
Sirapa VichaikulScleroderma Program, Division of Rheumatology, Department of Internal Medicine.
Alyssa RosekScleroderma Program, Division of Rheumatology, Department of Internal Medicine.
Lisa LeungDepartment of Molecular Integrative Physiology; and.
Xianying XingDepartment of Dermatology; University of Michigan Medical School, Ann Arbor, Michigan, USA.
Enze XingDepartment of Dermatology; University of Michigan Medical School, Ann Arbor, Michigan, USA.
Olesya PlazyoDepartment of Dermatology; University of Michigan Medical School, Ann Arbor, Michigan, USA.
Rachael BogleDepartment of Dermatology; University of Michigan Medical School, Ann Arbor, Michigan, USA.
Lam C TsoiDepartment of Dermatology; University of Michigan Medical School, Ann Arbor, Michigan, USA.
Cory D EmalDepartment of Chemistry, Eastern Michigan University, Ypsilanti, Michigan, USA.
Dinesh KhannaScleroderma Program, Division of Rheumatology, Department of Internal Medicine.
John VargaScleroderma Program, Division of Rheumatology, Department of Internal Medicine.
Thomas H SissonDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine.
Johann E GudjonssonScleroderma Program, Division of Rheumatology, Department of Internal Medicine.
Daniel A LawrenceDivision of Cardiovascular Medicine, Department of Internal Medicine.

Funding

Unraveling the role of tPA in the neurovascular unitR01HL055374 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI David Antonetti, Daniel A Lawrence · 1995 to 2026
$8.6M
The Role of PAI-1 in Cerebral Microvascular Dysfunction and the Development of Alzheimer’s Disease NeuropathologyR01AG074552 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LAWRENCE, DANIEL A, MURPHY, GEOFFREY G · 2021 to 2025
$3.4M
A Novel PAI-1 Function Drives Lung FibrosisR01HL163870 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Daniel A Lawrence, THOMAS H SISSON · 2023 to 2026
$2.8M
NHLBI NIH HHS R01 HL055374NHLBI NIH HHS R01 HL163870NIA NIH HHS R01 AG074552
6 · The paper itself

Abstract

Systemic sclerosis (SSc) is a complex and heterogeneous condition characterized by progressive fibrosis in multiple organs. Recent studies implicate plasminogen activator inhibitor-1 (PAI-1) in the pathogenesis of SSc, and PAI-1 is considered as a potential target for therapy. Here, using single-cell and spatial RNA-seq analysis of skin biopsies from 18 healthy individuals and 22 SSc patients, we found elevated PAI-1 colocalizing to myofibroblasts with enriched extracellular matrix-associated biological processes. Treatment of SSc dermal fibroblasts with the small-molecule PAI-1 inhibitor MDI-2517 reduced the expression of the profibrotic markers COL1A1 and ACTA2. To investigate the therapeutic potential of MDI-2517, we evaluated its efficacy in reducing fibrosis in a preclinical model of SSc. Treatment of mice with MDI-2517 significantly reduced both skin and lung fibrosis and was superior to treatment with either pirfenidone or mycophenolate mofetil. Additionally, MDI-2517 attenuated weight loss and significantly reduced the expression of key profibrotic markers. Compared with tiplaxtinin, another PAI-1 inhibitor previously shown to be effective in a model of SSc, MDI-2517 was found to have superior efficacy at a 10-fold lower dose. These findings highlight the role of PAI-1 in the pathogenesis of SSc, and the potential of MDI-2517 for the treatment of SSc.

Indexed as

Plasminogen Activator Inhibitor 1Scleroderma, SystemicActinsAdultAnimalsCollagen Type ICollagen Type I, alpha 1 ChainDisease Models, AnimalFemaleFibroblastsFibrosisHumansIndoleacetic AcidsMaleMiceMiddle AgedACTA2 protein, humanActinsCollagen Type ICollagen Type I, alpha 1 ChainIndoleacetic AcidsMycophenolic AcidpirfenidonePlasminogen Activator Inhibitor 1PyridonesSERPINE1 protein, humanSerpin E2tiplaxtininAutoimmunityFibrosisPulmonologyRheumatology

Identifiers

PMID41701900
PMCPMC13134730

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.