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The Untouched Axis

A new axis in
dry eye treatment

Adaptive Immunity

Targeted by existing drugs

Cyclosporine and lifitegrast suppress activated T-cells. They do not directly engage the innate immune system.

Cyclosporine Lifitegrast
Innate Immunity

Untouched until now

No approved therapy directly engages innate immune resolution. Regadenoson is the first to target A2A-driven macrophage repolarization.

Regadenoson · Topical A2A Agonist
M1 → M2Macrophage repolarization
A2A + A1Dual receptor
cAMP / Ca²⁺Dual signaling
OrthogonalAdditive to existing
Mechanism of Action

The Bicarbonate
Bridge

A2A — Hydration & Repair

cAMP signaling hydrates mucin via CFTR/bicarbonate channels. Calms innate inflammation by shifting macrophages from M1 to M2 — the mechanism cyclosporine cannot access.

A1 — Secretory Recruitment

At ocular surface concentrations, regadenoson engages A1 receptors, driving calcium-dependent secretion from Krause and Wolfring glands.

Dual Receptor
Innate Immune Resolution

Macrophage
repolarization

Pro-inflammatory Anti-inflammatory
01

A2A Engagement

Regadenoson binds A2A receptors on M1 macrophages in the conjunctival epithelium.

02

M1 Suppression

cAMP signaling brakes TNF-α, IL-1β, iNOS, and NLRP3 inflammasome activity.

03

M2 Resolution

Macrophages shift to Arg1, CD206, IL-10. Goblet cells secrete TGF-β.

Our Approach

Restoring the tear film's natural balance

Current therapies only address one side of the equation. We engage a dual-receptor mechanism that restores the ratio from both sides simultaneously.

Development Pipeline

Our path forward

Observational CohortFilamentary Keratitis / Severe Dry Eye
Preclinical SafetyOphthalmic GLP Toxicology
IND EnablingBiomarker-Enriched Dry Eye Trial
505

505(b)(2) Regulatory Pathway

Leveraging the existing Lexiscan NDA for systemic safety. Only route-specific ophthalmic data needs to be generated new.

Why Identité

Built on substance

R

Repurposed & Proven

Regadenoson (Lexiscan) has been used safely in hundreds of thousands of patients for cardiac imaging. We are repurposing it as a topical eye drop — leveraging existing safety data and the 505(b)(2) pathway to dramatically reduce development risk, cost, and time to clinic.

D

Dual Mechanism

Unlike single-mechanism therapies that plateau, our approach engages both A2A (hydration, epithelial repair, innate immune resolution) and A1 (secretory recruitment from surface-accessory glands) — two parallel pathways that restore the tear film's functional ratio.

S

Surface-Only Design

By targeting the corneal and conjunctival epithelium and surface-accessory glands of Krause and Wolfring — not the deep main lacrimal gland — we achieve therapeutic action where the drug is applied, with minimal systemic exposure and an excellent safety margin.