Design, Synthesis, and Evaluation of a Potent and Selective ROCK2 Inhibitor for Atopic Dermatitis Treatment

Atopic dermatitis (AD) remains a significant clinical challenge due to the limited efficacy and safety concerns associated with current therapies. To address this unmet need, we utilized structure-guided analysis and identified a previously unrecognized hydrophobic surface (S1) unique to ROCK2. Exploiting this structural feature through virtual screening led to the discovery of compound 10d, a potent ROCK2 inhibitor with markedly improved selectivity compared to the reference compound KD025. In a mouse model of MC903-induced AD, 10d effectively suppressed inflammation and achieved therapeutic efficacy superior to the model group, while maintaining a favorable safety profile. Mechanistically, we demonstrated that 10d attenuates AD pathology by downregulating S100A9, highlighting the ROCK2–S100A9 axis as a novel pathway in AD pathogenesis. Collectively, these findings establish 10d as a highly active and selective inhibitor, marking the first exploration of ROCK2-targeted therapy for AD treatment.