“…Apelin exists in several isoforms: apelin-36, apelin-17, apelin-13, [Pyr 1 ]-apelin-13, and [Pyr 1 ]-apelin-13 (1â12). Among them, [Pyr 1 ]-apelin-13 (Ape13) is the predominant isoform circulating in human plasma and heart tissues. ,â Apelin-13 can be generated from longer isoform such as preproapelin-55 or apelin-36 by the PCSK3 protease, , and the N-terminal glutamine can be cyclized to pyroglutamate to provide [Pyr 1 ]-apelin-13. , [Pyr 1 ]-apelin-13 (1â12) is generated from [Pyr 1 ]-apelin-13 upon angiotensin-converting enzyme 2 (ACE2) or prolylcarboxypeptidase (PRCP) cleavage. , In the cardiovascular system, apelin is a potent positive inotropic and vasodilator agent. , The therapeutic potential of the apelin/APJ system has been demonstrated both in animal models and in exploratory clinical trials. â Apelin improves animal survival in cardiovascular dysfunction induced by sepsis and restores cardiac parameters in the model of heart failure induced by transverse aortic constriction. , Early clinical trials in healthy subjects and patients with heart failure, , as well as patients suffering from pulmonary arterial hypertension (PAH), confirmed that treatment with apelin produced beneficial effects in humans and showed a real therapeutic perspective . In addition, the expression of apelin is increased under hypoxia , and stimulates the formation of new blood vessels, and many studies show its beneficial effect against the formation of skin ulcers, cardiac ischemia, or intracerebral hemorrhage in animal models. â All of the above suggests that the APJ receptor is a potential drug target, prompting both academics and industry to develop peptide analogues, small molecules, and functional antibodies targeting APJ. ,, …”