Targeting the apelin pathway as a novel therapeutic approach for cardiovascular diseases

The apelin/apelin receptor system plays a dominant role in cardiovascular homeostasis and diseases. Activation of the apelin receptor by apelin, apelin agonists, apelin analogues and Elabela/Toddler induces a wide range of physiological effects, including vasodilation, increased myocardial contractility, improved vascular function and fluid homeostasis. The apelin pathway is also implicated in atherosclerosis, hypertension, coronary artery disease, pulmonary arterial hypertension, heart failure and atherosclerosis, making it a promising therapeutic target. RAS, renin-angiotensin system; PAH, pulmonary arterial hypertension; PASMC, pulmonary arterial smooth muscle cell; VSMC, vascular smooth muscle cell; EC, endothelial cell; NO, nitric oxide; eNOS, endothelial nitric oxide synthase.136