Apelinergic system in acute kidney injury: Mechanistic insights and therapeutic potential

Area of Science:

• Nephrology
• Endocrinology
• Molecular Biology

Background:

• Acute kidney injury (AKI) presents a significant global health challenge with high mortality and limited therapeutic options.
• The apelinergic system, comprising apelin, elabela/toddler, and their receptor, is expressed in renal cells and is implicated in kidney function.
• Existing research suggests a renoprotective role for the apelinergic system in AKI, though its precise mechanisms and therapeutic potential require further investigation.

Purpose of the Study:

• To elucidate the role of the apelinergic system in the pathophysiology of AKI.
• To explore the interactions between the apelinergic system and key AKI pathomechanisms.
• To review the therapeutic potential of apelin-13 in AKI and its clinical status.

Main Methods:

• Literature review of studies on the apelinergic system and AKI.
• Analysis of the mechanisms by which the apelinergic system influences renal pathophysiology.
• Examination of preclinical and clinical data on apelin-13 therapy for AKI.

Main Results:

• The apelinergic system mitigates AKI by reducing endoplasmic reticulum (ER) stress, improving mitochondrial function, and inhibiting inflammation and apoptosis.
• Apelin promotes diuresis via renal vasodilation and counteracts reactive oxygen species (ROS).
• The exact contribution of the apelinergic system to AKI progression and the full therapeutic potential of apelin-13 remain to be fully elucidated.

Conclusions:

• The apelinergic system plays a crucial protective role in AKI through multiple pathways.
• Apelin-13 demonstrates therapeutic potential for AKI, warranting further clinical investigation.
• Understanding the apelinergic system's mechanisms is key to developing novel AKI therapies.