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Background <p>Diabetes mellitus predisposes patients to severe vascular and organ complications, in part driven by persistent inflammation and oxidative stress. Emerging evidence highlights the ELABELA (ELA)–APJ axis as a multifaceted regulator of diabetes-induced tissue injury and a potential target for preventing diabetic complications.</p> Methodology <p>This minireview synthesizes peer-reviewed experimental and clinical studies on ELABELA/APJ signaling in diabetes and related complications, with emphasis on inflammatory/oxidative injury and mechanistic pathways relevant to organ protection.</p> Results <p>Across diabetic settings, ELABELA shows protective effects against inflammation, oxidative stress, apoptosis, ferroptosis, and pyroptosis, and circulating ELABELA levels have been reported to correlate with complication severity. Mechanistically, reported pathways include NF-κB and NLRP3 inflammasome regulation, antioxidant programs (e.g., Nrf2), mitochondrial redox control (SIRT3–FOXO3a), and APJ-linked AMPK signaling, with evidence spanning kidney and heart complications. Therapeutic development is progressing along three main tracks: ELABELA peptides/analogs, gene-delivery strategies, and small-molecule APJ agonists.</p> Conclusion <p>Targeting the ELABELA–APJ axis represents a promising, multi-pathway strategy to mitigate diabetes-related organ injury; however, translation will require improved delivery strategies, optimized pharmacodynamics, and rigorous safety/clinical validation.</p>

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ELABELA in Diabetes and Related Diseases: A Multifaceted Regulator of Inflammation, Oxidative Stress, and Organ Protection

  • 期刊论文

  • 发表日期：

    2025年12月18日

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  • Qi Zhu,
  • Yu Liu,
  • Yunhua Di,
  • Xi Chen,
  • Chen Yang

摘要

Background

Diabetes mellitus predisposes patients to severe vascular and organ complications, in part driven by persistent inflammation and oxidative stress. Emerging evidence highlights the ELABELA (ELA)–APJ axis as a multifaceted regulator of diabetes-induced tissue injury and a potential target for preventing diabetic complications.

Methodology

This minireview synthesizes peer-reviewed experimental and clinical studies on ELABELA/APJ signaling in diabetes and related complications, with emphasis on inflammatory/oxidative injury and mechanistic pathways relevant to organ protection.

Results

Across diabetic settings, ELABELA shows protective effects against inflammation, oxidative stress, apoptosis, ferroptosis, and pyroptosis, and circulating ELABELA levels have been reported to correlate with complication severity. Mechanistically, reported pathways include NF-κB and NLRP3 inflammasome regulation, antioxidant programs (e.g., Nrf2), mitochondrial redox control (SIRT3–FOXO3a), and APJ-linked AMPK signaling, with evidence spanning kidney and heart complications. Therapeutic development is progressing along three main tracks: ELABELA peptides/analogs, gene-delivery strategies, and small-molecule APJ agonists.

Conclusion

Targeting the ELABELA–APJ axis represents a promising, multi-pathway strategy to mitigate diabetes-related organ injury; however, translation will require improved delivery strategies, optimized pharmacodynamics, and rigorous safety/clinical validation.