Apela-Apelin Receptor Ligand, Ela (ELABELA) in Gestational Complications

Abstract

ELABELA (also known as Apela) is an endogenous peptide ligand for the Apelin receptor (APLNR) that plays a crucial role in embryonic development, cardiovascular regulation, and fluid homeostasis. Recent studies have revealed its vital role in placental development, angiogenesis, and maternal–fetal circulation. Dysregulation of the ELABELA/Apelin–APLNR signaling pathway has been linked to impaired trophoblastic invasion, placental hypoperfusion, and the pathogenesis of preeclampsia and other gestational complications. In pregnancy, ELABELA contributes to vascular remodeling, endothelial protection, and modulation of angiogenic mediators such as vascular endothelial growth factor (VEGF) and soluble fms-like tyrosine kinase-1 (sFlt-1). Decreased serum ELABELA levels have been observed in patients with preeclampsia, suggesting a potential diagnostic and prognostic value. Moreover, ELABELA’s vasodilatory and cardioprotective effects may provide a mechanistic basis for its therapeutic potential in hypertensive disorders of pregnancy. Understanding ELABELA’s multifaceted biological actions could offer new insights into the pathophysiology of pregnancy-related hypertensive and ischemic disorders. Hence, maternal serum ELABELA measurement may serve as a promising biomarker for early detection, risk stratification, and future targeted interventions in preeclampsia and related gestational pathologies.