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Apelin-EV (also known as CAR-Apelin EV) is an engineered extracellular vesicle (EV) therapeutic developed by ShiftBio for the treatment of pulmonary arterial hypertension (PAH). The platform utilizes interferon-induced transmembrane protein 3 (IFITM3) as a type II transmembrane protein scaffold to orient the apelin peptide on the EV surface with its C-terminus fully exposed, preserving its critical binding interface. To enhance lesion-specific targeting, the EV is dual-engineered with the PAH-targeting peptide CARSKNKDC (CAR), which selectively binds to heparan sulfate overexpressed on PAH endothelial cells. Apelin-EV acts as an agonist of the apelin receptor (APJ/APLNR), promoting vascular homeostasis, reversing pathological vascular remodeling, and improving cardiac function.
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