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D-4F is an 18-amino acid apolipoprotein A-I mimetic peptide made of D-amino acids, designed to replicate the beneficial functions of ApoA-I, the primary protein in high-density lipoproteins (HDL). It forms a class A amphipathic helix that interacts with lipids but does not share homology with ApoA-I. D-4F exerts anti-inflammatory and anti-oxidative effects, improves HDL function, reduces atherosclerotic lesions, and ameliorates oxidative injuries and inflammation in endothelial cells and other tissues via mechanisms such as modulation of the AMP-activated protein kinase (AMPK)/protein kinase C (PKC) pathway, inhibition of NADPH oxidase (NOX) activation and endothelial nitric oxide synthase (eNOS) dysregulation, and upregulation of ATP-binding cassette transporter A1 (ABCA1) involved in cholesterol efflux. It has shown benefit in models of cardiovascular disease, idiopathic pulmonary fibrosis, spinal cord injury, asthma, and other inflammatory or oxidative injury conditions[1][2][4].
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