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Serelaxin is a recombinant form of the naturally occurring human relaxin-2 peptide hormone. It acts as an agonist at the relaxin/insulin-like family peptide receptor 1 (RXFP1), mediating vasodilation primarily through increased nitric oxide production and upregulation of vascular endothelial growth factor. Serelaxin also inhibits vasoconstrictors such as angiotensin II and endothelin-1, leading to decreased systemic vascular resistance, increased cardiac output, and improved renal blood flow. These effects are beneficial in acute heart failure (AHF), where serelaxin has been shown to improve symptoms such as dyspnea and may reduce cardiovascular mortality. Additional mechanisms include anti-fibrotic activity, end-organ protection via inhibition of inflammation and oxidative stress, stimulation of angiogenesis, and prevention of tissue fibrosis. Developed by Novartis for intravenous infusion over 24–48 hours in hospitalized patients with AHF, serelaxin is marketed under the brand name Reasanz in Russia but was not approved or marketed in other major regions[1][3][4][5][6].
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