4TEEN4 Pharmaceuticals, advancing a validated biomarker approach in shock. Our antibody aims to reverse life-threatening shock and restore organ function with invobenitug (procizumab).
Targeting a key pathological driver of mortality in shock
Unmet medical need
Shock is a severe and life-threatening condition in which the circulatory system fails to deliver sufficient oxygen to meet the body’s metabolic demands, leading to organ dysfunction. It can result from a variety of causes, including cardiac insults, sepsis, trauma, burns and major surgery, and accounts for approximately one in three admissions to intensive care units (ICUs).1
Shock remains an unaddressed medical condition with no adequate causal therapy available and mortality rates exceeding 40%.2,3,4
What is Cardiogenic Shock?
Cardiogenic shock (CS) is the second most common form of circulatory failure. It is most often triggered by acutemyocardial infarction (AMI) or acute decompensated heart failure (ADHF). This acute life-threatening condition accountsfor more than 100,000 deaths per year in the U.S. & Europe alone. CS is a tremendous cost burden for society with anaverage cost per patient of $ 150 to 190k in the U.S.5
Our therapeutic focus
We aim to change the trajectory of shock by addressing its underlying drivers rather than managing symptoms alone. Our approach targets the mechanisms that trigger and sustain circulatory failure, with the goal of restoring cardiovascular stability and preventing irreversible organ damage. By intervening at the source, we seek to reduce the persistent high mortality rates seen in shock and deliver meaningful improvements in patient survival.
We identified a key molecular driver of mortality in shock: circulating Dipeptidyl Peptidase 3 (cDPP3).
What is DPP3?
Under healthy conditions, DPP3 is an intracellular enzyme. When severe tissue injury and cell death occurs, it can be released into the bloodstream, where it disrupts cardiovascular regulation and accelerates the progression to circulatory failure — ultimately increasing the risk of death. In this context, circulating DPP3 (cDPP3) serves both as a powerful prognostic marker and as a major molecular driver of shock. The pathological role of cDPP3 has been validated across different types of shock in shock caused by cardiac failure, burns, major surgery, septic cardiomyopathy, and other critical conditions.
Shock prediction
High cDPP3 levels are a strong predictor of poor clinical outcomes and a key driver of shock across various etiologies. Elevated cDPP3 levels in critically ill patients are linked to in-hospital shock development, severe organ dysfunction, greater need for intensive cardiovascular support, and higher short-term mortality. Measuring cDPP3 can help clinicians rapidly identify high-risk patients and guide timely patient disposition and escalate interventions.
Our development strategy
We are advancing a first-in-class therapy designed to interrupt the shock spiral driven by cDPP3. Our current clinical program is focused on patients with cardiogenic shock who have elevated levels of cDPP3. The goal of our Phase 1b/2a trial is to define the optimal dosing regimen, which we will rapidly advance into a Phase 2/3 study. By combining biomarker-driven patient selection with a highly targeted treatment, we aim to deliver a meaningful survival benefit in one of critical care’s most challenging areas.
What is invobenitug (procizumab)?
Invobenitug (procizumab) is a humanized monoclonal antibody developed to selectively neutralize circulating dipeptidyl peptidase 3 (cDPP3). Under healthy conditions, DPP3 resides inside cells. When tissue injury and cell death occurs, cDPP3 is released into the bloodstream, where it degrades angiotensin peptides — disrupting the body’s renin-angiotensin aldosterone system (RAAS), destabilizing cardiovascular function, and accelerating the progression to shock and organ failure.
By blocking cDPP3 activity, invobenitug (procizumab) helps restore RAAS balance, stabilize cardiovascular function, and protect vital organs. Its therapeutic potential has been confirmed in non-clinical studies, early clinical studies and named-patient program. Invobenitug (procizumab) has consistently shown to restore cardiovascular and organ function with a favorable safety profile.
4Teen4 is supported by
The project is funded by the European Social Fund (ESF) and the Federal State of Brandenburg via the Brandeburg Ministry for Labor, Social Affairs, Health, Women and Family (MASGF).
