A practical reference on dual agonist: what it is, how it behaves, what the literature reports, and where the honest uncertainties sit.
Reviewed 2026-04-11. Anything still debated is marked as such rather than presented as settled.
Tirzepatide 是一种由 39 个氨基酸组成的合成肽，分子结构上以 GIP 序列为骨架并引入脂肪酸侧链修饰，使其能够同时与葡萄糖依赖性促胰岛素多肽（GIP）受体和胰高血糖素样肽-1（GLP-1）受体结合。这种双重激动特性使它在同类肽类药物中区别于选择性 GLP-1 受体激动剂。该分子最早由一家制药公司在 2010 年代报道，随后进入糖尿病与体重管理领域的临床研究。
在生理层面，GIP 与 GLP-1 均为肠道内分泌细胞分泌的肠促胰素，进食后参与胰岛素分泌调节与胃排空抑制。Tirzepatide 通过同时激活这两条信号通路，使胰岛素分泌的葡萄糖依赖性增强，并延缓冲胃排空、降低食欲信号。与单一 GLP-1 激动相比，双靶点作用在血糖控制和体重变化上的效应幅度更大，但具体贡献比例仍在研究之中。
Receptor activation by tirzepatide raises intracellular cyclic AMP through Gs-coupled signalling at both targets. At the GLP-1 receptor the downstream effect includes glucose-dependent insulin release, suppressed glucagon secretion, delayed gastric emptying, and reduced appetite signalling in the hypothalamus. GIP receptor engagement adds insulinotropic activity and appears to influence lipid handling in adipose tissue. Because both receptors are stimulated at the same time, the pharmacological profile differs from that of selective GLP-1 receptor agonists, and the relative contribution of each arm remains an area of active investigation.
Clinical development proceeded through large phase 3 programmes in type 2 diabetes and in obesity or overweight with at least one weight-related comorbidity. Regulatory approvals followed in several jurisdictions for both indications. Weekly subcutaneous dosing reflects an elimination half-life of roughly five days. Open questions include the durability of metabolic effects after treatment stops, long-term cardiovascular and hepatic outcomes beyond completed trials, and whether the dual mechanism confers benefits independent of total receptor occupancy. Published literature continues to expand on these points. Substantial uncertainty remains about interindividual variability in response.
| Property | Value | Notes |
|---|---|---|
| 分子类型 | 合成修饰肽 | 39 个氨基酸，含脂肪酸侧链 |
| 受体靶点 | GIP 与 GLP-1 受体 | 双重激动剂 |
| 分子量 | 约 4.8 kDa | 以游离肽计 |
| 外观 | 白色至类白色粉末 | 冻干形态常见 |
| 溶解性 | 可溶于水及水性缓冲液 | 溶解后宜低温保存 |
Tirzepatide is a synthetic peptide that acts as a dual agonist at the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. The molecule contains 39 amino acids and features a C20 fatty diacid moiety attached via a linker, which promotes albumin binding and extends its circulating half-life. Its sequence incorporates non-natural amino acids and modifications that reduce susceptibility to degradation by dipeptidyl peptidase-4. This dual receptor activity distinguishes it from selective GLP-1 receptor agonists.
The GIP receptor is expressed in pancreatic islets, adipose tissue, and the central nervous system, while GLP-1 receptors are found in pancreatic islets, the gastrointestinal tract, and the brain. Activation of both receptors can enhance glucose-dependent insulin secretion and reduce glucagon release. The relative contribution of each receptor to the overall pharmacological effect remains an area of ongoing investigation. Preclinical studies suggest that GIP receptor agonism may modulate appetite and energy balance, but the precise mechanisms in humans are not fully established.
In clinical research, tirzepatide has been studied in randomized controlled trials for glycemic control and body weight reduction. These trials typically measure changes in hemoglobin A1c and body weight over periods of several months. The drug is administered by subcutaneous injection, and its pharmacokinetic profile supports once-weekly dosing. Post-marketing surveillance continues to evaluate long-term outcomes and rare adverse events.
Both receptors are class B G protein-coupled receptors that signal largely through Gs-mediated cyclic AMP production. Activation within pancreatic islets increases glucose-dependent insulin secretion and suppresses glucagon release when glucose is elevated. Outside the pancreas, signaling in the central nervous system and gut appears to influence appetite and gastric emptying. The relative contribution of each receptor to observed clinical effects remains under investigation, and the two pathways are not simply additive in practice.
Reported outcomes in large trials include dose-dependent weight reduction and improvements in glycemic markers over periods ranging from several months to more than a year. Whether the compound alters long-term cardiovascular or renal outcomes is being examined in dedicated outcome studies, so those questions remain open. Labeling describes gastrointestinal effects such as nausea and diarrhea, which tend to appear during dose escalation. Discontinuation rates and the durability of effects after treatment stops vary across study populations and are still debated.
Tirzepatide is a synthetic peptide developed as a dual agonist at the glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors. Its structure is built on a GIP-derived backbone with non-natural amino acid substitutions and a fatty diacid side chain that promotes albumin binding and slows clearance. That modification supports once-weekly subcutaneous dosing. Registrational trial programs reported reductions in body weight and glycated hemoglobin alongside the drug's glycemic effects.
=== Dextran hydrogel colon-targeting === The colon is an ideal target for dextran hydrogel drug delivery systems due to the presence of dextranases. Dextran can be cross-linked with diisocyanate to form a hydrogel that can be loaded with hydrocortisone to treat swelling or inflammation in the colon. Hydrogels can also be synthesized from crosslinking epichlorohydrin (ECH) with dextran. Dextran-ECH hydrogels can be loaded with salmon calcitonin (sCT) to treat bone diseases. Dextran-ECH hydrogels loaded with sCT achieved comparable release rates to other polymeric hydrogels in the colon.
In an interview to Italian newspaper Corriere della Sera on 20 June, Lula asserted that Italy is a priority for Brazil, especially because Brazil has "30 million Brazilians of Italian descent and great relations with Italian trade unions, intellectuals and companies". On 20 June, Lula met with left-wing sociologist and professor emeritus at the Sapienza University of Rome Domenico De Masi during his visit to Rome. On 21 June, Lula met with General Secretary of the Democratic Party (PD), Elly Schlein, and former Prime Minister Massimo D'Alema, with whom he reportedly had talks about "democracy, world peace, climate change, inequality and challenges common to several countries". Brazilian government officials also said that Lula and Schlein had a talk about "gender violence and sexism in politics". Lula also met and dined with Italian president Sergio Mattarella at the Quirinal Palace to reportedly discuss about the relations between Brazil and Italy, as well as the Mercosur-European Union deal. Upon returning from his visit to the Vatican, he also had a meeting with Italian Prime Minister Giorgia Meloni at the Chigi Palace. During an interview to the press after the meeting, he praised Meloni, saying that "ideological differences wouldn't end diplomacy" between the two countries. Lula also had a meeting and private dinner with Rome mayor Roberto Gualtieri.
This is a list of investigational substance-related disorder drugs, or drugs that are currently under development for clinical use for the treatment of substance-related disorders but are not yet approved. Substance-related disorders include substance use disorders like alcoholism (alcohol use disorder), amphetamine use disorder, cocaine use disorder, nicotine use disorder, and opioid use disorder, among others. In addition, they include substance withdrawal syndromes like alcohol withdrawal and opioid withdrawal as well as substance overdoses like opioid overdose. Chemical/generic names are listed first, with developmental code names, synonyms, and brand names in parentheses. The format of list items is "Name (Synonyms) – Mechanism of Action – Indication [Reference]". This list was last comprehensively updated in January 2026. It is likely to become outdated with time.
In 1888 Friedrich Reinitzer examined the properties of various derivatives of cholesterol which now belong to the class of materials known as cholesteric liquid crystals. Previously, other researchers had observed distinct colour effects when cooling cholesterol derivatives just above the freezing point, but had not associated it with a new phenomenon. Reinitzer found that cholesteryl benzoate does not melt in the same way as most substances, but has two melting points. At 145.5 °C (293.9 °F) it melts into a cloudy liquid, and at 178.5 °C (353.3 °F) it melts again and the cloudy liquid becomes clear. The phenomenon is reversible. Reinitzer sought assistance to understand the phenomenon and, on 14 March 1888, he wrote to Otto Lehmann. They exchanged letters and samples. Lehmann examined the intermediate cloudy fluid, and reported seeing crystallites. Reinitzer's colleague Victor Leopold von Zepharovich also indicated that the intermediate "fluid" was crystalline. Reinitzer published his results, with credit to Lehmann and von Zepharovich, on 3 May 1888. By that time, Reinitzer had discovered and described three important features of liquid crystals (the term was coined by Lehmann in a 1904 monograph): the existence of two melting points, the reflection of circularly polarized light, and the ability to rotate the direction of polarized light. Reinitzer did not pursue the study of liquid crystals further, although in 1908 he had to defend his role in their discovery when Lehmann claimed the priority.
Sources: en.wikipedia.org
Biotechnology is a rapidly evolving field with significant potential to address pressing global challenges and improve the quality of life for people around the world; however, despite its numerous benefits, it also poses ethical and societal challenges, such as questions around genetic modification and intellectual property rights. As a result, there is ongoing debate and regulation surrounding the use and application of biotechnology in various industries and fields.
=== United States === Prominent outdoor retailers in the United States include Dick's Sporting Goods, Eddie Bauer, Backcountry.com, Outdoor Voices, REI, Patagonia, Marmot, Moosejaw, Sierra, The North Face and L.L.Bean.
=== Insulin === Insulin is released from the pancreas and into the bloodstream in response to increased glucose concentration in the blood. Insulin is stored in beta cells in the pancreas. When glucose in the blood binds to glucose receptors on the beta cell membrane, a signal cascade is initiated inside the cell that results in insulin stored in vesicles in these cells being released into the blood stream. Increased insulin levels cause the uptake of glucose into the cells. GLUT4 is stored in the cell in transport vesicles, and is quickly incorporated into the plasma membrane of the cell when insulin binds to membrane receptors. Under conditions of low insulin, most GLUT4 is sequestered in intracellular vesicles in muscle and fat cells. As the vesicles fuse with the plasma membrane, GLUT4 transporters are inserted and become available for transporting glucose, and glucose absorption increases. The genetically engineered muscle insulin receptor knock‐out (MIRKO) mouse was designed to be insensitive to glucose uptake caused by insulin, meaning that GLUT4 is absent. Mice with diabetes or fasting hyperglycemia, however, were found to be immune to the negative effects of the insensitivity.
Sources: en.wikipedia.org
它属于合成修饰肽，同时激动 GIP 与 GLP-1 两种肠促胰素受体。这类分子通常被称为双重肠促胰素受体激动剂，与选择性 GLP-1 激动剂在靶点范围上不同。
分子上的脂肪酸侧链使其与血浆白蛋白结合增强，显著延长循环半衰期。半衰期延长后，稳定血药浓度可在较长的给药间隔内维持，因此常见用法为每周一次。
同时激活两条肠促胰素通路可能在胰岛素分泌、胃排空和食欲调节上产生叠加效应。与单靶点相比，临床研究中观察到的血糖与体重变化幅度通常更明显，但各通路的具体贡献比例尚无定论。
It is a dual GIP and GLP-1 receptor agonist, frequently grouped with incretin-based peptide therapeutics. It is a peptide rather than a small molecule and is given by subcutaneous injection.