If you have been reading about incretin and want a single page that covers the useful parts, this is it: definitions, context, how it is studied, and the questions that come up repeatedly.
Last reviewed on 2026-05-02. Where a claim depends on a specific study, the study is described rather than over-claimed.
Published work supports the view that engaging two incretin receptors produces changes in glucose handling and body weight larger than those seen with single-receptor activation. Why that difference arises is not fully settled. Open questions include how much of the observed weight effect depends on central versus peripheral signaling, and whether the two receptors form interacting complexes. Most reported findings come from controlled trials and animal models, and translation between species is imperfect. Further research is expected to refine these points over time.
Tirzepatide is a synthetic peptide built from 39 amino acid residues. Its sequence is related to human glucose-dependent insulinotropic polypeptide, with modifications that include a C-terminal extension and a C20 fatty diacid joined through a linker. Those changes raise the molecule's affinity for serum albumin, which slows renal filtration and lengthens the time it stays in circulation. The free base has an average molecular mass near 4813.5 daltons. The compound is made by solid-phase peptide synthesis followed by chromatographic purification.
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。
| Property | Value | Notes |
|---|---|---|
| Molecular formula | C225H348N48O68 | 39-residue synthetic peptide |
| Average molecular mass | About 4813.5 Da | Free base form |
| Appearance | White to off-white powder | Solid after lyophilization |
| Solubility class | Freely soluble in water | Also soluble in neutral aqueous buffers |
| Typical storage | At or below -20 °C, desiccated | Protect from light and moisture |
Structural work on the molecule centers on a C20 fatty diacid moiety attached through a linker to the peptide backbone. This side chain promotes reversible binding to serum albumin, which slows renal clearance and supports a prolonged action profile. The peptide backbone incorporates aminoisobutyric acid substitutions that limit recognition by digestive enzymes. Together these modifications produce a molecule that is stable enough for subcutaneous delivery but still dependent on careful manufacturing control. Analytical characterization of the active pharmaceutical ingredient typically follows the conventions used for other synthetic peptides.
Tirzepatide is a synthetic peptide composed of 39 amino acids. It acts as a dual agonist at two incretin receptors, the glucose-dependent insulinotropic polypeptide receptor and the glucagon-like peptide-1 receptor. The molecule was designed by modifying the native sequence of glucose-dependent insulinotropic polypeptide to improve metabolic stability and extend its circulation time. Its structure includes several non-natural amino acid residues and a fatty acid side chain. These features distinguish it from earlier single-receptor incretin analogs studied in the same period.
The compound first appeared in the scientific literature as an investigational agent for type 2 diabetes. Clinical development proceeded through phase 1, phase 2, and phase 3 programs that measured glycemic control as a primary endpoint while recording body weight as a secondary outcome. Regulatory approval in the United States followed in 2022 for glycemic control, and a separate indication for chronic weight management was added later. Subsequent trials have examined cardiovascular outcomes in adults with elevated cardiovascular risk. Debates continue over how much of the observed effect derives from each receptor arm.
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.
Tirzepatide is a synthetic linear peptide of 39 amino acids that acts as a dual agonist at the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. Its sequence derives from native GIP but incorporates non-natural residues and a C20 fatty diacid moiety linked to a lysine side chain. The lipophilic chain promotes albumin binding, which slows renal clearance and extends circulation time. The unmodified peptide has a molecular formula of C225H348N48O68 and a molecular mass near 4,813 daltons.
An extended fatty diacid moiety promotes binding to serum albumin, which slows renal clearance and extends the circulating half-life to roughly five days. That property supports once-weekly administration and largely explains the dosing interval described in clinical reports. Published data come mainly from large randomised programmes that evaluated glycaemic control and body weight over periods of many months. Long-term outcomes beyond those trial windows, including what happens after treatment stops, remain an active area of investigation.
Tirzepatide is a synthetic peptide built from thirty-nine amino acids. Its sequence is derived from native glucose-dependent insulinotropic polypeptide, or GIP, with several non-natural residues and a fatty diacid side chain attached through a linker. The molecule behaves as a dual agonist at two incretin receptors, GIP and GLP-1, instead of targeting a single receptor. This dual engagement separates it from earlier single-receptor incretin compounds and underpins most of its reported pharmacological activity.
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.
The dimension of flux is "amount of q flowing per unit time, through a unit area". For example, in the mass continuity equation for flowing water, if 1 gram per second of water is flowing through a pipe with cross-sectional area 1 cm2, then the average mass flux j inside the pipe is (1 g/s) / cm2, and its direction is along the pipe in the direction that the water is flowing. Outside the pipe, where there is no water, the flux is zero. If there is a velocity field u which describes the relevant flow—in other words, if all of the quantity q at a point x is moving with velocity u(x)—then the flux is by definition equal to the density times the velocity field:
The game included a brawl shortly after half time sparked by Essendon's captain Matthew Lloyd knocking out Hawthorn midfielder Brad Sewell, which led Hawthorn's Campbell Brown, to label Lloyd a 'sniper', and promised revenge if Lloyd played on in 2010. North Melbourne – One of the fiercest rivalries in the AFL can be traced back to 1896, when several clubs, including Essendon, broke away from the Victorian Football Association to form the Victorian Football League. North sought to join the breakaway competition, but some argue this desire was not realised due to Essendon feeling threatened by North's proximity and the fact their inclusion could drain Essendon of vital talent. More than 100 years later, some North supporters have not forgiven Essendon for the decision and have blamed the Bombers for their small supporter base and gate revenue. North were finally admitted into the VFL in 1925 alongside Footscray and Hawthorn. In 1950, the two sides met in their first and only grand final meeting to date, which Essendon won by 38 points. The rivalry would flare up again in the 1980s. In 1982, the Krakouer brothers, Jim and Phil, led the Roos to an Elimination Final win. Essendon had their revenge a year later, winning a Preliminary Final by 86 points. The rivalry was re-ignited in the late 1990s and early 2000s due to the on-field success of the two sides.
Elizabeth Broadbent; Keith J Petrie; Jodie Main; John Weinman (2006). "The brief illness perception questionnaire". Journal of Psychosomatic Research. 60 (6): 631–637. doi:10.1016/j.jpsychores.2005.10.020. PMID 16731240. Wikidata Q50936509. Elizabeth Broadbent; Carissa Wilkes; Heidi Koschwanez; John Weinman; Sam Norton; Keith J Petrie (2015). "A systematic review and meta-analysis of the Brief Illness Perception Questionnaire". Psychology & Health. 30 (11): 1361–1385. doi:10.1080/08870446.2015.1070851. PMID 26181764. Wikidata Q38548518. E. Broadbent; R. Stafford; B. MacDonald (2009). "Acceptance of Healthcare Robots for the Older Population: Review and Future Directions". International journal of social robotics. 1 (4): 319–330. doi:10.1007/s12369-009-0030-6. Wikidata Q115258302. Hayley Robinson; Bruce Macdonald; Ngaire Kerse; Elizabeth Broadbent (2013). "The psychosocial effects of a companion robot: a randomized controlled trial". Journal of the American Medical Directors Association. 14 (9): 661–667. doi:10.1016/j.jamda.2013.02.007. PMID 23545466. Wikidata Q45166572. Elizabeth Broadbent; Liesje Donkin; Julia C Stroh (2011). "Illness and treatment perceptions are associated with adherence to medications, diet, and exercise in diabetic patients". Diabetes Care. 34 (2): 338–340. doi:10.2337/dc10-1779. PMC 3024345. PMID 21270191. Wikidata Q34507111.
The three substrates of this enzyme are L-valine, water, and oxidised nicotinamide adenine dinucleotide phosphate (NADP+). Its products are α-ketoisovaleric acid, reduced NADPH, ammonia, and a proton. This enzyme belongs to the family of oxidoreductases, specifically those acting on the CH-NH2 group of donors with NAD+ or NADP+ as acceptor. The systematic name of this enzyme class is L-valine:NADP+ oxidoreductase (deaminating). Other names in common use include valine dehydrogenase (nicotinamide adenine dinucleotide phosphate), and valine dehydrogenase (NADP+).
According to Kuroń, a "tremendous social democratization movement in all spheres" was taking place and could not be contained. Wałęsa had meetings with Kania, which brought no resolution to the impasse.
Sources: en.wikipedia.org
== Storage condition == Unlike wine, whose character may change in taste over time and storage conditions, tequila does not change much once bottled, even without ideal storage conditions, much like most other distilled spirits such as whiskey, rum, or vodka. The quality characteristics (flavor, aroma, color, etc.) of a tequila are primarily determined during its aging in wood barrels. To maintain the utmost quality though, some conditions should be met: a constant and moderate temperature (60 to 65 °F), protection from direct sunlight, and maintenance of the integrity of the seal of the bottle. Improper storage conditions will have more effect on the taste of aged tequila rather than the un-aged version, due to tannins and other compounds introduced into the spirit from the aging barrel. For instance, if stored in improper conditions, the dark and more complex flavors of the añejo tequila are more likely to be tainted than the blanco or the silver tequila. Once the bottle is opened, the tequila will be subject to oxidation that will continue to happen even if no more oxygen is introduced. In addition, if the bottle has more room for air, the process of oxidation occurs faster on the liquor remaining inside the bottle. Therefore, it may be the best to consume the tequila within one or two years after opening. For the most part, the change in quality of tequila is due to extreme conditions of improper storage, not due to oxidation.
Oxaloacetic acid + Glutamate ⇌ α-Ketoglutarate + Aspartate (catalyzed by aspartate aminotransferase) When skeletal muscle is at rest (ADP<ATP), the aspartate is no longer needed for the purine nucleotide cycle and can therefore be used with α-ketoglutarate to produce glutamate and oxaloacetic acid (the above reaction reversed).α-Ketoglutarate + Aspartate ⇌ Oxaloacetic acid + Glutamate (catalyzed by aspartate aminotransferase)
== Production == After removal from the horse, the hide is measured from the root of the tail 18 inches (460 mm) forward on the backbone. The hide is cut at right angles to the backbone and the resulting pieces termed a "front" (the forward part) and the "butt". The term cordovan leather applies to the product of both the tanned fronts and tanned butts, but is especially used in connection with the term galoshes, meaning the vamps or boot-fronts cut from the shell of the butt. After being tanned, leather from the "front" is typically used in the fabrication of gloves, or blackened, to be used in the tops of shoes. The "butt", after tanning, is passed through a splitting-machine which removes the grain, or hair side, revealing what is termed the "shell". The close fibers of the shell result in a smooth and pliable material.
== Causes == SJS is thought to arise from a disorder of the immune system. The immune reaction can be triggered by drugs or infections. Genetic factors are associated with a predisposition to SJS such as individuals expressing the human leukocyte antigen (i.e. HLA) serotypes HLA-B15:02 or HLA-A31:01 The cause of SJS is unknown in one-quarter to one-half of cases. SJS, SJS/TEN, and TEN are considered a single disease with common causes and mechanisms. Individuals with variations in their efficiency to absorb, distribute to tissues, metabolize, or excrete a drug are predisposed to develop SJS.
On the day of the surgery, the patient arrives to either a hospital or an outpatient surgery center, where the procedure will be performed. The patient is given a brief physical examination by the surgical team and is taken to the operating room. In the operating room, the patient lies down on an operating table and is either given general anesthesia, or local anesthesia and a sedative. With anesthesia induced, the surgical team prepares the eye to be operated on and drapes the face around the eye. An eyelid speculum is placed to keep the lids open, and some lubrication is placed on the eye to prevent drying. In children, a metal ring is stitched to the sclera which will provide support of the sclera during the procedure.
Sources: en.wikipedia.org
Agouti signalling peptide adopts an inhibitor cystine knot motif. Along with the homologous Agouti-related peptide, these are the only known mammalian proteins to adopt this fold. The peptide consists of 131 amino acids. The lethal yellow mutation (Ay) was the first embryonic mutation to be characterized in mice, as homozygous lethal yellow mice (Ay/ Ay) die early in development, due to an error in trophectoderm differentiation. Lethal yellow homozygotes are rare today, while lethal yellow and viable yellow heterozygotes (Ay/a and Avy/a) remain more common. In wild-type mice agouti is only expressed in the skin during hair growth, but these dominant yellow mutations cause it to be expressed in other tissues as well. This ectopic expression of the agouti gene is associated with the yellow obese syndrome, characterized by early onset obesity, hyperinsulinemia and tumorigenesis.
The game was released for Windows, PlayStation 4, macOS, Linux, and Xbox One in late 2016. The game received positive reviews from critics, and has been nominatively known alongside other "walking simulators". The original score to Firewatch by Chris Remo was released digitally alongside the game, and received a vinyl release later in 2016. A rerelease of the vinyl was crowdfunded independently by Remo in late 2020, and concluded in early 2021. A further, smaller release was held by Remo again on 1st April 2022. In February 2016, Vanaman stated that Campo Santo's next game would not be a sequel to Firewatch. In September 2016, both Campo Santo and Good Universe issued a partnership to produce a feature film adaptation of Firewatch and other content. In November 2016, the company stated that the game would begin a limited-run physical release towards the end of the year. At the same time, it was announced that Firewatch had sold over a million copies. In June 2016, Ford Motor Company used an image that closely resembled promotional art from Firewatch, which caused controversy from both Panic, Vanaman and others. Shortly thereafter, Quirk Auto Dealers issued an apology, stating that Ford was not involved within the advertisement planning. In September 2017, Sean Vanaman tweeted that he would be issuing a Digital Millennium Copyright Act (DMCA) takedown against the streamer PewDiePie's playthrough of Firewatch in response to him using a racial slur while streaming PlayerUnknown's Battlegrounds.
Although canagliflozin produces beneficial effects on HDL cholesterol, it has also been shown to increase LDL cholesterol to produce no change in total cholesterol. Evidence shows that apart from positive effects on glycemic levels, canagliflozin also reduces the risk of heart attacks and heart failures. SGLT2 inhibitors, including canagliflozin, reduce the likelihood of hospitalization for congestive heart failure or progression of renal disease in persons with diabetes mellitus type 2 and reduce the likelihood of stroke and heart attack in persons with diabetes mellitus type 2 who have known atherosclerotic vascular disease.
== Structure == Most sv-LAAOs are reported as being homodimers with multiple subunits that have molecular weights around 50–70 kDa and the interaction between the subunits occurs via non-covalent interactions. Sv-LAAOs are present in the acidic, basic, and neutral forms of the protein. Studies that look at x-ray crystal structures have confirmed that sv-LAAOs are often found as functional dimers, with each dimer having three domains. The three domains are the substrate-binding site, FAD-binding site, and a helical domain. The substrate-binding site lies at the bottom of a funnel-shaped cavity approximately 25 Å deep, enabling substrate specificity among sv-LAAOs. Structural differences in active site topology likely account for species-dependent substrate preferences. Additionally, LAAOs are thermolabile, with cold inactivation and heat reactivation properties, necessitating specific storage and pre-activation conditions to preserve enzymatic activity. It has also been determined that the FAD prosthetic group becomes deeply entrenched in the enzyme structure, which allows for pervasive interactions with both neighboring atoms and conserved water molecules. Additionally, this flavin-containing prosthetic group has been classified as providing snake venom with its quintessential dark yellow coloration, which is shown in Figure 2. One unusual characteristic reported for sv-LAAOs regards the cold inactivation and heat reactivation properties of the protein. Thereby, most sv-LAAOs are considered to be thermolabile enzymes.
Sources: en.wikipedia.org
It is a synthetic peptide and a dual agonist of two incretin receptors. It is not a small molecule, and it is not structurally related to the older single-receptor peptide agonists.
The C20 fatty diacid promotes tight binding to serum albumin. That binding reduces renal clearance and extends circulation time compared with an unmodified peptide of similar length.
It is not fully established. Studies indicate that both receptors contribute to the observed effects, but the exact split between the two signaling pathways in humans remains an open question.
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。