代谢疾病治疗的新机遇:基于胰高血糖素样肽-1的多靶点激动剂
Emerging opportunities for the treatment of metabolic diseases: Glucagon-like peptide-1 based multi-agonists.
作者信息
Finan Brian, Clemmensen Christoffer, Müller Timo D
机构信息
Institute for Diabetes and Obesity, Helmholtz Diabetes Center at Helmholtz Zentrum München, Neuherberg, Germany; Division of Metabolic Diseases, Department of Medicine, Technische Universität München, Munich, Germany.
Institute for Diabetes and Obesity, Helmholtz Diabetes Center at Helmholtz Zentrum München, Neuherberg, Germany; Division of Metabolic Diseases, Department of Medicine, Technische Universität München, Munich, Germany.
出版信息
Mol Cell Endocrinol. 2015 Dec 15;418 Pt 1:42-54. doi: 10.1016/j.mce.2015.07.003. Epub 2015 Jul 4.
Obesity is a pathogenic gateway to the metabolic syndrome and the complications thereof, thus interventions aimed at preventing or reversing the metabolic derangements underlying obesity hold great therapeutic promise. However, the complexity of energy balance regulation, combined with the heterologous pathophysiology of human obesity, renders effective medicinal intervention very difficult. Indeed, the search for the silver bullet in anti-obesity medicines has been laden with drugs of underwhelming efficacy and unacceptable side effects. This can partly be the consequence that many of these drug interventions have been historically directed at single molecular targets. New multi-molecular combination therapies have shown promising clinical outcomes in terms of weight loss, yet multi-functional single molecules may offer even more advantages than adjunctive co-treatments. Single molecules with integrated activities derived from multiple hormones involved in the physiological control of metabolism have emerged as one of the more promising candidates for reversing obesity. The inclusion of glucagon-like peptide-1 (GLP-1) as one of the constituents is a unifying factor amongst the majority of these unimolecular multi-agonists. The scope of this review is to summarize the current preclinical and clinical landscape of GLP-1-based therapies, focusing on combinatorial therapies with a particular emphasis on single molecule compounds displaying multi-agonist properties.
肥胖是通往代谢综合征及其并发症的致病途径,因此旨在预防或逆转肥胖潜在代谢紊乱的干预措施具有巨大的治疗前景。然而,能量平衡调节的复杂性,加上人类肥胖的异源病理生理学,使得有效的药物干预非常困难。事实上,寻找抗肥胖药物的万灵药一直充斥着疗效不佳和副作用不可接受的药物。这部分可能是由于历史上许多这些药物干预都针对单一分子靶点。新的多分子联合疗法在减肥方面已显示出有希望的临床结果,但多功能单分子可能比辅助联合治疗具有更多优势。具有源自参与代谢生理控制的多种激素的整合活性的单分子已成为逆转肥胖的更有希望的候选者之一。将胰高血糖素样肽-1(GLP-1)作为成分之一纳入是这些大多数单分子多激动剂的一个统一因素。本综述的范围是总结基于GLP-1疗法的当前临床前和临床情况,重点是联合疗法,特别强调显示多激动剂特性的单分子化合物。