Department of Experimental and Clinical Biomedical Sciences, Endocrinology Unit, University of Florence, Florence, Italy.
Department of Experimental and Clinical Biomedical Sciences, Endocrinology Unit, University of Florence, Florence, Italy; Diabetes Agency, Careggi Hospital, Florence, Italy.
Trends Endocrinol Metab. 2016 Jun;27(6):427-438. doi: 10.1016/j.tem.2016.03.017. Epub 2016 Apr 16.
The incretin hormone glucagon-like peptide-1 (GLP-1) binds to and activates its G-protein-coupled-receptor GLP-1R to reduce glycaemia through the stimulation of insulin and suppression of pancreatic glucagon secretion. Recently, GLP-1 effects unrelated to glucose homeostasis have been discovered in myocardium, bone, adipose tissue, and other target organs, which appear to be mainly mediated by GLP-1R-independent pathways. Here, we summarize knowledge on GLP-1R agonists (GLP-1RAs) as they relate to the improvement of glucose control, and focus on the most recently described effects, discussing the preclinical evidence of the involvement of alternative receptors and signalling mechanisms. It is now evident that the universe of GLP-1RAs is expanding further from the initial incretin effect, opening new unforeseen avenues for research and clinical applications.
肠促胰岛素激素胰高血糖素样肽-1(GLP-1)与 G 蛋白偶联受体 GLP-1R 结合并激活该受体,通过刺激胰岛素分泌和抑制胰高血糖素分泌来降低血糖。最近,在心肌、骨骼、脂肪组织和其他靶器官中发现了与葡萄糖稳态无关的 GLP-1 作用,这些作用似乎主要是通过 GLP-1R 非依赖性途径介导的。在这里,我们总结了 GLP-1R 激动剂(GLP-1RAs)在改善血糖控制方面的相关知识,并重点介绍了最近描述的作用,讨论了替代受体和信号机制参与的临床前证据。现在很明显,GLP-1RA 的范围正在从最初的肠促胰岛素作用进一步扩大,为研究和临床应用开辟了新的意想不到的途径。