Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
Institute for Diabetes and Obesity, Helmholtz Diabetes Center at Helmholtz Zentrum München, Germany and German Center for Diabetes Research (DZD), Munich, Germany.
Front Endocrinol (Lausanne). 2022 Mar 1;13:838410. doi: 10.3389/fendo.2022.838410. eCollection 2022.
The incretin hormone glucagon-like peptide-1 (GLP-1) has received enormous attention during the past three decades as a therapeutic target for the treatment of obesity and type 2 diabetes. Continuous improvement of the pharmacokinetic profile of GLP-1R agonists, starting from native hormone with a half-life of ~2-3 min to the development of twice daily, daily and even once-weekly drugs highlight the pharmaceutical evolution of GLP-1-based medicines. In contrast to GLP-1, the incretin hormone glucose-dependent insulinotropic polypeptide (GIP) received little attention as a pharmacological target, because of conflicting observations that argue activation or inhibition of the GIP receptor (GIPR) provides beneficial effects on systemic metabolism. Interest in GIPR agonism for the treatment of obesity and diabetes was recently propelled by the clinical success of unimolecular dual-agonists targeting the receptors for GIP and GLP-1, with reported significantly improved body weight and glucose control in patients with obesity and type II diabetes. Here we review the biology and pharmacology of GLP-1 and GIP and discuss recent advances in incretin-based pharmacotherapies.
在过去的三十年中,肠促胰岛素激素胰高血糖素样肽-1(GLP-1)作为肥胖和 2 型糖尿病治疗靶点受到了极大关注。GLP-1R 激动剂的药代动力学特性不断得到改善,从半衰期约 2-3 分钟的天然激素开始,发展到每日两次、每日一次甚至每周一次的药物,突出了基于 GLP-1 的药物的药物进化。与 GLP-1 相比,肠促胰岛素激素葡萄糖依赖性胰岛素释放肽(GIP)作为一种药理靶点几乎没有受到关注,因为相互矛盾的观察结果表明,GIP 受体(GIPR)的激活或抑制对全身代谢有有益的影响。最近,针对 GIP 和 GLP-1 受体的单分子双重激动剂在治疗肥胖和糖尿病方面取得了临床成功,报告称肥胖和 2 型糖尿病患者的体重和血糖控制显著改善,这激发了人们对 GIPR 激动剂治疗肥胖和糖尿病的兴趣。本文综述了 GLP-1 和 GIP 的生物学和药理学,并讨论了基于肠促胰岛素的药物治疗的最新进展。