Suppr超能文献

基于肠促胰岛素的多重作用的药理学进展:我们所知与未知

Pharmacological Advances in Incretin-Based Polyagonism: What We Know and What We Don't.

作者信息

Novikoff Aaron, Müller Timo D

机构信息

Institute for Diabetes and Obesity, Helmholtz Diabetes Center, Helmholtz Munich, Neuherberg, Germany.

German Center for Diabetes Research (DZD), Neuherberg, Germany.

出版信息

Physiology (Bethesda). 2024 May 1;39(3):142-156. doi: 10.1152/physiol.00032.2023. Epub 2024 Feb 14.

Abstract

The prevalence of obesity continues to rise in both adolescents and adults, in parallel obesity is strongly associated with the increased incidence of type 2 diabetes, heart failure, certain types of cancer, and all-cause mortality. In relation to obesity, many pharmacological approaches of the past have tried and failed to combat the rising obesity epidemic, particularly due to insufficient efficacy or unacceptable side effects. However, while the history of antiobesity medication is plagued by failures and disappointments, we have witnessed over the last 10 years substantial progress, particularly in regard to biochemically optimized agonists at the receptor for glucagon-like peptide-1 (GLP-1R) and unimolecular coagonists at the receptors for GLP-1 and the glucose-dependent insulinotropic polypeptide (GIP). Although the GIP receptor:GLP-1R coagonists are being heralded as premier pharmacological tools for the treatment of obesity and diabetes, uncertainty remains as to why these drugs testify superiority over best-in-class GLP-1R monoagonists. Particularly with regard to GIP, there remains great uncertainty if and how GIP acts on systems metabolism and if the GIP system should be activated or inhibited to improve metabolic outcome in adjunct to GLP-1R agonism. In this review, we summarize recent advances in GLP-1- and GIP-based pharmacology and discuss recent findings and open questions related to how the GIP system affects systemic energy and glucose metabolism.

摘要

青少年和成年人中肥胖症的患病率持续上升,与此同时,肥胖与2型糖尿病、心力衰竭、某些类型癌症的发病率增加以及全因死亡率密切相关。关于肥胖症,过去许多药物治疗方法都试图对抗肥胖症流行趋势,但均告失败,尤其是因为疗效不足或副作用难以接受。然而,尽管抗肥胖药物的历史充满失败和失望,但在过去10年中我们见证了重大进展,特别是在胰高血糖素样肽-1受体(GLP-1R)的生物化学优化激动剂以及GLP-1和葡萄糖依赖性促胰岛素多肽(GIP)受体的单分子共激动剂方面。尽管GIP受体:GLP-1R共激动剂被誉为治疗肥胖症和糖尿病的首要药物工具,但这些药物为何比同类最佳的GLP-1R单激动剂更具优势仍存在不确定性。特别是关于GIP,GIP是否以及如何作用于全身代谢系统,以及在GLP-1R激动作用的辅助下,激活或抑制GIP系统是否以及如何改善代谢结果,仍然存在很大的不确定性。在本综述中,我们总结了基于GLP-1和GIP的药理学的最新进展,并讨论了与GIP系统如何影响全身能量和葡萄糖代谢相关的最新发现和未解决问题。

相似文献

1
Pharmacological Advances in Incretin-Based Polyagonism: What We Know and What We Don't.
Physiology (Bethesda). 2024 May 1;39(3):142-156. doi: 10.1152/physiol.00032.2023. Epub 2024 Feb 14.
2
Diabetes and obesity treatment based on dual incretin receptor activation: 'twincretins'.
Diabetes Obes Metab. 2016 Sep;18(9):847-54. doi: 10.1111/dom.12685. Epub 2016 Jun 7.
3
Recent Advances in Incretin-Based Pharmacotherapies for the Treatment of Obesity and Diabetes.
Front Endocrinol (Lausanne). 2022 Mar 1;13:838410. doi: 10.3389/fendo.2022.838410. eCollection 2022.
4
Targeting the GIPR for obesity: To agonize or antagonize? Potential mechanisms.
Mol Metab. 2021 Apr;46:101139. doi: 10.1016/j.molmet.2020.101139. Epub 2020 Dec 5.
5
Incretin-mediated control of cardiac energy metabolism.
J Endocrinol. 2024 Aug 8;263(1). doi: 10.1530/JOE-24-0011. Print 2024 Oct 1.
7
Regulation of energy metabolism through central GIPR signaling.
Peptides. 2024 Jun;176:171198. doi: 10.1016/j.peptides.2024.171198. Epub 2024 Mar 26.
8
A Review of Incretin Therapies Approved and in Late-Stage Development for Overweight and Obesity Management.
Endocr Pract. 2024 Mar;30(3):292-303. doi: 10.1016/j.eprac.2023.12.010. Epub 2023 Dec 18.
9
The Effects of Dual GLP-1/GIP Receptor Agonism on Glucagon Secretion-A Review.
Int J Mol Sci. 2019 Aug 22;20(17):4092. doi: 10.3390/ijms20174092.

引用本文的文献

1
[Incretins as the basis of obesity treatment].
Inn Med (Heidelb). 2025 May;66(5):461-466. doi: 10.1007/s00108-025-01893-6. Epub 2025 Apr 10.
2
Why are we still in need for novel anti-obesity medications?
Lancet Reg Health Eur. 2024 Nov 7;47:101098. doi: 10.1016/j.lanepe.2024.101098. eCollection 2024 Dec.
3
Pharmacovigilance study of GLP-1 receptor agonists for metabolic and nutritional adverse events.
Front Pharmacol. 2024 Jul 8;15:1416985. doi: 10.3389/fphar.2024.1416985. eCollection 2024.

本文引用的文献

1
Seeking satiety: From signals to solutions.
Sci Transl Med. 2023 Nov 22;15(723):eadh4453. doi: 10.1126/scitranslmed.adh4453.
2
Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes.
N Engl J Med. 2023 Dec 14;389(24):2221-2232. doi: 10.1056/NEJMoa2307563. Epub 2023 Nov 11.
3
Glucose-dependent insulinotropic polypeptide regulates body weight and food intake via GABAergic neurons in mice.
Nat Metab. 2023 Dec;5(12):2075-2085. doi: 10.1038/s42255-023-00931-7. Epub 2023 Nov 9.
4
Gastric inhibitory polypeptide receptor antagonism suppresses intramuscular adipose tissue accumulation and ameliorates sarcopenia.
J Cachexia Sarcopenia Muscle. 2023 Dec;14(6):2703-2718. doi: 10.1002/jcsm.13346. Epub 2023 Oct 27.
6
GLP-1RAs caused gastrointestinal adverse reactions of drug withdrawal: a system review and network meta-analysis.
Front Endocrinol (Lausanne). 2023 Jul 6;14:1149328. doi: 10.3389/fendo.2023.1149328. eCollection 2023.
7
Uncovering CNS access of lipidated exendin-4 analogues by quantitative whole-brain 3D light sheet imaging.
Neuropharmacology. 2023 Nov 1;238:109637. doi: 10.1016/j.neuropharm.2023.109637. Epub 2023 Jun 28.
9
Biology and function of pericytes in the vascular microcirculation.
Animal Model Exp Med. 2023 Aug;6(4):337-345. doi: 10.1002/ame2.12334. Epub 2023 Jun 14.
10
The incretin co-agonist tirzepatide requires GIPR for hormone secretion from human islets.
Nat Metab. 2023 Jun;5(6):945-954. doi: 10.1038/s42255-023-00811-0. Epub 2023 Jun 5.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验