基于肠促胰岛素的疗法在肥胖管理中的作用机制原理
A Mechanistic Rationale for Incretin-Based Therapeutics in the Management of Obesity.
作者信息
Samms Ricardo J, Kusminski Christine M
机构信息
Diabetes, Obesity, and Complications, Eli Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, USA; email:
Touchstone Diabetes Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA; email:
出版信息
Annu Rev Physiol. 2025 Feb;87(1):279-299. doi: 10.1146/annurev-physiol-022724-105443. Epub 2025 Feb 3.
Driven by increased caloric intake relative to expenditure, obesity is a major health concern placing economic and operational strain on healthcare and social care worldwide. Pharmacologically, one of the most effective avenues for the management of excess adiposity is the suppression of appetite. However, owing to the body's natural physiological defense to weight loss and tolerability issues that typically accompany anorectic agents, leveraging this approach to induce sustained weight loss is often easier said than done. As such, to address these challenges, researchers have coupled a thorough understanding of the gut-brain axis with advancements in peptide engineering to design therapeutics mimicking the actions of endocrine hormones to promote a negative energy balance. Indeed, multireceptor agonists targeting the GLP-1, GIP, and glucagon receptors produce meaningful weight loss in people with obesity. Herein, we provide a rationale for how activation of the GIP receptor in the brain and the glucagon receptor in the liver and adipose tissue functions to synergize with GLP-1 receptor agonism to curb the drive to feed and ignite the combustion of excess calories for providing next-generation weight loss.
由于热量摄入相对于消耗增加,肥胖成为一个主要的健康问题,给全球医疗保健和社会护理带来经济和运营压力。从药理学角度来看,控制过多肥胖最有效的途径之一是抑制食欲。然而,由于身体对体重减轻的自然生理防御以及厌食剂通常伴随的耐受性问题,利用这种方法实现持续体重减轻往往说起来容易做起来难。因此,为应对这些挑战,研究人员将对肠-脑轴的深入理解与肽工程的进展相结合,设计出模仿内分泌激素作用的疗法,以促进负能量平衡。事实上,靶向胰高血糖素样肽-1(GLP-1)、葡萄糖依赖性促胰岛素多肽(GIP)和胰高血糖素受体的多受体激动剂能使肥胖者实现显著的体重减轻。在此,我们阐述了激活大脑中的GIP受体以及肝脏和脂肪组织中的胰高血糖素受体如何与GLP-1受体激动作用协同发挥功能,以抑制进食欲望并点燃多余热量的燃烧,从而实现下一代减肥效果的原理。