The short version of incretin fits in a sentence. The long version — which is the one that helps — is below.
Reviewed 2025-12-30. Anything still debated is marked as such rather than presented as settled.
皮下注射后吸收相对缓慢，绝对生物利用度约为百分之八十九，血药浓度峰值通常出现在给药后一到三天。与白蛋白结合使清除减慢，终末半衰期约为一百六十五小时，接近一周。连续给药约四到五周后达到稳态暴露水平。表观分布容积约为每千克零点二五升，血浆蛋白结合率超过百分之九十九。代谢以蛋白水解切割和脂肪二酸侧链的 β-氧化为主，相关产物主要经尿液与粪便排出。
序列层面的改动同时解决了两个问题，即酶解稳定性与肾脏清除速度。天然 GLP-1 在循环中的半衰期仅约两分钟，主要被二肽基肽酶-4 迅速灭活。酰化侧链与白蛋白的可逆结合形成循环储库，使分子缓慢释放并持续激活受体。这种设计思路后来被广泛用于同类长效肽的开发，属于该类药物化学改造的典型范式。
Receptor activation follows the canonical Gs pathway: binding increases intracellular cyclic AMP, which promotes protein kinase A activity. In pancreatic beta cells this amplifies glucose-dependent insulin release, so secretion rises when blood glucose is high and changes little when it is low. The same signalling suppresses glucagon release from alpha cells and slows gastric emptying. Receptors in the hypothalamus and brainstem are thought to contribute to reduced appetite and lower energy intake. Which of these effects dominates clinical outcomes remains an area of active study.
Semaglutide is a synthetic peptide analogue of glucagon-like peptide-1, a gut hormone released by intestinal L cells after food intake. The natural hormone acts on pancreatic and central receptors but is degraded within minutes by dipeptidyl peptidase-4 and other peptidases. Semaglutide belongs to the class of long-acting GLP-1 receptor agonists, a group distinguished by structural changes that slow breakdown and extend circulation time. Its development followed earlier short-acting analogues and reflects a general strategy in peptide drug design: preserve receptor activity while blocking proteolytic clearance.
| Property | Value | Notes |
|---|---|---|
| 分子式 | C187H291N45O59 | 按主链与 C18 二酸侧链计算 |
| 分子量 | 约 4113.6 道尔顿 | 游离碱形式，随反离子略有差异 |
| 外观 | 白色至类白色冻干粉末 | 具吸湿性，需干燥保存 |
| 溶解性 | 微溶于水，易溶于碱性缓冲液 | 溶解性随 pH 升高而改善 |
| 等电点 | 约 5.4 | 影响缓冲液选择与聚集倾向 |
Reverse-phase high-performance liquid chromatography with ultraviolet detection near 214 or 280 nanometres is widely used to assess purity and to resolve related impurities. Liquid chromatography coupled to mass spectrometry confirms identity through the protonated molecular ion and fragment ions formed in tandem experiments. Capillary electrophoresis and peptide mapping after enzymatic digestion supply complementary information on charge variants and modification sites. Circular dichroism and nuclear magnetic resonance can report on secondary structure in solution. Absolute quantification usually depends on an external standard, and reported purity depends on the detection wavelength and integration parameters chosen.
Lyophilised material appears as a white to off-white cake or powder that is hygroscopic, and containers are usually equilibrated to room temperature before opening to limit condensation. Dissolution is performed in water, phosphate-buffered saline, or a mildly alkaline buffer, since solubility rises above neutral pH. Gentle inversion or low-speed mixing is preferred, because vigorous vortexing can promote surface denaturation and aggregation. Complete dissolution may require several minutes, and brief sonication is sometimes applied. Passing the solution through a 0.22 micrometre membrane removes particulates but does not by itself sterilise the liquid.
Clinical development of this compound followed earlier short-acting GLP-1 analogues that required frequent injection. Once-weekly subcutaneous formulations entered use after 2017, and an oral formulation using a permeation enhancer later became available. The oral version pairs the peptide with sodium N-(8-[2-hydroxybenzoyl] amino) caprylate, a carrier that improves uptake across the gastric epithelium. Interest has expanded from glycaemic control into weight management and metabolic liver disease. Regulatory status and approved indications differ between countries, and the product remains subject to ongoing safety monitoring.
Semaglutide is a synthetic peptide that acts as an agonist at the glucagon-like peptide-1 receptor. It is a structural analogue of human GLP-1(7-37), modified to resist enzymatic degradation by dipeptidyl peptidase-4. The peptide backbone contains alpha-aminoisobutyric acid at position 8, a substitution that stabilises the helix and slows cleavage. A fatty diacid side chain attached through a linker at lysine 34 promotes binding to serum albumin, which extends the circulating half-life. These two modifications together allow less frequent administration than native GLP-1 requires.
Activation of the GLP-1 receptor couples to Gs signalling and raises intracellular cyclic AMP in pancreatic beta cells. The resulting insulin release depends on prevailing glucose concentrations, so the effect is greater when glucose is elevated. Receptor engagement also suppresses glucagon secretion and slows gastric emptying, which flattens post-meal glucose excursions. In the central nervous system, signalling in hypothalamic and brainstem regions is associated with reduced appetite and lower energy intake. Studies continue to examine effects on cardiac, renal and hepatic endpoints; whether those benefits are independent of weight change remains an open question.
The company that developed the compound filed it as a long-acting analogue, and it gained first approval in 2017 for type 2 diabetes. Later authorisations from several regulators extended the indication to chronic weight management, and the World Health Organization added the glucagon-like peptide-1 receptor agonist drug class to its model list of essential medicines in 2023. Production uses solid-phase peptide synthesis followed by side-chain conjugation and chromatographic purification. Supply constraints and cost differences across regions are well documented. Literature on long-term outcomes continues to grow, with many trials reporting surrogate endpoints rather than hard clinical endpoints.
Semaglutide is a synthetic peptide of thirty-one amino acids that shares roughly ninety-four percent sequence identity with human glucagon-like peptide-1. Two substitutions resist enzymatic cleavage by dipeptidyl peptidase-4, and a fatty diacid side chain attached through a linker promotes binding to serum albumin. That albumin binding slows renal clearance and extends the circulating half-life from minutes to approximately one week. The structural changes are well established in the published literature. Whether the same modifications affect receptor signalling bias in ways that matter clinically remains an open question.
Pharmacological activity arises from agonism at the glucagon-like peptide-1 receptor, a G protein-coupled receptor expressed in the pancreas, the gastrointestinal tract, and the brainstem. Receptor activation raises intracellular cyclic adenosine monophosphate and enhances insulin release in a glucose-dependent manner, an effect that diminishes when blood glucose concentration is low. Other effects include slowed gastric emptying and hypothalamic satiety signalling. These pathways are described well. Receptor desensitisation rates across tissues, relative to the endogenous hormone, are still under investigation, and reported findings differ between laboratories.
== Journalism and literary career == At the age of fifteen, while still in high school, Kermani began to work as a freelancer for the local editorial office of the regional daily newspaper Westfälische Rundschau. During his university studies, he wrote for national German newspapers, working as a regular contributor to the arts and culture section of the daily newspaper Frankfurter Allgemeine Zeitung from 1996 to 2000. Since 2006, Kermani has been co-hosting the Literarischer Salon [Literary Salon] in Cologne's Stadtgarten with fellow writer Guy Helminger. Kermani spent 2008 as a Villa Massimo fellow in Rome. Beginning in 2012, he co-directed the "Herzzentrum" ["Heart Center"] at Hamburg's Thalia Theater together with dramaturge Carl Hegemann. Kermani's literary work thematizes the human experience of extremes in everyday life, music, art, sexuality and in the face of death. His novels and essayistic books straddle the boundaries between autobiography and fiction, while his academic writings focus on the aesthetics of the Koran and Islamic mysticism. Kermani is also well known as a journalist who reports from crisis areas around the world. In September 2014, he reported from Iraq for the news magazine Der Spiegel. In October 2015, he traveled in the direction of the refugees to meet them on their route in the opposite direction, from Budapest to Turkey.
=== In art === The potato has been an essential crop in the Andes since the pre-Columbian era. The Moche culture from Northern Peru made ceramics from the earth, water, and fire. This pottery was a sacred substance, formed in significant shapes and used to represent important themes. Potatoes are represented anthropomorphically as well as naturally. During the late 19th century, numerous images of potato harvesting appeared in European art, including the works of Willem Witsen and Anton Mauve. Van Gogh's 1885 painting The Potato Eaters portrays a family eating potatoes. Van Gogh said he wanted to depict peasants as they really were. He deliberately chose coarse and ugly models, thinking that they would be natural and unspoiled in his finished work. Jean-François Millet's The Potato Harvest depicts peasants working in the plains between Barbizon and Chailly. It presents a theme representative of the peasants' struggle for survival. Millet's technique for this work incorporated paste-like pigments thickly applied over a coarsely textured canvas.
In 1984, the chain returned to the U.S. with a location in Tonawanda, New York. Starting in the mid-1990s, however, the chain began expanding in the U.S. by acquiring former locations from fast-food chains. In 1996 and 1997, thirty-seven former Rax locations in Ohio, Kentucky, and West Virginia were bought by Wendy's International Inc.; 30 of these were converted to Tim Hortons, while the others became Wendy's franchise locations. Thirty-five closed Hardee's stores in the Detroit area were also purchased with the intention of being converted. By 2004, the chain had also acquired 42 Bess Eaton coffee and donut restaurants in southern New England. Several combination Wendy's/Tim Hortons units were opened in the US; both in the "traditional" markets of Maine and Buffalo, where there were well over 180 locations as of 2011, and in the markets entered through acquisition. In October 2008, Tim Hortons announced a plan to add 82 locations in Tops Markets stores in the United States. On July 13, 2009, Tim Hortons opened stores in New York City at former Dunkin' Donuts locations operated by the Riese Organization. One of the stores is at Madison Square Garden, where Horton played as a member of the New York Rangers from 1969 to 1971. In November 2010, Tim Hortons announced it was closing 36 stores in the northeastern United States due to high competition with New England–based Dunkin' Donuts and Au Bon Pain.
Trump issued NSPM-7 (National Security Presidential Memorandum-7) on September 25, 2025, directing a government-wide strategy to counter what it characterizes as organized domestic terrorism and political violence. The memorandum cites "common threads" such as "anti-Americanism", "anti-capitalism", "anti-Christianity", support for 'overthrowing' the United States Government, and extremism related to migration, race, and gender. It assigns the National Joint Terrorism Task Force to lead investigations, directs the United States Department of Justice to prioritize prosecutions and consider domestic terrorist organization designations, and instructs the Department of the Treasury and the Internal Revenue Service to disrupt financial networks, while noting that the directive creates no enforceable rights. Thirty-one members of Congress later warned in a letter that NSPM-7 raises constitutional and civil-liberties concerns if used to target political dissent or ideological speech.
=== 1973 Antitrust case over griseofulvin === In the 1960s, Glaxo Group Ltd. (Glaxo) and Imperial Chemical Industries (ICI) each owned patents covering various aspects of the antifungal drug griseofulvin. They created a patent pool by cross-licensing their patents, subject to express licensing restrictions that the chemical from which the "finished" form of the drug (tablets and capsules) was made must not be resold in bulk form, and they licensed other drug companies to sell the drug in finished form and subject to similar restrictions. The effect and intent of the bulk-sale restriction was to keep the drug chemical out of the hands of small companies that might act as price-cutters, and the effect was to maintain stable, uniform prices. The United States brought an antitrust suit against the two companies—United States v. Glaxo Group Ltd.—charging them with violation of the Sherman Act and also seeking to have the patents declared invalid. The trial court found that the defendants had engaged in several unlawful conspiracies, but dismissed the part of the suit seeking invalidation of patents and refused to grant as relief mandatory sales of the bulk drug chemical and compulsory licensing of the patents. The government appealed to the Supreme Court, which reversed, in United States v. Glaxo Group Ltd., 410 U.S. 52 (1973).
Sources: en.wikipedia.org
=== Structure === Tirzepatide is an analog of the human GIP hormone with a C20 fatty diacid portion attached, used to optimise the uptake and metabolism of the compound. The fatty-diacid section (eicosanedioic acid) is linked via a glutamic acid and two (2-(2-aminoethoxy)ethoxy)acetic acid units to the side chain of the lysine residue. This arrangement allows for a much longer half-life, extending the time between doses, because of its high affinity to albumin.
== Function == TN-X is constitutively expressed in adult tissues such as skin, ligaments, tendons, lungs, kidneys, optic nerves, mammary and adrenal glands, blood vessels, testis, and ovaries. It is also found in different compartments of the digestive tract, including pancreas, stomach, jejunum, ileum, and colon. In this wide variety of organs, TN-X is mainly located within the connective tissue such as peritendineum (external structural component of tendons), epimysium and perimysium (muscle components), renal glomeruli, blood vessels and skin dermis. TN-X has been proposed to have an important structural and architectural function, especially within the skin. In fact, in vitro experiments demonstrate that TN-X physically interacts with fibrillar collagens type I, III and V, as well as FACIT (Fibrillar Associated Collagen with Interruption of the Triple helix) including type XII and XIV collagens. It also interacts with Transforming Growth Factor (TGF)-β which is a pro-fibrotic cytokine and Decorin, a small 100 kDa dermatan sulfate proteoglycan that is essential to collagen fibrillogenesis. In vivo, transmission electron microscopy coupled with immuno-labelling confirms the very close location of TN-X with collagen fibers in dermis, tendons and kidney glomeruli. In addition to this architectural function, TN-X also demonstrated counter-adhesive properties, at least for human osteosarcoma cells (MG-63), murine embryonic fibroblasts (MRC-5) as well as human endothelial cells (ECV-304).
== Signs and symptoms == The various types of VWD present with varying degrees of bleeding tendency, usually in the form of easy bruising, nosebleeds, and bleeding gums. Women may experience heavy menstrual periods and blood loss during childbirth. Symptoms of VWD vary depending on age, sex, and VWD type. In children, bruising and nosebleeds are common symptoms. In adults, easy bruising, heavy menstrual bleeding, and bleeding from minor wounds are more common. Sixty to eighty percent of people with VWD have excessive bleeding after surgery or dental extractions. Gastrointestinal bleeding from dilated blood vessels lining the gut (angiodysplasia) can result in severe, lifethreatening gastrointestinal bleeding. This most commonly occurs in seniors with type 2 or 3 VWD. Von Willebrand factor levels normally increase with age, so disease severity often decreases with older age. In women with VWD, 80% have heavy menstrual bleeding with 20% requiring removal of the uterus (hysterectomy). Due to its association with heavy menstrual bleeding, VWD is more commonly diagnosed in women. Women with VWD may also experience heavy bleeding after delivery (postpartum bleeding). Severe internal bleeding and bleeding into joints are rare in those with VWD, but they are more common in those with the more severe type 3 disease. Bleeding in the brain or spinal cord is exceedingly rare in all 3 types of VWD.
=== Tawing === Tawing is a method that uses alum and other aluminium salts, generally in conjunction with binders such as egg yolk, flour, or other salts. The hide is tawed by soaking in a warm potash alum and salts solution, between 20 and 30 °C (68 and 86 °F). The process increases the hide's pliability, stretchability, softness, and quality. Then, the hide is air dried (crusted) for several weeks, which allows it to stabilize. The use of alum alone for tanning rawhides is not recommended, as it shrinks the surface area of the skin, making it thicker and hard to the touch. If alum is applied to the fur, it makes the fur dull and harsh.
Soldiers returning home from the Crusades in the 11th to 13th century brought opium with them. Opium is said to have been used for recreational purposes from the 14th century onwards in Muslim societies. Ottoman and European testimonies confirm that from the 16th to the 19th centuries Anatolian opium was eaten in Constantinople as much as it was exported to Europe. In 1573, for instance, a Venetian visitor to the Ottoman Empire observed many of the Turkish natives of Constantinople regularly drank a "certain black water made with opium" that makes them feel good, but to which they become so addicted, if they try to go without, they will "quickly die". From drinking it, dervishes claimed the drugs bestowed them with visionary glimpses of future happiness. Indeed, the Ottoman Empire supplied the West with opium long before China and India. Extensive textual and pictorial sources also show that poppy cultivation and opium consumption were widespread in Safavid Iran and Mughal India.
Sources: en.wikipedia.org
=== COVID-19 === The pharmacokinetic boosting property of ritonavir has been successfully repurposed for the treatment of COVID-19. It is co-packaged with nirmatrelvir, a SARS-CoV-2 main protease (3CLpro) inhibitor, under the brand name Paxlovid. In this combination regimen, ritonavir has no direct activity against SARS-CoV-2; rather, it inhibits the CYP3A4-mediated metabolism of nirmatrelvir, enhancing its systemic exposure to levels sufficient to halt viral replication. Clinical trials demonstrated that this combination significantly reduced the risk of hospitalization or death in high-risk patients when administered early (within five days of symptom onset), leading to emergency use authorizations and approvals by agencies such as the US Food and Drug Administration (FDA) and the World Health Organization (WHO).
==== Metabolism ==== In vitro studies found very minimal metabolism of enobosarm by human cytochrome P450 enzymes. The greatest degree of oxidative metabolite generation occurred with CYP3A4. Upon incubation with human UDP-glucuronosyltransferase (UGT) enzymes, enobosarm glucuronide was generated, with a majority of this inactive metabolite being produced by UGT1A1 and UGT2B7. Enobosarm glucuronide is the primary circulating metabolite of enobosarm. Coadministration of the strong CYP3A4 inhibitor itraconazole had minimal impact on the pharmacokinetics of enobosarm and enobosarm glucuronide, whereas the strong CYP3A4 inducer rifampin reduced enobosarm peak levels by 23%, elimination half-life by 23%, and area-under-the-curve levels by 43%. Coadministration of the pan-UGT inhibitor probenecid with enobosarm resulted in similar peak levels of enobosarm but the elimination half-life of enobosarm was extended by 78% and area-under-the-curve levels increased by 50%. These data are consistent with the preclinical findings that enobosarm is a substrate of CYP3A4 and UGT enzymes. The metabolism of enobosarm is similar to that of the closely structurally related drug bicalutamide.
In the quarterfinals, he beat Borna Ćorić in four sets to reach his second major semifinal. There, he lost the first two sets to Pablo Carreño Busta, but came back to win the match in five; this was his first-ever match win from two sets down. He thus advanced to his first major final, where he faced Dominic Thiem. He became the runner-up, losing the final in a final-set tiebreaker despite leading by two sets and twice coming within two points of the title in the final set. Zverev was seeded 6th at the French Open. He beat Dennis Novak, Pierre-Hugues Herbert, and Marco Cecchinato, before losing in four sets to Jannik Sinner. In October, he won two consecutive ATP 250 events in Cologne, which took place in the 2020 ATP Tour because of the cancellation of several tournaments due to the COVID-19 pandemic. In the finals, he defeated Félix Auger-Aliassime and Diego Schwartzman, both in straight sets. Zverev then reached the final of the Paris Masters, beating Nadal in straight sets in the semifinals, where he lost to Daniil Medvedev in three sets. In the ATP Finals, Zverev was eliminated in the group stage after a three-set win over Diego Schwartzman, and straight-set losses to Djokovic and the eventual champion Medvedev.
=== Groupings === Russian Cossacks are divided into two broad groups: the Stepnoy (Ru:Степной), those of the Steppes, and the Kavkas (Ru:Кавкас), those of the Caucasus. In 1917 the Caucasians were divided into two hosts, the Kuban and the Terek; while the Steppe were divided into 8 hosts, the Don (the largest), Siberia, Orenburg, Astrakhan, Trans-Baikal, Semiretchi, Amur, and Ussurki voiskos.
== Function == Dietary copper enters the bloodstream primarily in its oxidized Cu(II) form. Once absorbed, Cu(II) is taken up by the hCTR1, which mediates its cellular import. At the extracellular face, the flexible N-termini extends outward and captures Cu(II) from the blood carrier protein, after that it reduces Cu(II) to Cu(I) state and preserves the reduced Cu(I) oxidation state. The extracellular domain of hCTR1 holds both Cu(II) and Cu(I) binding sites: 1MDHxHH and 22HHH, serve as two Cu(II) binding sites; 7MxMxxM and 41MMMxM, comprise the first Cu(I) binding sites in the extracellular domain of hCTR1. The extracellular hCTR1 domain is also characterized by two glycosylation sites, N15 and T27. The transmembrane domain of hCTR1 is characterized by 150MxxxM and 167GxxxG motifs. In the second transmembrane helix, M150 and M154 are considered as Cu(I)-binding residues. There are two methionine triads lining the pore, and these methionine rings have soft sulfur ligands and create the "selectivity filter" for Cu(I), that excludes harder ions such as Ca(II). The hCTR1 C-terminal domain controls the distribution of Cu(I), it plays a role in copper trafficking and regulation. It interacts with metallochaperones and with the of the 188HCH motif transfers the Cu(I) ion to Atox1. Althogether hCTR1 operates as a dynamic, adaptable transporter, delicately balancing the flexibility and selectivity of copper ions.
Sources: en.wikipedia.org
差别集中在三处：第 8 位残基被非天然氨基酸取代，第 34 位换成精氨酸，第 26 位增加一条脂肪酸侧链。前两处改动降低酶解速率，侧链则通过白蛋白结合延长循环时间。综合结果是半衰期从约两分钟延长到约一周。
胰岛素释放需要细胞内环腺苷酸与钙信号升高，同时依赖葡萄糖代谢产生的协同信号。血糖水平较低时协同信号不足，分泌增强有限。这一机制在降糖效果与低血糖风险之间提供了缓冲。
白蛋白结合是主要原因，它减少肾小球滤过并保护分子免受蛋白酶降解。序列修饰带来的酶解抵抗同样不可忽略，二者共同作用。脂肪链的疏水性还会影响组织分布，但其对总半衰期的贡献程度仍在研究之中。
Native GLP-1 is a short-lived peptide cleared within one to two minutes by dipeptidyl peptidase-4 and related enzymes. Semaglutide keeps the receptor-binding backbone but adds substitutions and a lipid chain. These changes block the main cleavage site and allow reversible albumin binding, extending the half-life to roughly 165 hours.