The short version of Incretin fits in a sentence. The long version — which is the one that helps — is below.
Reviewed 2026-03-07. Anything still debated is marked as such rather than presented as settled.
Both receptors are class B G protein-coupled receptors that signal largely through Gs-mediated cyclic AMP production. Activation within pancreatic islets increases glucose-dependent insulin secretion and suppresses glucagon release when glucose is elevated. Outside the pancreas, signaling in the central nervous system and gut appears to influence appetite and gastric emptying. The relative contribution of each receptor to observed clinical effects remains under investigation, and the two pathways are not simply additive in practice.
Reported outcomes in large trials include dose-dependent weight reduction and improvements in glycemic markers over periods ranging from several months to more than a year. Whether the compound alters long-term cardiovascular or renal outcomes is being examined in dedicated outcome studies, so those questions remain open. Labeling describes gastrointestinal effects such as nausea and diarrhea, which tend to appear during dose escalation. Discontinuation rates and the durability of effects after treatment stops vary across study populations and are still debated.
Tirzepatide is a synthetic peptide developed as a dual agonist at the glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors. Its structure is built on a GIP-derived backbone with non-natural amino acid substitutions and a fatty diacid side chain that promotes albumin binding and slows clearance. That modification supports once-weekly subcutaneous dosing. Registrational trial programs reported reductions in body weight and glycated hemoglobin alongside the drug's glycemic effects.
当前公开资料把 tirzepatide 归为肠促胰素类受体双重激动剂。它并非激素天然变体，而是经过序列改造的工程化肽。其分子量、等电点与疏水性等基础参数已在药典和化学数据库中收录，可作为分析检测和质量研究的参照。
Tirzepatide 是一种由 39 个氨基酸组成的合成肽，分子结构上以 GIP 序列为骨架并引入脂肪酸侧链修饰，使其能够同时与葡萄糖依赖性促胰岛素多肽（GIP）受体和胰高血糖素样肽-1（GLP-1）受体结合。这种双重激动特性使它在同类肽类药物中区别于选择性 GLP-1 受体激动剂。该分子最早由一家制药公司在 2010 年代报道，随后进入糖尿病与体重管理领域的临床研究。
在生理层面，GIP 与 GLP-1 均为肠道内分泌细胞分泌的肠促胰素，进食后参与胰岛素分泌调节与胃排空抑制。Tirzepatide 通过同时激活这两条信号通路，使胰岛素分泌的葡萄糖依赖性增强，并延缓冲胃排空、降低食欲信号。与单一 GLP-1 激动相比，双靶点作用在血糖控制和体重变化上的效应幅度更大，但具体贡献比例仍在研究之中。
| Property | Value | Notes |
|---|---|---|
| Molecular class | Synthetic 39-residue peptide | GIP-derived backbone with non-natural residues |
| Molar mass | Approximately 4.8 kDa | Peptide chain plus linker and lipid modifications |
| Appearance | White to off-white powder | Typical of lyophilized research material |
| Solubility | Soluble in water and aqueous buffer | Practically insoluble in nonpolar solvents |
| Storage temperature | Typically −20 °C for dry powder | Solutions usually held at 2–8 °C short term |
Research-grade material circulates through suppliers that differ widely in documentation and testing practice, so a certificate of analysis is a starting point rather than proof of quality. Independent verification typically repeats chromatographic purity and mass confirmation on the received lot, and compares results against a retained reference standard. Regulatory status varies by jurisdiction, and a substance cleared as a medicine is not interchangeable with a research chemical of the same name. Open questions include how closely non-pharmaceutical lots match approved material in impurity profile and in aggregate content.
Solid tirzepatide is handled as a lyophilised, hygroscopic peptide powder that should be kept desiccated, protected from light, and stored frozen, typically at or below minus twenty degrees Celsius for long-term retention. Material left at ambient temperature for extended periods can take up moisture, which promotes aggregation and deamidation. Commercial liquid presentations are kept refrigerated between two and eight degrees Celsius and are not frozen. Reconstituted laboratory solutions are generally held cold and used within a short window because hydrolysis and oxidation continue slowly in solution.
Regulatory and quality discussions place the peptide within established guidance for synthetic peptides and biologics. Forced degradation studies, in which samples are exposed to heat, acid, base, peroxide, and light, identify likely degradation products and validate the selectivity of analytical methods. Reference standards allow comparison across laboratories and production batches. Purity specifications reported in the literature usually combine chromatographic purity with mass confirmation. Which impurity thresholds are meaningful for long-term behavior is still debated, and no single universal specification has been adopted across all jurisdictions.
Routine characterization of the peptide relies on reversed-phase high-performance liquid chromatography for purity assessment, usually with ultraviolet detection near 214 nanometers. Intact mass measurement by liquid chromatography coupled to mass spectrometry confirms molecular identity against a theoretical value. Sequence-level confirmation uses enzymatic digestion followed by tandem mass spectrometry, an approach known as peptide mapping. Amino acid analysis gives an independent check on composition. Circular dichroism spectra are used to estimate helical content in aqueous buffer.
Stability depends strongly on physical form. The dry powder is generally regarded as stable for extended periods when held at or below minus twenty degrees Celsius in a sealed, desiccated container. In solution, degradation pathways include deamidation of asparagine and glutamine residues, oxidation of methionine, and aggregation. Reaction rates for these pathways rise with temperature. Repeated freezing and thawing of solutions promotes aggregation, and light exposure can accelerate some oxidative changes. Buffer composition and pH influence which pathway dominates at a given temperature.
Development began in the 2010s, when researchers modified a GIP-based scaffold to add GLP-1 activity and then attached the fatty diacid to lengthen its half-life. Clinical evaluation proceeded through large phase 3 programmes in type 2 diabetes and in obesity, and regulators in the United States cleared the compound for type 2 diabetes in 2022 and for chronic weight management in 2023. Several cardiovascular and metabolic outcome studies are still reporting, so the picture of long-term benefit and risk is incomplete. Approvals in other regions followed on different timelines.
Tirzepatide is a synthetic peptide of 39 amino acids that carries a C20 fatty diacid side chain attached through a linker. Its molecular formula is C225H348N48O68, and its molecular weight is about 4813 daltons. The compound belongs to the incretin mimetic class and is administered by subcutaneous injection. The fatty acid chain promotes binding to serum albumin, which slows renal clearance and extends the circulation time of the molecule. It was identified during screening of sequences derived from glucose-dependent insulinotropic polypeptide.
Tirzepatide activates both the glucose-dependent insulinotropic polypeptide receptor and the glucagon-like peptide-1 receptor, making it a dual agonist rather than a selective agent. Engagement of the GLP-1 receptor is linked to glucose-dependent insulin release, slower gastric emptying, and reduced appetite signalling. The relative contribution of the GIP arm remains an active research question; proposed roles include improved insulin sensitivity and altered adipose tissue handling. Receptor occupancy studies suggest the molecule interacts with both targets at circulating concentrations achieved during therapy.
Essendon defeated Collingwood by 82 points in the first semi-final, and North Melbourne by 17 points in the preliminary final. In the grand final against Carlton, Essendon won by 73 points, 18.17 (125) to 6.16 (52). Best players for Essendon included Norm McDonald, Bob McLure, Bill Hutchinson and Ron McEwin. John Coleman kicked six goals. In 1950, Essendon defeated the North Melbourne Football Club in both the Second Semi-Final and the Grand Final to secure consecutive VFL premierships. Best afield in the 1950 Grand Final, his final match as a player, was captain-coach Dick Reynolds, alongside Norm McDonald, Wally May, Les Gardiner, and Bob McLure. With Reynolds, aka 'King Richard', still holding court as coach in 1951, albeit now in a non-playing capacity, Essendon seemed on course for a third consecutive flag, but a controversial four-week suspension dished out to John Coleman on the eve of the finals effectively destroyed their chances. Coleman was reported for retaliation after twice being struck by his direct Carlton opponent, Harry Caspar, and without him the Dons were rated a four-goals-poorer team. Nevertheless, they still managed to battle their way to a sixth successive grand final with wins over Footscray by eight points in the first semi-final and Collingwood by two points in the preliminary final. The Dons sustained numerous injuries in the preliminary final, and the selectors sprang a surprise on Grand Final day by naming the officially retired Dick Reynolds as 20th man.
=== Books === 1910 Conflicts in the Child's Soul 1912 Psychology of the Unconscious 1916 Seven Sermons to the Dead (a part of the Red Book, published privately) 1921 Psychological Types 1933 Modern Man in Search of a Soul (essays) 1944 Psychology and Alchemy 1951 Aion: Researches into the Phenomenology of the Self 1952 Symbols of Transformation (revised edition of Psychology of the Unconscious) 1954 Answer to Job 1956 Mysterium Coniunctionis: An Inquiry into the Separation and Synthesis of Psychic Opposites in Alchemy 1957 The Undiscovered Self 1959 Flying Saucers: A Modern Myth of Things Seen in the Skies (Translated by R. F. C. Hull) 1960 Synchronicity: An Acausal Connecting Principle 1962 Memories, Dreams, Reflections (autobiography, co-written with Aniela Jaffé) 1964 Man and His Symbols (Jung contributed one part, his last writing before his death in 1961; the other four parts are by Marie-Louise von Franz, Joseph L. Henderson, Jaffé, and Jolande Jacobi) 2009 The Red Book: Liber Novus (manuscript produced c. 1915–1932) 2020 Black Books (private journals produced c. 1913–1932, on which the Red Book is based)
The port is accessible by road from the M20/A20 (leading to Folkestone) and the M2/A2 (to Canterbury), and by train from Dover Priory station with Southeastern services to London St Pancras via Folkestone Central, Ashford International, Ebbsfleet International, Stratford International as well as trains to London Victoria or London Charing Cross via Canterbury East and the Medway towns such as Gillingham, Chatham and Rochester or via Ashford International then either via Tonbridge and Sevenoaks or Maidstone East. There are trains to Deal and Ramsgate.
Spruce beer – a beverage made using pine needles. Also called pine beer and nettle beer, it was most likely originally brewed by First Nations, and predates the arrival of Europeans. Squash – the people of southern Mexico were the first to grow squash. Squash along with maize (corn) and beans represented the three sister crops of the ancient Mesoamericans. Sundials – the Inca and other pre-Columbian Americans constructed elaborate sundials for both ceremonial and religious purposes, but also for record-keeping. Sunflower – indigenous Americans were the first peoples in the world to cultivate the common sunflower. Suspension bridge – the ancient Maya constructed a suspension bridge over the Usumacinta River in Yaxchilan. This Maya Bridge at Yaxchilan would have been one of the longest bridges in use in the ancient past. The bridge was constructed in the 7th century CE and was a very long suspension bridge with a relatively level pathway. Syringe – indigenous American medicine men used syringes and hypodermic needles made from materials fashioned from hollow bird bones and animal bladders to inject medicine into sick patients and treat the illness of the patients.
=== R139w === One further single nucleotide polymorphism, found homozygous in 0% to 5% of different ethnic population, is leading to an amino acid exchange on position 139 from arginine to tryptophane. Furthermore, an alternative RNA splicing site is created leading to a loss of the quinone binding site. The variant protein of NQO1*3 has similar stability as its wild-type counterpart. The variation between the two is substrate specific and it has reduced activity for some substrates. It has been recently shown that the NQO1*3 polymorphism may also lead to reduced NQO1 protein expression.
Sources: en.wikipedia.org
Villhauer at Novartis started to explore N-substituted glycinyl-cyanopyrrolidines based on the fact that DPP-4 identifies N-methylglycine as an N-terminal amino acid. This group of new cyanopyrrolidines became extremely popular field of research in the following years. Some trials with dual inhibitors of DPP-4 and vasopeptidase have been represented, since vasopeptidase inhibition is believed to enhance the antidiabetic effect of DPP-4 inhibition by stimulating insulin secretion. Vasopeptidase-inhibiting motif is connected to the DPP-4 inhibitor at the N-substituent.
Tyrosine hydroxylase activity is increased in the short term by phosphorylation. The regulatory domain of tyrosine hydroxylase contains multiple serine (Ser) residues, including Ser8, Ser19, Ser31 and Ser40, that are phosphorylated by a variety of protein kinases. Ser40 is phosphorylated by the cAMP-dependent protein kinase. Ser19 (and Ser40 to a lesser extent) is phosphorylated by the calcium-calmodulin-dependent protein kinase. MAPKAPK2 (mitogen-activated-protein kinase-activating protein kinase) has a preference for Ser40, but also phosphorylates Ser19 about half the rate of Ser40. Ser31 is phosphorylated by ERK1 and ERK2 (extracellular regulated kinases 1&2), and increases the enzyme activity to a lesser extent than for Ser40 phosphorylation. The phosphorylation at Ser19 and Ser8 has no direct effect on tyrosine hydroxylase activity. But phosphorylation at Ser19 increases the rate of phosphorylation at Ser40, leading to an increase in enzyme activity. Phosphorylation at Ser19 causes a two-fold increase of activity, through a mechanism that requires the 14-3-3 proteins. Phosphorylation at Ser31 causes a slight increase of activity, and here the mechanism is unknown. Tyrosine hydroxylase is somewhat stabilized to heat inactivation when the regulatory serines are phosphorylated. Tyrosine hydroxylase is mainly present in the cytosol, although it also is found in some extent in the plasma membrane. The membrane association may be related to catecholamine packing in vesicles and export through the synaptic membrane.
Erik Johnson, the project lead, said that the Hunters are "big and impressive, but they can go anywhere the player can go", as the player can encounter them both indoors and outdoors. Ted Backman, a senior artist, said the Hunter can express emotions to show the player it is aggressive, hurt, or angry. Hunters are aggressive and they tend to operate in packs, but can also be found supporting other Combine troops. Later, they support Strider enemies, using their flechette guns to protect them. Hunters primarily attack the player by bracing themselves and firing bursts from their flechette cannon. Four flechettes can vaporize an ordinary human soldier. If they do not strike a living target, the flechettes charge up for several seconds and then explode, dealing minor damage to everything nearby. Hunters may also conduct a charging attack or strike with their legs if the player gets too close. Hunters are vulnerable to all weapons, but to compensate, are still quite resilient, making explosives and the pulse rifle's charged energy ball the most attractive options. Objects thrown with the gravity gun are also effective, especially if the player catches some of their flechettes with the object before hurling it. In outdoor environments, they can be run over with a vehicle.
=== Conservation of mass in mixing calculations === 2H and 1H are stable isotopes. Therefore, the 2H/1H ratio of a pool containing hydrogen, remains constant as long as no hydrogen is added or removed, a property known as conservation of mass. When two pools of hydrogen A and B mix with molar amounts of hydrogen mA and mB, each with their own starting fractional abundance of deuterium (FA and FB), then the fractional abundance of the resulting mixture is given by the following exact equation:
When H+ ions accumulate in the muscles causing the blood pH level to reach low levels, temporary muscle fatigue results. Another limitation of the lactic acid system that relates to its anaerobic quality is that only a few moles of ATP can be resynthesized from the breakdown of sugar. This system cannot be relied on for extended periods of time. The lactic acid system, like the ATP-CP system, is important primarily because it provides a rapid supply of ATP energy. For example, exercises that are performed at maximum rates for between 1 and 3 minutes depend heavily upon the lactic acid system. In activities such as running 1500 meters or a mile, the lactic acid system is used predominantly for the "kick" at the end of the race.
Sources: en.wikipedia.org
In 1895, a plan to take Johannesburg, and end the control of the Transvaal government, was hatched with the connivance of Cape Prime Minister Rhodes and Johannesburg gold magnate Alfred Beit. A column of 600 armed men was led over the border from Bechuanaland towards Johannesburg by Leander Starr Jameson, the Administrator in Rhodesia of the British South Africa Company, of which Rhodes was the chairman. The column, mainly made up of Rhodesian and Bechuanaland British South Africa Policemen, was equipped with Maxim machine guns and artillery pieces. The plan was to make a three-day dash to Johannesburg and trigger an uprising by the primarily British expatriate uitlanders, organised by the Johannesburg Reform Committee, before the Boer commandos could mobilise. However, the Transvaal authorities had warning of the raid and tracked it from when it crossed the border. Four days later, the dispirited column was surrounded near Krugersdorp, within sight of Johannesburg. After a skirmish in which the column lost 65 killed and wounded—while the Boers lost one man—Jameson's men surrendered and were arrested. The botched raid had repercussions throughout southern Africa and Europe. In Rhodesia, the departure of so many policemen enabled the Matabele and Mashona peoples' rising against the British South Africa Company. The rebellion, known as the Second Matabele War, was suppressed only at a great cost. A few days after the raid, the German Kaiser sent the "Kruger telegram", congratulating President Kruger and the government of the South African Republic on their success.
The disorder prediction category is a part of biannual CASP experiment that is designed to test methods according accuracy in finding regions with missing 3D structure (marked in PDB files as REMARK465, missing electron densities in X-ray structures). Disorder prediction can be more complicated for de novo-emerged and orphan proteins, which often lack detectable homologs and are generally shorter than "classical" proteins, reducing the reliability of predictors trained largely on conserved, globular proteins. Comparative benchmarks further show that structure/disorder predictors behave differently on de novo and random proteins than on conserved proteins, including different relationships between predicted disorder and confidence scores of 3D structure predictors, such as AlphaFold and ESMfold.
=== Subsequent history === The discovery of TOR and mTOR stemmed from independent studies of the natural product rapamycin by Joseph Heitman, Rao Movva, and Michael N. Hall in 1991; by David M. Sabatini, Hediye Erdjument-Bromage, Mary Lui, Paul Tempst, and Solomon H. Snyder in 1994; and by Candace J. Sabers, Mary M. Martin, Gregory J. Brunn, Josie M. Williams, Francis J. Dumont, Gregory Wiederrecht, and Robert T. Abraham in 1995. In 1991, working in yeast, Hall and colleagues identified the TOR1 and TOR2 genes. In 1993, Robert Cafferkey, George Livi, and colleagues, and Jeannette Kunz, Michael N. Hall, and colleagues independently cloned genes that mediate the toxicity of rapamycin in fungi, known as the TOR/DRR genes. Rapamycin arrests fungal activity at the G1 phase of the cell cycle. In mammals, it suppresses the immune system by blocking the G1 to S phase transition in T-lymphocytes. Thus, it is used as an immunosuppressant following organ transplantation. Interest in rapamycin was renewed following the discovery of the structurally related immunosuppressive natural product FK506 (later called Tacrolimus) in 1987. In 1989–90, FK506 and rapamycin were determined to inhibit T-cell receptor (TCR) and IL-2 receptor signaling pathways, respectively. The two natural products were used to discover the FK506- and rapamycin-binding proteins, including FKBP12, and to provide evidence that FKBP12–FK506 and FKBP12–rapamycin might act through gain-of-function mechanisms that target distinct cellular functions.
An OECD proposal to allocate multinational profits (for taxing purposes) to countries where they do business, by a formula, including to markets which multinationals sell into without a physical presence. This is hoped to eliminate the need for Digital Services Tax implemented by several countries, including France. There are exclusions and minimum thresholds, including banking and extractive industries. The proposal involves allocating only residual profit (i.e., profits above what is established through transfer pricing, thus creating a hybrid mechanism). This is essentially no change to what is currently allowed (routine profits allocated using transfer pricing + residual profits allocated through profit split). Pillar 2
== Epidemiology == Biliary atresia seems to affect females slightly more often than males, and Asians and African Americans more often than Caucasians. It is common for only one child in a pair of twins or within the same family to have the condition. There seems to be no link to medications or immunizations given immediately before or during pregnancy. Diabetes during pregnancy particularly during the first trimester seems to predispose to a number of distinct congenital abnormalities in the infant such as sacral agenesis, transposition of the great vessels and the syndromic form of biliary atresia.
Sources: en.wikipedia.org
It acts as an agonist at both the GIP and GLP-1 receptors, two related class B G protein-coupled receptors. This dual activity distinguishes it from single-receptor GLP-1 agonists. The clinical consequences of engaging both receptors are still being characterized.
It is given by subcutaneous injection, generally on a weekly schedule. Dosing usually begins low and increases in steps to limit gastrointestinal side effects. Formulated product is supplied as a ready-to-use pen or vial in most markets.
No. Receptor engagement is documented, but how central appetite circuits, gut signals, and insulinotropic effects combine is incompletely resolved. Investigators continue to separate GIP-driven from GLP-1-driven contributions in animal and human models.
它属于合成修饰肽，同时激动 GIP 与 GLP-1 两种肠促胰素受体。这类分子通常被称为双重肠促胰素受体激动剂，与选择性 GLP-1 激动剂在靶点范围上不同。