This is a working overview of dual agonist, written for readers who want more than a one-paragraph summary but less than a textbook.
Reviewed 2026-05-28. Anything still debated is marked as such rather than presented as settled.
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。
Structural work on the molecule centers on a C20 fatty diacid moiety attached through a linker to the peptide backbone. This side chain promotes reversible binding to serum albumin, which slows renal clearance and supports a prolonged action profile. The peptide backbone incorporates aminoisobutyric acid substitutions that limit recognition by digestive enzymes. Together these modifications produce a molecule that is stable enough for subcutaneous delivery but still dependent on careful manufacturing control. Analytical characterization of the active pharmaceutical ingredient typically follows the conventions used for other synthetic peptides.
Tirzepatide is a synthetic peptide composed of 39 amino acids. It acts as a dual agonist at two incretin receptors, the glucose-dependent insulinotropic polypeptide receptor and the glucagon-like peptide-1 receptor. The molecule was designed by modifying the native sequence of glucose-dependent insulinotropic polypeptide to improve metabolic stability and extend its circulation time. Its structure includes several non-natural amino acid residues and a fatty acid side chain. These features distinguish it from earlier single-receptor incretin analogs studied in the same period.
| Property | Value | Notes |
|---|---|---|
| 分子类型 | 合成修饰肽 | 39 个氨基酸，含脂肪酸侧链 |
| 受体靶点 | GIP 与 GLP-1 受体 | 双重激动剂 |
| 分子量 | 约 4.8 kDa | 以游离肽计 |
| 外观 | 白色至类白色粉末 | 冻干形态常见 |
| 溶解性 | 可溶于水及水性缓冲液 | 溶解后宜低温保存 |
Receptor activation by tirzepatide raises intracellular cyclic AMP through Gs-coupled signalling at both targets. At the GLP-1 receptor the downstream effect includes glucose-dependent insulin release, suppressed glucagon secretion, delayed gastric emptying, and reduced appetite signalling in the hypothalamus. GIP receptor engagement adds insulinotropic activity and appears to influence lipid handling in adipose tissue. Because both receptors are stimulated at the same time, the pharmacological profile differs from that of selective GLP-1 receptor agonists, and the relative contribution of each arm remains an area of active investigation.
Clinical development proceeded through large phase 3 programmes in type 2 diabetes and in obesity or overweight with at least one weight-related comorbidity. Regulatory approvals followed in several jurisdictions for both indications. Weekly subcutaneous dosing reflects an elimination half-life of roughly five days. Open questions include the durability of metabolic effects after treatment stops, long-term cardiovascular and hepatic outcomes beyond completed trials, and whether the dual mechanism confers benefits independent of total receptor occupancy. Published literature continues to expand on these points. Substantial uncertainty remains about interindividual variability in response.
Tirzepatide is a synthetic linear peptide of 39 amino acids that acts as a dual agonist at the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. Its sequence derives from native GIP but incorporates non-natural residues and a C20 fatty diacid moiety linked to a lysine side chain. The lipophilic chain promotes albumin binding, which slows renal clearance and extends circulation time. The unmodified peptide has a molecular formula of C225H348N48O68 and a molecular mass near 4,813 daltons.
An extended fatty diacid moiety promotes binding to serum albumin, which slows renal clearance and extends the circulating half-life to roughly five days. That property supports once-weekly administration and largely explains the dosing interval described in clinical reports. Published data come mainly from large randomised programmes that evaluated glycaemic control and body weight over periods of many months. Long-term outcomes beyond those trial windows, including what happens after treatment stops, remain an active area of investigation.
Tirzepatide is a synthetic peptide built from thirty-nine amino acids. Its sequence is derived from native glucose-dependent insulinotropic polypeptide, or GIP, with several non-natural residues and a fatty diacid side chain attached through a linker. The molecule behaves as a dual agonist at two incretin receptors, GIP and GLP-1, instead of targeting a single receptor. This dual engagement separates it from earlier single-receptor incretin compounds and underpins most of its reported pharmacological activity.
The GIP receptor is expressed in pancreatic islets, adipose tissue, and the central nervous system, while GLP-1 receptors are found in pancreatic islets, the gastrointestinal tract, and the brain. Activation of both receptors can enhance glucose-dependent insulin secretion and reduce glucagon release. The relative contribution of each receptor to the overall pharmacological effect remains an area of ongoing investigation. Preclinical studies suggest that GIP receptor agonism may modulate appetite and energy balance, but the precise mechanisms in humans are not fully established.
In clinical research, tirzepatide has been studied in randomized controlled trials for glycemic control and body weight reduction. These trials typically measure changes in hemoglobin A1c and body weight over periods of several months. The drug is administered by subcutaneous injection, and its pharmacokinetic profile supports once-weekly dosing. Post-marketing surveillance continues to evaluate long-term outcomes and rare adverse events.
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.
=== Christian churches and the Eucharist === Speaking generally, the various denominations of Christians celebrate a Eucharist in which a wafer or small piece of sacramental bread from wheat bread is blessed and then eaten. Small communion wafers typically contain 2–5 mg of gliadin if they are not a gluten-free variety, and many people with coeliac disease report altering their religious practices because of coeliac symptoms caused by these wafers. Some Christian churches such as the United Methodist, Christian Reformed, Episcopal, Anglican and Lutheran churches offer their communicants gluten-free alternatives, usually in the form of a rice-based cracker or gluten-free bread. Catholics may receive from the chalice alone, or ask for gluten-reduced hosts; gluten-free ones however are not considered still to be wheat bread, and hence are invalid matter. Roman Catholic doctrine states that for a valid Eucharist, the bread to be used at Mass must be made from wheat. Low-gluten hosts meet all of the Catholic Church's requirements, but they are not entirely gluten-free. As of 2017, the Vatican still disapproves of the use of gluten-free bread for Holy Communion.
Static light scattering and dynamic light scattering use light to determine the average molecular weight and behavior of the copolymer in solution whereas small-angle neutron scattering uses neutrons to determine the molecular weight and chain length. Additionally, x-ray scattering techniques, such as small-angle X-ray scattering (SAXS) can help determine the nanometer morphology and characteristic feature size of a microphase-separated block-copolymer or suspended micelles. Differential scanning calorimetry is a thermoanalytical technique used to determine the thermal events of the copolymer as a function of temperature. It can indicate when the copolymer is undergoing a phase transition, such as crystallization or melting, by measuring the heat flow required to maintain the material and a reference at a constantly increasing temperature. Thermogravimetric analysis is another thermoanalytical technique used to access the thermal stability of the copolymer as a function of temperature. This provides information on any changes to the physicochemical properties, such as phase transitions, thermal decompositions, and redox reactions. Size-exclusion chromatography can separate copolymers with different molecular weights based on their hydrodynamic volume. From there, the molecular weight can be determined by deriving the relationship from its hydrodynamic volume. Larger copolymers tend to elute first as they do not interact with the column as much.
Golodirsen, sold under the brand name Vyondys 53, is a medication used for the treatment of Duchenne muscular dystrophy. It is an antisense oligonucleotide medication of phosphorodiamidate morpholino oligomer (PMO) chemistry. The most common side effects include headache, fever, fall, cough, vomiting, abdominal pain, cold symptoms (nasopharyngitis) and nausea.
Forty-six Israeli civilians, 28 soldiers and one security officer were killed in Hezbollah's attacks on Israel. An additional three soldiers were killed in non-combat incidents; one by malfunctioning ammunition and the other two in a tank accident. Forty-seven soldiers, including a civilian researcher posthumously recognized as a soldier, were killed during combat in southern Lebanon. Hezbollah's attacks resulted in the evacuation of over 90,000 people—60,000 forced and 30,000 voluntary—from northern Israel. As of July 2024, the Israeli government issued orders for the evacuation of 43 settlements located within 3 miles (4.8 km) of the border with Lebanon. At least eight Israeli UAVs were shot down over Lebanon: four Hermes 450 and four Hermes 900 models. According to the Israeli Army Radio, 2,874 buildings have been reported damaged by Hezbollah, including 841 in need of rebuilding. Property damage was estimated to be around ₪1 billion (US$273 million). As of November 2024, over 60% of the buildings in Metula were destroyed by Hezbollah attacks since the start of the conflict. Three-fourths of the buildings in Manara, 382 buildings in Kiryat Shmona, and 55,000 acres of nature in northern Israel and the Golan Heights have been damaged or destroyed by Hezbollah's attacks, while major damage also took place in Nahariya and Shlomi.
The Department was founded in 1934 in Kazan Teachers’ Institute to educate future teachers of chemistry. In November, 2011 the Department of Chemical Education became a structural unit of A. M. Butlerov Institute of Chemistry of Kazan (Volga Region) Federal University. Educational research was combined with fundamental and applied research in chemistry. International, All-Russian and regional research-to-practice conferences on chemical education organized by the Department are of the utmost interest. The Department has received letters of gratitude from school principals for instructing students in research and methodology in their preparation for teaching practice. Today 3 Doctors of Science and 5 Doctors of Philosophy are involved in the educational and bringing-up process at the Department. Since 2010 teachers have been retrained in the field of “Teacher of Chemistry”.The head of the Department is Suria I. Gilmanshina, Doctor of Philosophy in Chemistry, Doctor of Science in Education. The Department conducts research in the following fields:
Sources: en.wikipedia.org
Uranium-236 has a half-life of about 23 million years; and is neither fissile with thermal neutrons, nor very good fertile material, but is generally considered a nuisance and long-lived radioactive waste. It is found in spent nuclear fuel and in the reprocessed uranium made from spent nuclear fuel.
== Modifications == Before biosynthetic human recombinant analogues became available, porcine insulin was chemically modified to create human insulin. These semisynthetic insulins were produced by altering amino acid side chains at the N-terminus and C-terminus to modify absorption, distribution, metabolism, and excretion (ADME) characteristics. Novo Nordisk developed one such method by enzymatically converting porcine insulin into human insulin by replacing the single differing amino acid. Unmodified human and porcine insulins naturally form hexamers with zinc, requiring dissociation into monomers before binding to insulin receptors. This delays insulin activity when injected subcutaneously, making it less effective for postprandial glucose control. Basal insulin analogues were developed with altered isoelectric points, allowing them to precipitate at physiological pH and dissolve slowly, providing insulin coverage for up to 24 hours. Some, like insulin detemir, bind to albumin rather than fat, prolonging their action. Non-hexameric (monomeric) insulins were later introduced for faster-acting mealtime coverage, mimicking naturally occurring monomeric insulins found in certain animal species. These advancements in insulin formulation allowed for greater flexibility in diabetes management, with basal insulin analogues providing steady background insulin levels and short-acting analogues offering improved postprandial glucose control.
=== 7-12 August 2008 === On 7 August, the Georgian Foreign Ministry issued a statement holding Russia responsible and stating that Russia must compel South Ossetian separatists to cease artillery attacks on Georgian villages and Russian military assistance of the separatists was "yet another act of aggression against Georgia." One hour before the advance of Georgian troops on Tskhinvali on late 7 August 2008, deputy foreign minister Grigol Vashadze told Interfax that the South Ossetian regime might not attend peace talks scheduled in Tskhinvali on 8 August because the Ossetian regime needed the conflict. He further stated: "For fifteen years, we are drawing attention to the fact that the technical, material and military resources arrive in the Tskhinvali region through the Roki Tunnel. But the peacemakers, instead of acting to demilitarise the region, were turning a blind eye." On 7 August 2008, Assistant Secretary of State Daniel Fried said: "It appears that the South Ossetians have instigated this uptick in violence. We have urged the Russians to urge their South Ossetian friends to pull back and show greater restraint." Fried did not suspect the Russians of inciting the South Ossetians to violence. On 8 August 2008, Georgian minister Temur Iakobashvili said that Georgia intended to eliminate "a criminal regime". On 8 August 2008, Swedish Minister for Foreign Affairs Carl Bildt said that the crisis was due to provocations from the South Ossetian side and that Georgian forces were trying to restore the constitutional order.
== Criticisms == In 2013, studies of autologous bone marrow stem cells on ventricular function were found to contain "hundreds" of discrepancies. Critics report that of 48 reports, just five underlying trials seemed to be used, and that in many cases whether they were randomized or merely observational accepter-versus-rejecter, was contradictory between reports of the same trial. One pair of reports of identical baseline characteristics and final results, was presented in two publications as, respectively, a 578-patient randomized trial and as a 391-subject observational study. Other reports required (impossible) negative standard deviations in subsets of people or contained fractional subjects, negative NYHA classes. Overall, many more people were reported as having receiving stem cells in trials, than the number of stem cells processed in the hospital's laboratory during that time. A university investigation, closed in 2012 without reporting, was reopened in July 2013. In 2014, a meta-analysis on stem cell therapy using bone-marrow stem cells for heart disease revealed discrepancies in published clinical trial reports, whereby studies with a higher number of discrepancies showed an increase in effect sizes. Another meta-analysis based on the intra-subject data of 12 randomized trials was unable to find any significant benefits of stem cell therapy on primary endpoints, such as major adverse events or increase in heart function measures, concluding there was no benefit.
Sources: en.wikipedia.org
In osteology, the osteon or haversian system (; named for Clopton Havers) is the fundamental functional unit of much compact bone. Osteons are roughly cylindrical structures that are typically between 0.25 mm and 0.35 mm in diameter. Their length is often hard to define, but estimates vary from several millimeters to around 1 centimeter. They are present in many bones of most mammals and some bird, reptile, and amphibian species.
Fossils attributable to the genus Ginkgo first appeared in the Middle Jurassic. The genus Ginkgo diversified and spread throughout Laurasia during the Jurassic and Early Cretaceous. The Ginkgophyta declined in diversity as the Cretaceous progressed, and by the Paleocene, Ginkgo adiantoides was the only Ginkgo species left in the Northern Hemisphere, while a markedly different (and poorly documented) form persisted in the Southern Hemisphere. Along with that of ferns, cycads, and cycadeoids, the species diversity in the genus Ginkgo drops through the Cretaceous, at the same time the flowering plants were on the rise; this supports the hypothesis that, over time, flowering plants with better adaptations to disturbance displaced Ginkgo and its associates. At the end of the Pliocene, Ginkgo fossils disappeared from the fossil record everywhere except in a small area of central China, where the modern species survived.
=== MURI === The Multidisciplinary University Research Initiative (MURI) encompasses dozens of Universities and a few government organizations. Participating universities include UC Berkeley, UC Los Angeles, UC San Diego, Massachusetts Institute of Technology, and Imperial College in London. The sponsors are Office of Naval Research and the Defense Advanced Research Project Agency. MURI supports research that intersects more than one traditional science and engineering discipline to accelerate both research and translation to applications. As of 2009, 69 academic institutions were expected to participate in 41 research efforts.
=== 27 March === The SAF reportedly cleared the last pockets of RSF control south of Khartoum and captured Jabal Awliya. They also claimed to have neutralized 23 RSF personnel and captured an artillery piece. A swarm of drones attacked the city of Ad-Damazin in Blue Nile State, with some explosions and smoke being reported. The SAF claimed to have shot down five drones over the armored corps base, 4th infantry division headquarters, and the city's airport.
== Efficacy == Hydrocolloid has been shown to be superior to other dressing substrates (e.g., alginate, film, gauze, hydrofiber, or silicone) tested for treating skin-graft donor sites. There is tentative but unclear (as of 2013) evidence for the efficacy of hydrocolloid dressings for superficial and partial-thickness burns. The results of meta-analyses indicate no significant difference in healing rates between hydrocolloid dressings and other dressings (including simple gauze dressings) for venous ulcers, or for diabetic foot ulcers.
Sources: en.wikipedia.org
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。
分子上的脂肪酸侧链使其与血浆白蛋白结合增强，显著延长循环半衰期。半衰期延长后，稳定血药浓度可在较长的给药间隔内维持，因此常见用法为每周一次。
同时激活两条肠促胰素通路可能在胰岛素分泌、胃排空和食欲调节上产生叠加效应。与单靶点相比，临床研究中观察到的血糖与体重变化幅度通常更明显，但各通路的具体贡献比例尚无定论。
It activates both the glucose-dependent insulinotropic polypeptide receptor and the glucagon-like peptide-1 receptor. This dual activity separates it from agents that act on only one of the two receptors. The relative contribution of each receptor to clinical effects remains an open area of study.