This is a working overview of Dual agonist, written for readers who want more than a one-paragraph summary but less than a textbook.
This page was last updated on 2025-10-04 and is reviewed periodically as new material appears.
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.
溶解操作一般使用注射用水或适宜的水性缓冲液，必要时加入少量助溶剂以改善溶解速度，但应避免剧烈涡旋振荡，因为剪切力可能促进聚集。配制后的溶液在冷藏条件下的稳定时间通常短于固体形态，具体时限取决于浓度、缓冲体系与容器材质。是否加入防腐成分，则取决于用途是否为多次取样。
定量分析的主流方法是反相高效液相色谱联用紫外或质谱检测，利用肽在疏水固定相上的保留行为确定纯度与含量。对于生物基质中的浓度测定，常采用液相色谱串联质谱，并配合固相萃取或蛋白沉淀进行样品前处理。免疫分析法也可使用，但可能受到结构相关肽的交叉反应干扰。
纯度评估通常综合反相色谱、体积排阻色谱与质谱三方面信息：前者反映疏水性杂质，后者反映聚集体，质谱则确认分子量与主要降解产物。有关降解途径的完整图谱——例如脱酰胺、氧化与水解各占多大比例——在不同储存条件下仍有差异，属于需要逐案验证的问题。
| Property | Value | Notes |
|---|---|---|
| Molecular formula | C225H348N48O68 | Peptide backbone with a fatty diacid chain |
| Molecular weight | About 4813 Da | Calculated from the formula |
| Receptor targets | GIP and GLP-1 receptors | Dual agonist activity at both sites |
| Route of administration | Subcutaneous injection | No approved oral form at present |
| Elimination half-life | About 5 days | Supports extended intervals between administrations |
After subcutaneous injection, absorption is gradual, and peak plasma levels are generally reached within one to three days. Albumin binding extends the apparent half-life to roughly five days, which supports a weekly administration schedule. Metabolism proceeds mainly through proteolytic cleavage of the peptide backbone and beta-oxidation of the fatty acid chain, rather than through cytochrome P450 pathways. Eliminated fragments are largely recycled through general protein turnover, and excretion of intact drug in urine is minimal. These properties distinguish the molecule from short-acting incretin mimetics.
Tirzepatide is a synthetic peptide of 39 amino acids engineered from the native glucose-dependent insulinotropic polypeptide sequence. Its structure incorporates several non-natural residues and a C-terminal segment derived from glucagon-like peptide-1, together with a C20 fatty diacid moiety attached through a linker. The lipophilic side chain promotes binding to serum albumin, which slows renal clearance after administration. The compound is classified as a dual incretin receptor agonist and is supplied as a lyophilized powder for reconstitution or as a preformulated solution, depending on the presentation.
The peptide activates two G protein-coupled receptors, GIPR and GLP-1R. Binding triggers adenylyl cyclase activity and raises intracellular cyclic AMP in pancreatic beta cells, which potentiates insulin release when glucose is elevated. Signaling in the central nervous system is associated with reduced appetite and lower energy intake, while effects on gastric emptying and glucagon secretion are also reported. Because activity at both receptors is retained, the pharmacological profile is often described as incretin-based rather than selective for a single receptor.
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.
At the receptor level, the compound binds both GIP and GLP-1 receptors and triggers downstream signalling that raises cyclic AMP in target cells. GLP-1 receptor activation is associated with glucose-dependent insulin release, slower gastric emptying, and reduced appetite signalling. GIP receptor activation contributes effects that are less completely characterised, and how much each receptor adds to the overall clinical response is still an open question. The two pathways appear to interact in a complementary rather than a purely additive way.
Purified material is typically handled as a lyophilized powder kept at or below minus twenty degrees Celsius, shielded from light and moisture. In that state the solid remains stable for extended periods, although repeated freeze-thaw cycling can encourage aggregation. Once dissolved, aqueous solutions are less durable and are generally held cold and used within a brief window. Buffer composition, pH and ionic strength all influence degradation rates, and mildly acidic to neutral conditions are commonly examined. Actual shelf life depends on formulation, concentration and container, so stability limits are established experimentally rather than assumed.
Verification of research-grade material involves checking purity, sequence and counter-ion content against a certificate of analysis. Reported purity figures usually reflect chromatographic area percentage and do not by themselves establish biological activity. Independent laboratories may repeat mass confirmation and peptide mapping to detect substitutions or truncations. Open questions concern how residual solvents, trace metals and subtle conformational variants affect measured behavior, and how consistently different suppliers define their specifications. Documentation of analytical methods matters as much as the headline purity number when results are compared across studies.
Routine characterization relies on reversed-phase high-performance liquid chromatography, often coupled to mass spectrometry, to confirm identity and estimate purity. Peptide mapping after enzymatic digestion verifies the amino acid sequence and locates appended groups such as the fatty acid chain. Size-exclusion chromatography detects aggregates and fragments, while ion-exchange chromatography resolves charge variants. Circular dichroism and nuclear magnetic resonance supply secondary and higher-order structural information in research settings. No single technique covers every attribute, so laboratories combine orthogonal methods and compare outcomes against a reference standard where one exists.
==== Photometric test-strip method ==== The test-strip method employs the above-mentioned enzymatic conversion of glucose to gluconic acid to form hydrogen peroxide. The reagents are immobilised on a polymer matrix, the so-called test strip, which assumes a more or less intense color. This can be measured reflectometrically at 510 nm with the aid of an LED-based handheld photometer. This allows routine blood sugar determination by nonscientists. In addition to the reaction of phenol with 4-aminoantipyrine, new chromogenic reactions have been developed that allow photometry at higher wavelengths (550 nm, 750 nm).
There is sympathetic innervation of both afferent and efferent arterioles at the glomerulus. Sympathetic activation, for instance during a state of stress, causes vasoconstriction of both the afferent and efferent arterioles. This decreases renal blood flow and GFR. Sympathetic activation also causes the release of renin.
BASF SE (German pronunciation: [beːaːɛsˈʔɛf] ), an initialism of its original name Badische Anilin- & Soda-Fabrik (German for 'Baden Aniline & Soda Factory'), is a German multinational company and the largest chemical producer in the world. Its headquarters is located in Ludwigshafen, Germany. BASF comprises subsidiaries and joint ventures in more than 80 countries, operating six integrated production sites and 390 other production sites across Europe, Asia, Australia, the Americas and Africa. BASF has customers in over 190 countries and supplies products to a wide variety of industries. Despite its size and global presence, BASF has received relatively little public attention since it abandoned the manufacture and sale of BASF-branded consumer electronics products in the 1990s. The company began as a dye manufacturer in 1865. Fritz Haber worked with Carl Bosch, one of its employees, to invent the Haber-Bosch process by 1912, after which the company grew rapidly. In 1925, the company merged with several other German chemical companies to become the chemicals conglomerate IG Farben. IG Farben would go on to play a major role in the economy of Nazi Germany. It extensively employed forced and slave labor during the Nazi period, and produced the notorious Zyklon B chemical used in the Holocaust. IG Farben was disestablished by the Allies in 1945. BASF was reconstituted from the remnants of IG Farben in 1952. It was part of the German economic miracle, and has since expanded considerably. It has received modern criticism for its poor environmental record.
Pennyroyal is frequently used as an insecticide and pest repellent. As a pest repellent, it is used to keep fleas away from household animals as well as on humans to ward off gnats and mosquitos. Some flea collars for pets have pennyroyal oil or the herb can be crushed in the lining. Humans have also put crushed pennyroyal stems in their pockets or on their clothing to ward off unwanted insects. However, when using the pennyroyal plant as a pest repellent, the use of the concentrated pennyroyal oil should be avoided. Pennyroyal oil can be extremely toxic to both humans and animals, even in small quantities. With the use of pennyroyal around animals and humans comes the risk of it being absorbed through the skin and causing negative health effects. The less concentrated leaves of the plant should be used instead as an insect repellent. Pennyroyal has historically also been used as a mint flavoring in herbal teas and foods. It is recommended that pennyroyal tea should not be drunk on a regular basis. Consumption of pennyroyal tea can be fatal to infants and children. In Italy the fresh leaves of this plant, which in Rome and the surrounding area is called menta romana, are used in the capital's cuisine to flavour lamb and tripe. In culinary use it should not be confused with lesser calamint (Clinopodium nepeta), which in Rome is used to prepare artichokes. The pennyroyal plant has also been used as an emmenagogue and an abortifacient.
Polyubiquitylation is the formation of a ubiquitin chain on a single lysine residue on the substrate protein. Following addition of a single ubiquitin moiety to a protein substrate, further ubiquitin molecules can be added to the first, yielding a polyubiquitin chain. These chains are made by linking the glycine residue of a ubiquitin molecule to a lysine of ubiquitin bound to a substrate. Ubiquitin has seven lysine residues and an N-terminus that serves as points of ubiquitination; they are K6, K11, K27, K29, K33, K48, K63 and M1, respectively. Lysine 48-linked chains were the first identified and are the best-characterised type of ubiquitin chain. K63 chains have also been well-characterised, whereas the function of other lysine chains, mixed chains, branched chains, M1-linked linear chains, and heterologous chains (mixtures of ubiquitin and other ubiquitin-like proteins) remains more unclear. Lysine 48-linked polyubiquitin chains target proteins for destruction, by a process known as proteolysis. Multi-ubiquitin chains at least four ubiquitin molecules long must be attached to a lysine residue on the condemned protein in order for it to be recognised by the 26S proteasome. This is a barrel-shape structure comprising a central proteolytic core made of four ring structures, flanked by two cylinders that selectively allow entry of ubiquitylated proteins. Once inside, the proteins are rapidly degraded into small peptides (usually 3–25 amino acid residues in length).
Sources: en.wikipedia.org
In this manner, some became tied to the very parcel of land into which they had been born a slave having little freedom or economic opportunity because of Jim Crow laws which perpetuated discrimination, limited education, promoted persecution without due process and resulted in continued poverty. Fear of reprisals such as unjust incarcerations and lynchings deterred upward mobility further.
== The yachts == Early races had a very wide range of boat types, but concerns after the 1989–1990 race led to the development of the Whitbread 60 single design. This was a reaction to increasing costs of the biggest, "maxi", boats, and their advantage over the rest of the field – Steinlager 2 won every leg in the maxi division and was the winner overall, with many of the smaller boats finishing legs more than ten days after the winner. The Whitbread 60 design was used for all smaller boats in the 1993–1994 race, and for all in the 1997–1998 race. The race continued to be restricted to a single class for the next seven races – but moved to the Volvo Open 70, then the Volvo Ocean 65. Two classes of boats were used for the 2023 edition of the race: the Volvo Ocean 65 and the IMOCA 60.
==== Air via nasogastric tube ==== Several neonatologists have described the allegation that Letby murdered three infants by injecting air into their stomachs via a nasogastric tube as implausible, variously calling the theory "nonsensical", "ridiculous", "fantastical" and "not practically feasible". An X-ray heavily relied upon by the prosecution in relation to Child C was taken when Letby had not been on shift since the infant's birth. Following the trial, the prosecution's lead medical witness, Dr Dewi Evans, subsequently stated that he had changed his opinion regarding the cause of Baby C's death. He no longer believed that the air in Baby C's stomach, which he had told the jury had caused the infant's collapse, was responsible for his death. Instead, Evans said that the stomach bubble was not responsible for the death and that Baby C died later, as a result of air entering the bloodstream. He therefore altered his view of the precise physiological mechanism by which Baby C died, while continuing to maintain that Letby was responsible for Baby C's death. The Lee panel concluded that there was no evidence that air had been forced down any infant's nasogastric tube.
== Fungus-derived == Edible mushrooms Mycoprotein – a form of single-cell protein, also known as fungal protein, it is able to provide greater satiety than traditional protein sources such as chicken, while also being rich in protein and low in caloric content Fistulina hepatica – a common mushroom known as beefsteak fungus Fusarium venenatum – a microfungus of the genus Fusarium that has a high protein content Hericium erinaceus – also known as lion's mane mushroom and has been explored as a steak alternative Laetiporus – a mushroom which is also named chicken of the woods Lyophyllum decastes – a mushroom known as fried chicken mushroom Neurospora crassa – a type of red bread mold of the phylum Ascomycota Pleurotus ostreatus – better known as the oyster mushroom, famous in the vegan community as one of the best substitutes for fried chicken
== Overview == VersaCold started in 1946 as B.C. Ice & Cold Storage Co., serving Vancouver’s fishing industry. In the decades that followed, the company expanded steadily east. By the 1980s the company had established a strong base in the West with eight facilities in BC, Alberta and Washington. A series of mergers and acquisitions throughout the 1990s put VersaCold on the continental and, by 2005, global map, as the purchase of P&O Cold Storage added operations in the US, Australia, New Zealand and Argentina. In 2010, VersaCold sold its offshore operations and returned to its Canadian roots. VersaCold is jointly owned by Toronto-based private equity firm KingSett Capital and Quebec-based investor Ivanhoé Cambridge. Today, VersaCold operates the largest temperature-sensitive logistics network in Canada, with 27 temperature-controlled warehouses and distribution centres and a fleet of trucks providing local, regional, national and international transportation across Canada and the United States. In August 2022, American multinational logistics chain Lineage announced its acquisition of VersaCold for an undisclosed sum.
Sources: en.wikipedia.org
== External links == Clinical trial number NCT02781727 for "A Phase 3 Trial of the Safety, Tolerability and Efficacy of TransCon hGH Weekly Versus Daily hGH in Children With Growth Hormone Deficiency (GHD)" at ClinicalTrials.gov
=== Anesthesia === To induce general anesthesia, propofol is the drug used almost exclusively, having largely replaced sodium thiopental. It is often administered as part of an anesthesia maintenance technique called total intravenous anesthesia, using either manually programmed infusion pumps or computer-controlled infusion pumps in a process called target controlled infusion (TCI). Propofol is also used to sedate people who are receiving mechanical ventilation but not undergoing surgery, such as patients in the intensive care unit. In critically ill patients, propofol is superior to lorazepam both in effectiveness and overall cost. Propofol is relatively inexpensive compared to medications of similar use due to shorter ICU stay length. One of the reasons propofol is thought to be more effective (although it has a longer half-life than lorazepam) is that studies have found that benzodiazepines like midazolam and lorazepam tend to accumulate in critically ill patients, prolonging sedation. Propofol has also been suggested as a sleep aid for critically ill adults in an ICU setting; however, its effectiveness in replicating the mental and physical aspects of sleep for people in the ICU is unclear. Propofol can be administered via a peripheral IV or central line. Propofol is often paired with fentanyl (for pain relief) in intubated and sedated people. The two drugs are molecularly compatible in an IV mixture form. Propofol is also used to deepen anesthesia to relieve laryngospasm. It may be used alone or followed by succinylcholine.
Cycloalkanes have relatively intense molecular ion peaks (two bonds have to break). Alkene fragmentation peaks are often most significant mode. Loss of “CH2CH2“ (= 28) is common, if present. However, for the substituted cycloalkanes, they prefer to form the cycloalkyl cations by cleavage at the branched points.
Etoxadrol (CL-1848C) is a dissociative anaesthetic drug that has been found to be an NMDA antagonist and produce similar effects to PCP in animals. Etoxadrol, along with another related drug dexoxadrol, were developed as analgesics for use in humans, but development was discontinued in the late 1970s after patients reported side effects such as nightmares and hallucinations.
Strontium is named after the Scottish village of Strontian (Scottish Gaelic: Sròn an t-Sìthein), where it was discovered in the ores of the lead mines. In 1790, Adair Crawford, a physician engaged in the preparation of barium, and his colleague William Cruickshank, recognised that the Strontian ores exhibited properties that differed from those in other "heavy spars" sources. This allowed Crawford to conclude on page 355 "... it is probable indeed, that the scotch mineral is a new species of earth which has not hitherto been sufficiently examined." The physician and mineral collector Friedrich Gabriel Sulzer analysed together with Johann Friedrich Blumenbach the mineral from Strontian and named it strontianite. He also came to the conclusion that it was distinct from the witherite and contained a new earth (neue Grunderde). In 1793 Thomas Charles Hope, a professor of chemistry at the University of Glasgow studied the mineral and proposed the name strontites. He confirmed the earlier work of Crawford and recounted: "... Considering it a peculiar earth I thought it necessary to give it an name. I have called it Strontites, from the place it was found; a mode of derivation in my opinion, fully as proper as any quality it may possess, which is the present fashion." The element was eventually isolated by Sir Humphry Davy in 1808 by the electrolysis of a mixture containing strontium chloride and mercuric oxide, and announced by him in a lecture to the Royal Society on 30 June 1808. In keeping with the naming of the other alkaline earths, he changed the name to strontium.
Sources: en.wikipedia.org
It is a synthetic 39-amino-acid peptide that acts on two incretin receptors, the GIP receptor and the GLP-1 receptor. It is given by subcutaneous injection and has a circulating half-life of roughly five days. It is not a small molecule and is not absorbed usefully from the gut in conventional oral form.
Selective agents act on one receptor, while tirzepatide engages both GIP and GLP-1 receptors. The added GIP activity may contribute effects on insulin sensitivity and on fat metabolism. Whether the dual action produces meaningful clinical advantages beyond differences in potency is still being examined.
The downstream consequences of GIP receptor activation are not fully characterised in humans. It is also unclear how much each receptor contributes to appetite reduction and to shifts in body composition. Published work describes associations and proposed pathways rather than settled causal chains.
建议在低温、避光、干燥环境中密封保存，常见条件为 2 至 8 摄氏度，长期存放可置于更低温度。应避免反复冻融，并尽量减少容器开启次数。