If you have been reading about incretin and want a single page that covers the useful parts, this is it: definitions, context, how it is studied, and the questions that come up repeatedly.
Updated 2026-03-09. Numbers and descriptions here follow the published literature rather than marketing material.
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.
Three structural changes define the molecule. At position 8 an alpha-aminoisobutyric acid residue replaces alanine, which blocks dipeptidyl peptidase-4 cleavage. At position 34 arginine replaces lysine, and at position 26 a lysine carries a C18 fatty diacid attached through a short linker. The fatty chain binds serum albumin, and this albumin association reduces renal filtration and enzymatic attack. The unchanged backbone retains the receptor contacts that produce signalling. The free base has the formula C187H291N45O59 and a molecular weight near 4114 daltons.
该分子作为 GLP-1 受体的选择性激动剂发挥作用，受体属于 B 类 G 蛋白偶联受体家族，激活后经 Gs 通路提升细胞内环腺苷酸水平。在胰腺 β 细胞，信号促进葡萄糖依赖性的胰岛素释放，血糖偏低时该作用明显减弱。在胰岛 α 细胞，胰高血糖素分泌受到抑制。中枢神经系统与胃肠道同样存在受体表达，相应信号参与食欲调节以及胃排空速率的降低。
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。
| Property | Value | Notes |
|---|---|---|
| Molecular formula | C187H291N45O59 | free base, without counter-ion |
| Molecular weight | About 4114 Da | peptide backbone plus attached lipid chain |
| Plasma half-life | About 165 hours | supports once-weekly dosing in humans |
| Plasma protein binding | Greater than 99 percent | attributed mainly to serum albumin |
| Receptor target | GLP-1 receptor | Gs-coupled, raises intracellular cyclic AMP |
Reported molecular weight is approximately 4113.6 daltons for the free base, and the peptide is supplied as a lyophilized powder or in buffered liquid form depending on the intended use. It is freely soluble in water when formulated with appropriate excipients, though the unconjugated peptide shows limited stability at neutral pH over long periods. Analytical characterization typically relies on reversed-phase high-performance liquid chromatography and mass spectrometry. Purity specifications for research-grade material commonly exceed ninety-five percent by area. Isotopic and impurity profiles differ between suppliers.
Two principal therapeutic variants exist under separate regulatory filings, one indicated for glycemic control in type 2 diabetes and one for chronic weight management. Both use the same active molecule; differences lie in formulation strength, titration schedule, and labeling. Regulatory agencies in the United States and European Union approved injectable forms in 2017 and 2018 respectively. An oral tablet formulation received approval later, using a carrier molecule to enhance absorption across the gastric epithelium. Labeling differs by jurisdiction and by indication.
The distinction between established facts and open questions matters here. That the peptide binds the GLP-1 receptor and stimulates insulin release in a glucose-dependent manner is well documented. How individual variability in receptor density, gastric emptying rate, and gut microbiome composition shapes response remains an active research area. Long-term outcomes beyond five years of continuous use are not yet fully characterized in published trials, and several extension studies are ongoing.
Receptor binding triggers G protein signaling that raises intracellular cyclic AMP in pancreatic beta cells. Insulin release follows in a glucose-dependent manner, so secretion increases when blood glucose is elevated and diminishes when it is not. The same signaling suppresses glucagon release from alpha cells and slows gastric emptying, which blunts the post-meal glucose rise. In the brain, receptor activation in regions such as the arcuate nucleus is associated with reduced appetite and lower energy intake. How much each of these effects contributes to overall weight change is not fully settled.
Two structural features account for the prolonged half-life of semaglutide. A modified amino acid at position 8 resists cleavage by dipeptidyl peptidase-4, the enzyme that rapidly degrades native GLP-1. A fatty diacid side chain binds serum albumin, which limits renal clearance and protects the peptide from enzymatic breakdown. These modifications yield a plasma half-life of approximately one week in humans, allowing once-weekly administration. The relationship between plasma concentration and clinical effect varies between individuals, and sources of that variability are still being characterized.
Semaglutide is a synthetic peptide analog of glucagon-like peptide-1 (GLP-1), a hormone released from intestinal L-cells after food intake. The compound belongs to the incretin mimetic class and acts at GLP-1 receptors distributed across pancreatic, gastrointestinal, cardiovascular, and central nervous system tissues. Compared with native GLP-1, the molecule carries structural changes that extend its activity from minutes to roughly one week. It is studied for glycemic control in type 2 diabetes and for weight management, and its effects on cardiovascular and other outcomes remain active research areas.
Lyophilized semaglutide is typically stored at temperatures between minus 20 and minus 80 degrees Celsius for long-term preservation. Short-term storage at 2 to 8 degrees Celsius is common for working aliquots. Repeated freeze-thaw cycles can degrade the peptide and are usually avoided. The molecule is hygroscopic in its solid form, so containers should remain sealed with desiccant. Solutions are less stable than powders and are generally prepared fresh. Light exposure is limited because aromatic residues can undergo photo-oxidation.
Semaglutide dissolves readily in water and in aqueous buffers near neutral pH. Solubility decreases near the isoelectric point, where net charge is minimal. Common laboratory solvents include phosphate-buffered saline and dilute ammonium bicarbonate. Strongly acidic or basic conditions may accelerate hydrolysis. Working concentrations are usually prepared by diluting a concentrated stock. Vial surfaces can adsorb small amounts of peptide at low concentrations, so carrier proteins or low-binding tubes are sometimes used.
The primary target is the GLP-1 receptor, a class B G protein-coupled receptor expressed on pancreatic beta cells, in the gut, and in several brain regions. Receptor activation raises intracellular cyclic AMP, which potentiates glucose-dependent insulin secretion and lowers glucagon release when blood glucose is elevated. Signalling in the hypothalamus and brainstem is associated with reduced appetite and slower gastric emptying. Because the insulinotropic effect depends on prevailing glucose levels, the hypoglycaemic risk of the peptide alone is described as low in most study settings. The relative contribution of peripheral and central actions remains an active research question.
Large randomised trials in adults with type 2 diabetes and in adults with obesity have reported reductions in body weight and improvements in several cardiovascular risk markers. One outcome trial found a lower incidence of major adverse cardiovascular events in participants with diabetes and established cardiovascular disease. Gastrointestinal effects such as nausea and vomiting are the most frequently reported adverse events and often diminish over time. Changes in lean body mass during weight loss are an area of ongoing investigation. Effects in adolescents and in pregnancy are less well characterised, and current labelling advises against use during pregnancy.
Semaglutide is a synthetic peptide analogue of glucagon-like peptide-1, a gut hormone released after nutrient intake. The molecule contains 31 amino acid residues and differs from the native sequence at several positions. A non-natural residue at position eight resists the enzyme that normally truncates the hormone, while a lysine-linked fatty diacid side chain promotes binding to serum albumin. These two modifications extend the circulating half-life from minutes to roughly one week. The peptide is produced by solid-phase synthesis followed by selective acylation, and its identity and purity are confirmed by spectrometric and chromatographic techniques.
=== Tolerance and withdrawal === Diazepam, as with other benzodiazepine drugs, can cause tolerance, physical dependence, substance use disorder, and benzodiazepine withdrawal syndrome. Withdrawal from diazepam or other benzodiazepines often leads to withdrawal symptoms similar to those seen during barbiturate or alcohol withdrawal. The higher the dose and the longer the drug is taken, the greater the risk of experiencing unpleasant withdrawal symptoms. Withdrawal symptoms can occur from standard dosages and also after short-term use, and can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis. Withdrawal symptoms can sometimes resemble pre-existing conditions and be misdiagnosed. Diazepam may produce less intense withdrawal symptoms due to its long elimination half-life. Benzodiazepine treatment is recommended to be discontinued as soon as possible by a slow and gradual dose reduction regimen. Tolerance develops to the therapeutic effects of benzodiazepines; for example, tolerance occurs to the anticonvulsant effects and as a result benzodiazepines are not generally recommended for the long-term management of epilepsy. Dose increases may overcome the effects of tolerance, but tolerance may then develop to the higher dose, and adverse effects may increase. The mechanism of tolerance to benzodiazepines includes uncoupling of receptor sites, alterations in gene expression, down-regulation of receptor sites, and desensitization of receptor sites to the effect of GABA.
Telisotuzumab vedotin, sold under the brand name Emrelis, is an antibody drug conjugate used for the treatement of non-small cell lung cancer. Telisotuzumab vedotin is a c-Met-directed antibody and microtubule inhibitor conjugate. It was developed by AbbVie. The most common adverse reactions include peripheral neuropathy, fatigue, decreased appetite, and peripheral edema. The most common grade 3 or 4 laboratory abnormalities include decreased lymphocytes, increased glucose, increased alanine aminotransferase, increased gamma glutamyl transferase, decreased phosphorus, decreased sodium, decreased hemoglobin, and decreased calcium. Telisotuzumab vedotin was approved for medical use in the United States in May 2025. The US Food and Drug Administration considers it to be a first-in-class medication.
In practice, Sucre depended so much on the orders of Bolívar that he was quickly seen by Peruvians and people of the River Plate as a puppet or bridgehead of the Liberator in the continental south, a “proconsul of the Bolivian empire”. "You can't think of the multitude of papers that come from Peru to upset Bolivia. Until today they have had no influence, but perhaps in the long run they will do something. the Argentines. I am happy about this because I will be able to carry out the project of the federation of Chile, Bolivia and Buenos Aires." Subsequently, Sucre would have carried out an intense campaign to seize Arica from Peru and give it to Bolivia for its annexation to a natural outlet to the sea, proposing it in October 1826, he also warned Bolívar, during one of his letters of the year 1828, about the danger that Peru would be for Gran Colombia: "If Peru conquers Bolivia and keeps it, the South of Colombia (current Ecuador) runs a thousand and a thousand risks." To this is added the testimony of the Argentine minister M. Bustos, who on October 27, 1828, said in the Buenos Aires newspaper "El Tiempo" that Sucre and Gamarra had put together a plan to make Bolívar the Emperor of South America, separating Puno, Arequipa and Cuzco from the Republic of Peru, something Bolívar was aware of but did not want to make a false step. The centralism of the capital only produced new supporters of federalism and, in some cases, of secession, in Arequipa.
==== Blue ==== Prussian blue, or blue, a coloring used in the treatment of radiation, cesium, and thallium poisoning, can turn the feces blue. Substantial consumption of products containing blue food dye, such as blue curaçao or grape soda, can have the same effect.
And while it had been speculated that the availability of such treatment options might change public perception of the risks associated with drug use and might lead to an increase in illicit drug use, the incidence of heroin abuse in Switzerland has declined sharply since the introduction of heroin-assisted treatment. As a study published in The Lancet concluded:
Sources: en.wikipedia.org
== BP in Positron Emission Tomography == BP is a pivotal measure in the use of positron emission tomography (PET) to measure the density of "available" receptors, e.g. to assess the occupancy by drugs or to characterize neuropsychiatric diseases (yet, one should keep in mind that binding potential is a combined measure that depends on receptor density as well as on affinity). An overview of the related methodology is e.g. given in Laruelle et al. (2002). Estimating BP with PET usually requires that a reference tissue is available. A reference tissue has negligible receptor density and its distribution volume should be the same as the distribution volume in the target region if all receptors were blocked. Although the BP can be measured in a relatively unbiased way by measuring the whole time course of labelled ligand association and blood radioactivity, this is practically not always necessary. Two other common measures have been derived, which involve assumptions, but result in measures that should correlate with BP:
== Cause == The most common underlying pathology leading to TIA and stroke is a cardiac condition called atrial fibrillation, where poor coordination of heart contraction may lead to the formation of a clot in the atrial chamber that can become dislodged and travel to a cerebral artery. Unlike in stroke, the blood flow can become restored prior to infarction which leads to the resolution of neurologic symptoms. Another common culprit of TIA is an atherosclerotic plaque located in the common carotid artery, typically by the bifurcation between the internal and external carotids, that becomes an embolism to the brain vasculature similar to the clot in the prior example. A portion of the plaque can become dislodged and lead to embolic pathology in the cerebral vessels. In-situ thrombosis, an obstruction that forms directly in the cerebral vasculature unlike the remote embolism previously mentioned, is another vascular occurrence with possible presentation as TIA. Also, carotid stenosis secondary to atherosclerosis narrowing the diameter of the lumen and thus limiting blood flow is another common cause of TIA. Individuals with carotid stenosis may present with TIA symptoms, thus labeled symptomatic, while others may not experience symptoms and be asymptomatic.
High-performance liquid chromatography (HPLC), formerly referred to as high-pressure liquid chromatography, is a chromatography technique in analytical chemistry used to separate, identify, and quantify specific components (analytes) in mixtures. The mixtures can originate from food, chemicals, pharmaceuticals, biological, environmental and agriculture, etc., in which the sample analyzed is either a liquid or has been dissolved into a liquid. HPLC is essentially a pressurized form of column chromatography, which uses pressurized pumps instead of the force of gravity, and thinner and longer columns with smaller adsorbent particles. These increase its analytic resolution. HPLC is widely used for manufacturing (e.g., during the production process of pharmaceutical and biological products), legal (e.g., detecting performance enhancement drugs in urine), research (e.g., separating the components of a complex biological sample, or of similar synthetic chemicals from each other), and medical (e.g., detecting vitamin D levels in blood serum) purposes. High pressure pumps force mixtures of various solvents (the mobile phase, e.g., water, buffers, acetonitrile and/or methanol) to flow through a sample mixture and pick up analytes, delivering it into a cylinder (the chromatography column). The column is filled with solid particles made of adsorbent material (the stationary phase). The particles are usually made of silica, polymers, and 1.5–50 μm in diameter. Elution occurs as the mobile phase passes through the stationary phase.
== Scientific career == Yonath accepted postdoctoral positions at Carnegie Mellon University (1969) and MIT (1970). While a postdoctoral researcher at MIT she spent some time in the laboratory of subsequent 1976 chemistry Nobel Prize winner William N. Lipscomb, Jr. of Harvard University where she was inspired to pursue very large structures.
The skin consists of a thin epidermis with mucous cells and sensory cells and a fibrous dermis made of collagen and containing various cells that allow colour change. Most of the body is made of soft tissue, allowing it to squeeze through tiny gaps; even the larger species can pass through a gap little more than 2.5 cm (1 in) in diameter. Lacking skeletal support, the arms work as muscular hydrostats and feature longitudinal, transverse, and circular muscles around a central axial nerve. They can squash and stretch, coil at any place in any direction or stiffen. The interior surfaces of the arms are covered with circular, adhesive suckers. The suckers allow the octopus to secure itself in place or to handle objects. Each sucker is typically circular and bowl-like and has two distinct parts: an outer disc-shaped infundibulum and an inner cup-like acetabulum, both of which are thick muscles covered in connective tissue. A chitinous cuticle lines the outer surface. When a sucker attaches to a surface, the orifice between the two structures is sealed and the infundibulum flattens. Muscle contractions allow for attachment and detachment. Each of the eight arms senses and responds to light, allowing the octopus to control its limbs even if its head is obscured.
Sources: en.wikipedia.org
== Metabolism == The two bioactive forms of vitamin B12 are methylcobalamin in cytosol and adenosylcobalamin in mitochondria. The cyanide is converted to thiocyanate and excreted by the kidney. The MMACHC gene product catalyzes the decyanation of cyanocobalamin as well as the dealkylation of alkylcobalamins including methylcobalamin and adenosylcobalamin. The MMACHC gene product is characterised as a cyanocobalamin reductase (cyanide-eliminating) and an alkylcobalamin reductase. It enables the interconversion of cyano- and alkylcobalamins. Endogenous vitamin B12 becomes inactive when exposed to hydrogen cyanide and nitric oxide in cigarette smoke. More specifically, it causes the active forms to convert to cyanocobalamin, causing a functional deficiency. Functional vitamin B12 deficiency can also develop with heavy regular use of nitrous oxide N2O, also known as "laughing gas", by oxidizing the cobalt atom and inactivating the vitamin. Used for anaesthesia in a clinical setting or as a propellant gas, it's commonly abused as a recreational drug. The enzymes that use B12 as a built-in cofactor are methylmalonyl-CoA mutase (PDB 4REQ) and methionine synthase (PDB 1Q8J).
=== Dietary pattern === In general, a healthy dietary pattern is encouraged, and food modifications may be useful in promoting sperm quality. Some studies have concluded that intake of antioxidants is associated with better sperm parameters as high concentrations of reactive oxygen species can negatively affect the sperm. Consumption of an adequate portion of vegetables and fruits, dietary fibers, omega-3, poultry, and low-fat dairy products may help to lessen risk of male infertility. On the other hand, diets that have been negatively associated with male infertility include high intake of potatoes, soy foods, coffee, alcohol, and sweetened beverages. According to a review, higher consumers of cola showed a statistically significant decrease in semen volume. The high starch levels in potatoes promotes oxidative stress along with risk of inflammation from a resulting high glycemic index. Meanwhile, processed meats can possibly contain xenoestrogens and may compromise semen quality. However, additional research is warranted prior to recommending a set dietary regimen in regard to improving sperm parameters. Currently, the only general recommendation that can be made is to adhere to a healthy dietary pattern such as the DASH diet or Mediterranean diet. As low density of the sperm population is usually associated with infertility, hypospermia becomes an infertility issue when one is also identified to have oligospermia. Further semen analysis may be needed prior to being identified as oligospermic.
== External links == Understanding Pompe Disease - US National Institute of Arthritis and Musculoskeletal and Skin Diseases AGSD — Association of Glycogen Storage Disease in the United States AGSD-UK — Association of Glycogen Storage Disease in the UK AMDA — Acid Maltase Deficiency Association (Pompe disease) IPA — International Pompe Association IamGSD — International Association for Muscle Glycogen Storage Disease
According to some analysts, India–U.S. relations have been strained over the Obama administration's approach to Pakistan and the handling of the Taliban insurgency in Afghanistan. India's National Security Adviser M. K. Narayanan criticized the Obama administration for linking the Kashmir dispute to the instability in Pakistan and Afghanistan, and said that by doing so, President Obama was "barking up the wrong tree." Foreign Policy in February 2009 also criticized Obama's approach to South Asia, saying that "India can be a part of the solution rather than part of the problem" in South Asia. It also suggested that India take a more proactive role in rebuilding Afghanistan, irrespective of the attitude of the Obama administration. In a clear indication of the growing rift between the two countries, India decided not to accept a US invitation to attend a conference on Afghanistan at the end of February 2009. Bloomberg has also reported that, since the 2008 Mumbai attacks, the public mood in India has been to pressure Pakistan more aggressively to take actions against the culprits behind the terrorist attack, and that this might reflect on the upcoming Indian general elections in May 2009. Consequently, the Obama administration may find itself at odds with India's rigid stance against terrorism. In the early 2010s, India and US governments have differed on a variety of regional issues ranging from America's military relations with Pakistan and India's military relations with Russia to foreign policy disagreements relating to Iran, Sri Lanka, Maldives, Myanmar and Bangladesh.
Sources: en.wikipedia.org
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.
Albumin is the most abundant protein in plasma and carries molecules that bear fatty-acid chains. Binding shields the peptide from renal filtration and from peptidases, keeping a circulating reservoir. Slow release from this reservoir produces sustained receptor occupancy and supports infrequent dosing.
The insulinotropic effect is glucose-dependent, meaning secretion increases mainly when glucose is elevated. This property is often described as lowering the chance of hypoglycaemia when the compound is used alone. Other glucose-lowering agents used at the same time can still cause low blood glucose.
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。