Peptide-based multi-agonists: a new paradigm in metabolic pharmacology
| Autor: | M. H. Tschöp, Richard D. DiMarchi, Timo D. Müller, Kerstin Stemmer, Sara J. Brandt |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Drug media_common.quotation_subject 030209 endocrinology & metabolism Type 2 diabetes Peptide hormone Pharmacology Glucagon Gastrointestinal Hormones 03 medical and health sciences 0302 clinical medicine Weight loss Glucagon-Like Peptide 1 Diabetes mellitus Internal Medicine medicine Animals Humans ddc:610 Obesity Receptor media_common Diabetes Gip Glp-1 Multi-agonism Peptides business.industry medicine.disease 3. Good health ddc 030104 developmental biology medicine.symptom business Hormone |
| Zdroj: | Journal of Internal Medicine J. Intern. Med. 284, 581-602 (2018) |
| Popis: | Obesity and its comorbidities, such as type 2 diabetes, are pressing worldwide health concerns. Available anti-obesity treatments include weight loss pharmacotherapies and bariatric surgery. Whilst surgical interventions typically result in significant and sustained weight loss, available pharmacotherapies are far less effective, typically decreasing body weight by no more than 5-10%. An emerging class of multi-agonist drugs may eventually bridge this gap. This new class of specially tailored drugs hybridizes the amino acid sequences of key metabolic hormones into one single entity with enhanced potency and sustained action. Successful examples of this strategy include multi-agonist drugs targeting the receptors for glucagon-like peptide-1 (GLP-1), glucagon and the glucose-dependent insulinotropic polypeptide (GIP). Due to the simultaneous activity at several metabolically relevant receptors, these multi-agonists offer improved body weight loss and glucose tolerance relative to their constituent monotherapies. Further advancing this concept, chimeras were generated that covalently link nuclear acting hormones such as oestrogen, thyroid hormone (T3 ) or dexamethasone to peptide hormones such as GLP-1 or glucagon. The benefit of this strategy is to restrict the nuclear hormone action exclusively to cells expressing the peptide hormone receptor, thereby maximizing combinatorial metabolic efficacy of both drug constituents in the target cells whilst preventing the nuclear hormone cargo from entering and acting on cells devoid of the peptide hormone receptor, in which the nuclear hormone might have unwanted effects. Many of these multi-agonists are in preclinical and clinical development and may represent new and effective tools in the fight against obesity and its comorbidities. |
| Databáze: | OpenAIRE |
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