This is a working overview of incretin, written for readers who want more than a one-paragraph summary but less than a textbook.
Reviewed 2026-07-27. Anything still debated is marked as such rather than presented as settled.
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.
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.
| Property | Value | Notes |
|---|---|---|
| Molecular class | Acylated GLP-1 receptor agonist | 31-residue synthetic peptide |
| Molecular formula | C187H291N45O59 | established for the free peptide |
| Appearance | White to off-white powder | as supplied before formulation |
| Solubility | Freely soluble in water | aqueous buffers near neutral pH |
| Typical storage | 2 to 8 degrees Celsius, protected from light | powder and solution forms differ in shelf life |
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。
Reverse-phase high-performance liquid chromatography with ultraviolet detection near 214 or 280 nanometres is widely used to assess purity and to resolve related impurities. Liquid chromatography coupled to mass spectrometry confirms identity through the protonated molecular ion and fragment ions formed in tandem experiments. Capillary electrophoresis and peptide mapping after enzymatic digestion supply complementary information on charge variants and modification sites. Circular dichroism and nuclear magnetic resonance can report on secondary structure in solution. Absolute quantification usually depends on an external standard, and reported purity depends on the detection wavelength and integration parameters chosen.
Lyophilised material appears as a white to off-white cake or powder that is hygroscopic, and containers are usually equilibrated to room temperature before opening to limit condensation. Dissolution is performed in water, phosphate-buffered saline, or a mildly alkaline buffer, since solubility rises above neutral pH. Gentle inversion or low-speed mixing is preferred, because vigorous vortexing can promote surface denaturation and aggregation. Complete dissolution may require several minutes, and brief sonication is sometimes applied. Passing the solution through a 0.22 micrometre membrane removes particulates but does not by itself sterilise the liquid.
Storage at minus 20 degrees Celsius or lower in a desiccated container preserves the peptide for extended periods, while working solutions are commonly held at two to eight degrees Celsius for short intervals. Light exposure and repeated freeze-thaw cycles accelerate degradation, so dividing material into single-use aliquots is generally recommended. Adsorption to glass and plastic surfaces can lower the measured concentration of dilute solutions, particularly below one milligram per millilitre. The degradation routes most often reported for GLP-1 analogues are deamidation, methionine oxidation, and backbone hydrolysis. Relative rates under specific conditions are frequently described only for individual formulations.
Pharmacological activity arises from agonism at the glucagon-like peptide-1 receptor, a G protein-coupled receptor expressed in the pancreas, the gastrointestinal tract, and the brainstem. Receptor activation raises intracellular cyclic adenosine monophosphate and enhances insulin release in a glucose-dependent manner, an effect that diminishes when blood glucose concentration is low. Other effects include slowed gastric emptying and hypothalamic satiety signalling. These pathways are described well. Receptor desensitisation rates across tissues, relative to the endogenous hormone, are still under investigation, and reported findings differ between laboratories.
The company that developed the compound filed it as a long-acting analogue, and it gained first approval in 2017 for type 2 diabetes. Later authorisations from several regulators extended the indication to chronic weight management, and the World Health Organization added the glucagon-like peptide-1 receptor agonist drug class to its model list of essential medicines in 2023. Production uses solid-phase peptide synthesis followed by side-chain conjugation and chromatographic purification. Supply constraints and cost differences across regions are well documented. Literature on long-term outcomes continues to grow, with many trials reporting surrogate endpoints rather than hard clinical endpoints.
Semaglutide is a synthetic peptide of thirty-one amino acids that shares roughly ninety-four percent sequence identity with human glucagon-like peptide-1. Two substitutions resist enzymatic cleavage by dipeptidyl peptidase-4, and a fatty diacid side chain attached through a linker promotes binding to serum albumin. That albumin binding slows renal clearance and extends the circulating half-life from minutes to approximately one week. The structural changes are well established in the published literature. Whether the same modifications affect receptor signalling bias in ways that matter clinically remains an open question.
Receptor activation raises intracellular cyclic AMP through Gs coupling, which promotes glucose-dependent insulin release and suppresses glucagon secretion when blood glucose is elevated. Effects outside the pancreas include slower gastric emptying and altered appetite signalling in the hypothalamus and hindbrain. The relative contribution of each tissue to overall metabolic outcomes remains an area of active investigation. Central mechanisms in particular are inferred mainly from animal models and indirect human measures rather than direct observation.
Serum protein binding dominates the pharmacokinetic profile. The attached chain associates strongly with albumin, shielding the peptide from enzymatic attack and slowing filtration by the kidney. This interaction extends the circulation half-life to roughly one week in humans, which supports weekly administration intervals. An oral version pairs the peptide with an absorption enhancer that transiently alters gastric epithelium, permitting limited uptake; bioavailability by that route is substantially lower than by injection.
All At Once, which will document Collins alongside her family as she embarks on IVF treatment and plans her wedding following her engagement to Rami Hawash. On the commissioning of the show, Collins described the upcoming year as the "most important in her life", and said that "for the first time [in the series] people will get to see the Gemma behind the GC." [...] Collins added that she felt "ready to truly open up, not just about the present, but about [her] past and everything [she'd] been through to become the woman [she is] today.
=== Nonsyndromic deafness === Mutations in the COL11A2 gene have been shown to cause hearing loss without other signs or symptoms (nonsyndromic deafness autosomal dominant) in two large families. One family carries a mutation that substitutes the amino acid cysteine (a building block of proteins) for the amino acid arginine at position 549 (written as Arg549Cys) in the alpha 2 chain of type XI collagen. A second family has a mutation that substitutes the amino acid glutamic acid for the amino acid glycine at position 323 (written as Gly323Glu) in this protein. These mutations prevent the normal assembly of type XI collagen. Type XI collagen plays an important role in the structure and function of the inner ear. When mutations in the COL11A2 gene affect the structure of collagen fibrils, hearing loss can result.
Indium is created by the long-lasting (up to thousands of years) s-process (slow neutron capture) in low-to-medium-mass stars (range in mass between 0.6 and 10 solar masses). When a silver-109 atom captures a neutron, it transmutes into silver-110, which then undergoes beta decay to become cadmium-110. Capturing further neutrons, it becomes cadmium-115, which decays to indium-115 by another beta decay. This explains why the radioactive isotope is more abundant than the stable one. The stable indium isotope, indium-113, is one of the p-nuclei, the origin of which is not fully understood; although indium-113 is known to be made directly in the s- and r-processes (rapid neutron capture), and also as the daughter of very long-lived cadmium-113, which has a half-life of about eight quadrillion years, this cannot account for all indium-113. Indium is the 68th most abundant element in Earth's crust at approximately 50 ppb. This is similar to the crustal abundance of silver, bismuth and mercury. It very rarely forms its own minerals, or occurs in elemental form. Fewer than 10 indium minerals such as roquesite (CuInS2) are known, and none occur at sufficient concentrations for economic extraction. Instead, indium is usually a trace constituent of more common ore minerals, such as sphalerite and chalcopyrite. From these, it can be extracted as a by-product during smelting. While the enrichment of indium in these deposits is high relative to its crustal abundance, it is insufficient, at current prices, to support extraction of indium as the main product.
Imipenem/cilastatin, sold under the brand name Primaxin among others, is an antibiotic useful for the treatment of a number of bacterial infections. It is made from a combination of imipenem and cilastatin. Specifically it is used for pneumonia, sepsis, endocarditis, joint infections, intra-abdominal infections, and urinary tract infections. It is given by injection into a vein or muscle. Common side effects include nausea, diarrhea, and pain at the site of injection. Other side effects may include Clostridioides difficile diarrhea and allergic reactions including anaphylaxis. It is unclear if use during pregnancy is safe for the baby. Imipenem is in the carbapenem family of medications and works by interfering with the bacteria's cell wall. Cilastatin blocks the activity of dehydropeptidase I which prevents the breakdown of imipenem. Imipenem/cilastatin was first sold in 1987. It is on the World Health Organization's List of Essential Medicines.
According to one of Liu's generals, education would make it so that “within ten to twenty years, the people will have forgotten even the names of the minority groups.” He established several schools for Tibetans in the borderlands in order to facilitate "Han-Tibetan language exchange". The language of instruction within schools was a matter of much debate within the provincial government, but by 1942, Liu's administration began prioritizing bilingual education in order to encourage Tibetans to learn Chinese. This came along with a slate of other measures aimed at creating a mobile educational system using geshe or khenpo monks to disseminate nationalist values to isolated and nomadic borderland communities. Liu recognized that the monks and lamas held more power in many areas of Xikang than the government; thus, the government would have to co-opt them. As part of this effort, anti-Japanese war propaganda and bilingual newspapers were posted on the walls of temples. Liu Wenhui criticized the Sinicization policies of past Xikang ruler Zhao Erfeng for being "extremist", saying that Zhao "emphasized force and acted too hastily"; however, this must be placed in light of his own contradictory stances.
Sources: en.wikipedia.org
Clinical trials involving new drugs are commonly classified into five phases. Each phase of the drug approval process is treated as a separate clinical trial. The drug development process will normally proceed through phases I–IV over many years, frequently involving a decade or longer. If the drug successfully passes through phases I, II, and III, it will usually be approved by the national regulatory authority for use in the general population. Phase IV trials are performed after the newly approved drug, diagnostic or device is marketed, providing assessment about risks, benefits, or best uses.
This was first done for lysozyme, an enzyme found in tears, saliva and egg whites that digests the coating of some bacteria; the structure was solved by a group led by David Chilton Phillips and published in 1965. This high-resolution structure of lysozyme marked the beginning of the field of structural biology and the effort to understand how enzymes work at an atomic level of detail.
=== Pharmacokinetics === When administered parenterally (non-orally or non-rectally, e.g., intravenously or by injection), as is most common, naloxone has a rapid distribution throughout the body. The mean serum half-life has been shown to range from 30 to 81 minutes, shorter than the average half-life of some opiates, necessitating repeat dosing if opioid receptors must be stopped from triggering for an extended period. Naloxone is primarily metabolized by the liver. Its major metabolite is naloxone-3-glucuronide, which is excreted in the urine. For people with liver diseases such as alcoholic liver disease or hepatitis, naloxone usage has not been shown to increase serum liver enzyme levels. Naloxone has low systemic bioavailability when taken by mouth due to hepatic first-pass metabolism, but it does block opioid receptors that are located in the intestine.
=== September === 1 September – Prime Minister Keir Starmer performs a cabinet reshuffle. 2 September – Zack Polanski is elected leader of the Green Party of England and Wales. Mothin Ali and Rachel Millward are elected as joint deputy leaders. 3 September – Deputy Prime Minister Angela Rayner admits to underpaying stamp duty on an £800,000 flat in Hove. First Minister of Scotland John Swinney announces a pause of public money from the Scottish Government to arms companies supplying weapons to Israel. Addressing a US congressional committee, Nigel Farage urges US politicians and businesses to oppose what he feels is the UK government's stance on freedom of speech. 4 September – The Scottish Government publishes a new paper setting out the case for Scottish independence. First Minister John Swinney urges the UK government to hold a second Scottish independence referendum if the SNP wins a majority at the 2026 Scottish Parliament election. Former Conservative Party minister Nadine Dorries defects to Reform UK. Warwickshire County Council's Reform cabinet votes to strip the chief executive of responsibility for deciding what flags can be flown outside its building, handing it to the council chairman. 5 September – Angela Rayner resigns as both Deputy Prime Minister and Deputy Leader of the Labour Party after admitting underpaying stamp duty on her £800,000 home in Hove, East Sussex.
=== Epigenetic reprogramming === Epigenetic reprogramming through a novel gene therapy shows promise in restoring vision loss in a non-human primate model of NAION. This study builds on previous research demonstrating that AAV2-induced transient expression of the reprogramming genes Oct4, Sox2, and Klf4 (OSK) could reverse retinal aging and restore visual function in mice. Given the limitations of mice for modeling human vision, African green monkeys were used as a more accurate model. NAION was induced in these primates, and two groups were treated with either AAV2-OSK gene therapy or a vehicle. The results showed that pre-treated eyes with AAV2-OSK had significantly improved visual function compared to vehicle-treated eyes, as measured by parameters such as pERG response and optic nerve axon count. Post-treatment also resulted in significant recovery, albeit after an initial decline. These findings suggest that AAV2-OSK gene therapy has potential for clinical application in treating human optic nerve diseases.
Sources: en.wikipedia.org
== Function == Dietary copper enters the bloodstream primarily in its oxidized Cu(II) form. Once absorbed, Cu(II) is taken up by the hCTR1, which mediates its cellular import. At the extracellular face, the flexible N-termini extends outward and captures Cu(II) from the blood carrier protein, after that it reduces Cu(II) to Cu(I) state and preserves the reduced Cu(I) oxidation state. The extracellular domain of hCTR1 holds both Cu(II) and Cu(I) binding sites: 1MDHxHH and 22HHH, serve as two Cu(II) binding sites; 7MxMxxM and 41MMMxM, comprise the first Cu(I) binding sites in the extracellular domain of hCTR1. The extracellular hCTR1 domain is also characterized by two glycosylation sites, N15 and T27. The transmembrane domain of hCTR1 is characterized by 150MxxxM and 167GxxxG motifs. In the second transmembrane helix, M150 and M154 are considered as Cu(I)-binding residues. There are two methionine triads lining the pore, and these methionine rings have soft sulfur ligands and create the "selectivity filter" for Cu(I), that excludes harder ions such as Ca(II). The hCTR1 C-terminal domain controls the distribution of Cu(I), it plays a role in copper trafficking and regulation. It interacts with metallochaperones and with the of the 188HCH motif transfers the Cu(I) ion to Atox1. Althogether hCTR1 operates as a dynamic, adaptable transporter, delicately balancing the flexibility and selectivity of copper ions.
While Marco Polo wrote of Mongolian Tatar troops in the time of Kublai Khan who carried sun-dried skimmed milk as "a kind of paste", the first modern production process for dried milk was invented by the Russian doctor Osip Krichevsky in 1802. The first commercial production of dried milk was organized by the Russian chemist M. Dirchoff in 1832. In 1855, T. S. Grimwade took a patent on a dried milk procedure, though William Newton had patented a vacuum drying process as early as 1837. In modern times, powdered milk is usually made by spray drying nonfat skimmed milk, whole milk, buttermilk or whey. Pasteurized milk is first concentrated in an evaporator to approximately 50 percent milk solids. The resulting concentrated milk is then sprayed into a heated chamber where the water almost instantly evaporates, leaving fine particles of powdered milk solids. Alternatively, the milk can be dried by drum drying. Milk is applied as a thin film to the surface of a heated drum, and the dried milk solids are then scraped off. However, powdered milk made this way tends to have a cooked flavour, due to caramelization caused by greater heat exposure. Another process is freeze drying, which preserves many nutrients in milk, compared to drum drying. The drying method and the heat treatment of the milk as it is processed alters the properties of the milk powder, such as its solubility in cold water, its flavour, and its bulk density.
==== Gomori-positive astrocytes and brain dysfunction ==== A type of astrocyte with an aging-related pathology has been described over the last fifty years. Astrocytes of this subtype possess prominent cytoplasmic granules that are intensely stained by Gomori's chrome alum hematoxylin stain, and hence are termed Gomori-positive (GP) astrocytes. They can be found throughout the brain, but are by far the most abundant in the olfactory bulbs, medial habenula, dentate gyrus of the hippocampus, arcuate nucleus of the hypothalamus, and in the dorsal medulla, just beneath the area postrema. Gomori-positive cytoplasmic granules are derived from damaged mitochondria engulfed within lysosomes. Cytoplasmic granules contain undigested remnants of mitochondrial structures. These contents include heme-linked copper and iron atoms remaining from mitochondrial enzymes. These chemical substances account for the pseudoperoxidase activity of Gomori-positive granules that can utilized to stain for these granules. Oxidative stress is believed to be cause of damage to these astrocytes. However, the exact nature of this stress is uncertain. Brain regions enriched in Gomori-positive astrocytes also contain a sub-population of specialized astrocytes that synthesize Fatty Acid Binding Protein 7 (FABP7). Indeed, astrocytes in the hypothalamus that synthesize FABP7 have also been shown to possess Gomori-positive granules. Thus, a connection between these two glial features is apparent.
South Beach challenged rival AriZona in sales and was pursuing Snapple for leadership in the new age drink category. Less than pleased, rival AriZona slapped the company with a lawsuit claiming that SoBe had copied its bottle design or stolen trade secrets. Then Judge Sonia Sotomayor ruled in SoBe's favor denying a preliminary injunction. Legal action proceeded and persisted on the federal and state level until 2007, long after the company had been sold to PepsiCo. In 2007, the court dismissed all AriZona claims on summary judgement In 2001, Bello was named Ernst and Young's National Entrepreneur of the Year in the Consumer Products category for his accomplishments at SoBe.
=== Cells === Wandering cells - cells that migrate into the tissue from blood stream in response to a variety of stimuli; for example, immune system blood cells causing inflammatory response. Fixed cells - cells that are permanent inhabitants of the tissue. Fibroblast - produce and secrete the organic parts of the ground substance and extracellular fibers of the matrix.
Sources: en.wikipedia.org
Native GLP-1 is degraded within minutes by dipeptidyl peptidase-4 and neutral endopeptidases. Semaglutide carries a non-natural amino acid at position eight that blocks that cleavage, and a fatty diacid side chain that binds albumin. The result is a much longer duration of action than the native hormone.
The fatty diacid chain associates strongly with serum albumin, which keeps the peptide in circulation and shields it from rapid renal clearance. Bound peptide is released gradually, producing a sustained receptor signal. This mechanism also reduces the peak-to-trough variation seen with shorter-acting analogues.
The balance between peripheral receptor activation and signalling in the central nervous system is not fully resolved. The extent to which slowed gastric emptying accounts for reduced energy intake, compared with direct effects on appetite circuits, is debated. Long-term effects on lean mass and on tissues outside the gut and brain are still under study.
Native GLP-1 is degraded within minutes by dipeptidyl peptidase-4 and cleared quickly. Semaglutide carries a position 8 substitution that blocks that cleavage and a fatty diacid chain that binds albumin. Together these changes extend its circulating half-life to about one week.