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.
Last reviewed on 2026-06-10. Where a claim depends on a specific study, the study is described rather than over-claimed.
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.
Tirzepatide activates both the glucose-dependent insulinotropic polypeptide receptor and the glucagon-like peptide-1 receptor, making it a dual agonist rather than a selective agent. Engagement of the GLP-1 receptor is linked to glucose-dependent insulin release, slower gastric emptying, and reduced appetite signalling. The relative contribution of the GIP arm remains an active research question; proposed roles include improved insulin sensitivity and altered adipose tissue handling. Receptor occupancy studies suggest the molecule interacts with both targets at circulating concentrations achieved during therapy.
Development of tirzepatide took place under a research program that sought to test whether simultaneous engagement of two incretin receptors would produce greater metabolic effects than single-receptor agonism. Clinical trials were organized into the SURPASS series for type 2 diabetes and the SURMOUNT series for obesity and weight management. Regulatory clearance for type 2 diabetes came in 2022 in the United States, followed by approval for chronic weight management in 2023. The trial programs reported reductions in glycated hemoglobin and body weight relative to comparators, though long-term cardiovascular and durability data continue to accumulate.
The peptide backbone contains 39 amino acids and includes alpha-aminoisobutyric acid residues, which are not among the standard proteinogenic set. A C20 fatty diacid moiety is attached through a linker, allowing the compound to bind serum albumin and extend its circulation time. This albumin binding is the main reason the molecule supports once-weekly administration rather than more frequent dosing. The measured molecular mass is approximately 4,813 daltons, placing it firmly in the peptide rather than small-molecule class.
| 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 |
固体状态的 tirzepatide 通常以冻干粉形式保存，推荐在低温、避光、干燥条件下存放，常见区间为 2 至 8 摄氏度，长期保存可考虑更低温度并避免反复冻融。冻融循环会导致肽链聚集或析出，从而影响后续定量结果。容器密封性与湿度控制同样是稳定性研究中反复强调的因素。
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。
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.
Tirzepatide is a synthetic peptide that acts as a dual agonist at the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. The molecule contains 39 amino acids and features a C20 fatty diacid moiety attached via a linker, which promotes albumin binding and extends its circulating half-life. Its sequence incorporates non-natural amino acids and modifications that reduce susceptibility to degradation by dipeptidyl peptidase-4. This dual receptor activity distinguishes it from selective GLP-1 receptor agonists.
=== Treatment research === The sugar cyclodextrin (CD) removed cholesterol that had built up in the arteries of mice fed a high-fat diet. CD is absorbed into the mouse bloodstream. It increases the production of oxysterols in macrophages and plaques, which causes the activation of LXR in macrophages. This, in turn, causes the macrophages to be more capable of cholesterol efflux and makes them more anti-inflammatory.
Oxidative phosphorylation ADP/ATP translocase (ANT) imports adenosine diphosphate ADP from the cytosol and exports ATP from the mitochondrial matrix, which are key transport steps for oxidative phosphorylation in eukaryotic organisms. ADP from the cytosol is transported back into the mitochondrion for ATP synthesis and the synthesised ATP, produced from oxidative phosphorylation, is exported out of the mitochondrion for use in the cytosol, providing the cells with its main energy currency.
== Clinical development == The precursor molecule to BOLD-100, KP1339 was tested in a Phase 1 monotherapy clinical trial in heavily pretreated patients with advanced cancers. In this dose escalation study, KP1339 was administered to 46 patients with doses ranging from 20 mg/m2 to 780 mg/m2. KP1339 was well tolerated, with the treatment-emergent adverse events occurring in >20% of patients being nausea, fatigue, vomiting, anaemia and dehydration. These adverse events were mainly grade 2 or lower. In the 38 efficacy-evaluable patients, nine patients achieved stable disease and 1 patient had a durable partial response. 625 mg/m2 was determined to be the recommended Phase 2 dose. BOLD-100 is being tested in a Phase 1b/2a clinical trial in combination with the chemotherapy regimen FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin) for the treatment of gastrointestinal cancers, including gastric, pancreatic, colon and bile duct cancer. This trial includes a dose escalation phase followed by a cohort expansion with 117 patients enrolled. Interim data presented at ASCO GI in January 2024 showed that BOLD-100 + FOLFOX was active and well-tolerated treatment in a heavily pre-treated Stage IV mCRC study population with 36 patients. Progression Free Survival, Overall Survival, and Objective Response Rate demonstrate significant clinical benefit and improvement over the currently available therapies, with minimal treatment emergent neuropathy or significant toxicities.
=== The molecular clock and the units of time === Typically, a branch length of a phylogenetic tree is expressed as the expected number of substitutions per site; if the evolutionary model indicates that each site within an ancestral sequence will typically experience x substitutions by the time it evolves to a particular descendant's sequence then the ancestor and descendant are considered to be separated by branch length x. Sometimes a branch length is measured in terms of geological years. For example, a fossil record may make it possible to determine the number of years between an ancestral species and a descendant species. Because some species evolve at faster rates than others, these two measures of branch length are not always in direct proportion. The expected number of substitutions per site per year is often indicated with the Greek letter mu (μ). A model is said to have a strict molecular clock if the expected number of substitutions per year μ is constant regardless of which species' evolution is being examined. An important implication of a strict molecular clock is that the number of expected substitutions between an ancestral species and any of its present-day descendants must be independent of which descendant species is examined. Note that the assumption of a strict molecular clock is often unrealistic, especially across long periods of evolution. For example, even though rodents are genetically very similar to primates, they have undergone a much higher number of substitutions in the estimated time since divergence in some regions of the genome.
Sources: en.wikipedia.org
Cereulide 2-methyl-5-HT Alpha-Methyltryptamine Bufotenin Chlorophenylbiguanide Ibogaine Phenylbiguanide Quipazine RS-56812 – Potent and selective 5-HT3 partial agonist, 1000× selectivity over other serotonin receptors SR-57227 Varenicline YM-31636 S 21007 (SAR c.f. CGS-12066A)
Hypertension, including hypertensive crises have been reported. QT interval prolongation and torsades de pointes have been reported. Thrombotic microangiopathy has been reported. Thrombotic thrombocytopenic purpura has been reported. Haemolytic uremic syndrome has been reported. Haematologic parameter alterations have been reported in 31–37% of patients. Events of cardiac dysfunction (decreased left ventricular ejection fraction and congestive heart failure) have been observed. Fatal haemorrhage, arterial and venous thrombotic events and perforations in the gastrointestinal tract have been observed in randomized clinical trials.
In many histological preparations of the submandibular gland, the serous acinar cells located in the hybrid seromucous acini are pushed out from between the mucous acinar cells, and appear as crescent-shaped demilunes located at the back of the acini. This fixation artifact can be avoided by rapid-freezing fixation.
A nuclear isomer is a metastable state of an atomic nucleus in which one or more nucleons (protons or neutrons) occupy excited state levels (higher energy levels). "Metastable" describes nuclei whose excited states have half-lives of 10−9 seconds or longer, 100 to 1000 times longer than the half-lives of the excited nuclear states that decay with a "prompt" half-life (ordinarily on the order of 10−12 seconds). Some references recommend using a threshold of 5×10−9 seconds to distinguish the metastable half-life from the normal "prompt" gamma-emission half-life. The half-lives of a number of isomers are far longer than this and may be minutes, hours, or years. The most extreme example known is the 180m73Ta nuclear isomer, which survives so long (at least 2.9×1017 years) that it has never been observed to decay spontaneously, and occurs naturally as a primordial nuclide, though uncommonly at only 1/8000 of all tantalum. The second most stable isomer is 210m83Bi, which does not occur naturally; its half-life is 3.04×106 years to alpha decay. The half-life of a nuclear isomer can exceed that of the ground state of the same nuclide, as with the two above, as well as, for example, 186m75Re, 192m277Ir, 212m84Po, 242m95Am and multiple holmium isomers.
== Adverse effects == The most common adverse effect of metformin is gastrointestinal irritation, including diarrhea, cramps, nausea, vomiting, and increased flatulence. Metformin is more commonly associated with gastrointestinal adverse effects than most other antidiabetic medications. The most serious potential adverse effect of metformin is lactic acidosis; this complication is rare, and seems to be related to impaired liver or kidney function. Metformin is not approved for use in those with severe kidney disease, but may still be used at lower doses in those with kidney problems.
Sources: en.wikipedia.org
=== Use in BLAST === BLOSUM matrices are also used as a scoring matrix when comparing DNA sequences or protein sequences to judge the quality of the alignment. This form of scoring system is utilized by a wide range of alignment software including BLAST.
=== 2018 === In April 2018, RTL started broadcasting its own UHD channel in Germany. First available at Astra 19.2°E, the Channel shows UHD productions, Formula 1, Football and Deutschland sucht den Superstar. Satellite operator SES broadcast an 8K television signal via its satellite system for the first time in May 2018. The 8K demonstration content, with a resolution of 7680 × 4320 pixels, a frame rate of 60 fps, and 10 bpc color depth, was encoded in HEVC and transmitted at a rate of 80 Mbit/s via the Astra 3B satellite during SES's Industry Days conference in Luxembourg. In June 2018, fuboTV broadcast the 2018 FIFA World Cup live in 4K and HDR10 becoming the first OTT streaming service to do so. Quarter, Semi and Final matches were available on many popular streaming devices including Apple TV, Chromecast Ultra, Fire TV, Roku and Android TVs. Content was streamed at 60 frames per second using HLS and DASH. Video was sent in fragmented MP4 containers delivering HEVC encoded video. On December 1, 2018, NHK launched BS8K, a broadcast channel transmitting at 8K resolution.
==== MeSH D12.125.166 – amino acids, sulfur ==== MeSH D12.125.166.175 – cystathionine MeSH D12.125.166.215 – cysteic acid MeSH D12.125.166.230 – cysteine MeSH D12.125.166.230.259 – acetylcysteine MeSH D12.125.166.230.310 – carbocysteine MeSH D12.125.166.230.330 – cysteinyldopa MeSH D12.125.166.230.369 – cystine MeSH D12.125.166.230.700 – selenocysteine MeSH D12.125.166.388 – ethionine MeSH D12.125.166.498 – homocysteine MeSH D12.125.166.498.050 – s-adenosylhomocysteine MeSH D12.125.166.554 – homocystine MeSH D12.125.166.676 – methionine MeSH D12.125.166.676.180 – s-adenosylmethionine MeSH D12.125.166.676.450 – n-formylmethionine MeSH D12.125.166.676.450.440 – n-formylmethionine leucyl-phenylalanine MeSH D12.125.166.676.620 – methionine sulfoximine MeSH D12.125.166.676.620.125 – buthionine sulfoximine MeSH D12.125.166.676.900 – selenomethionine MeSH D12.125.166.676.950 – vitamin u MeSH D12.125.166.786 – penicillamine MeSH D12.125.166.786.500 – s-nitroso-n-acetylpenicillamine MeSH D12.125.166.800 – thiopronine MeSH D12.125.166.893 – thiorphan
==== Triglyceride ==== In this process, green coffee beans are soaked in a hot water and coffee solution to draw the caffeine to the surface of the beans. Next, the beans are transferred to another container and immersed in coffee oils that were obtained from spent coffee grounds and left to soak. After several hours of high temperatures, the triglycerides in the oils remove the caffeine, but not the flavor elements, from the beans. The beans are separated from the oils and dried. The caffeine is removed from the oils, which are reused to decaffeinate another batch of beans. This is a direct-contact method of decaffeination.
== Structure and reactivity == Of the halobenzoquinones, DCBQ is the most commonly detected in drinking waters, up to 275 ng/L, and in chlorinated swimming pools, up to 299 ng/L. DCBQ can undergo hydrolysis, and its main hydrolysis product is DCBQ-OH. The transformation of DCBQ is much quicker in cell tissues than in water. The half-life of DCBQ is ~7h in water compared to ~1h in cell cultures, and is thus more reactive in cell tissues. In the human body, DCBQs can produce reactive oxidative species (ROS) at certain doses, causing mitochondrial dysfunction by reducing the mitochondrial membrane potential, and could promote the mitochondrial apoptosis pathway. DCBQ causes oxidative stress. DCBQ induced a concentration-dependent decrease in cell viability. It has also been found that DCBQ might cause nuclear DNA damage.
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.
It binds and activates both the GIP and GLP-1 receptors, making it a dual incretin receptor agonist. Single-receptor GLP-1 agonists act on one target only. The dual profile is the defining pharmacological feature of the molecule.