The short version of GIP receptor fits in a sentence. The long version — which is the one that helps — is below.
Reviewed 2025-12-31. Anything still debated is marked as such rather than presented as settled.
在生理层面，GIP 与 GLP-1 均为肠道内分泌细胞分泌的肠促胰素，进食后参与胰岛素分泌调节与胃排空抑制。Tirzepatide 通过同时激活这两条信号通路，使胰岛素分泌的葡萄糖依赖性增强，并延缓冲胃排空、降低食欲信号。与单一 GLP-1 激动相比，双靶点作用在血糖控制和体重变化上的效应幅度更大，但具体贡献比例仍在研究之中。
脂肪酸侧链的存在使该肽与血浆白蛋白结合能力增强，从而延长循环半衰期，支持每周一次给药的用药间隔。白蛋白结合同时改变组织分布特征，减慢肾脏清除速度。该设计思路在多种长效肽类药物中被反复采用，属于既定的药代动力学策略。
Receptor activation by tirzepatide raises intracellular cyclic AMP through Gs-coupled signalling at both targets. At the GLP-1 receptor the downstream effect includes glucose-dependent insulin release, suppressed glucagon secretion, delayed gastric emptying, and reduced appetite signalling in the hypothalamus. GIP receptor engagement adds insulinotropic activity and appears to influence lipid handling in adipose tissue. Because both receptors are stimulated at the same time, the pharmacological profile differs from that of selective GLP-1 receptor agonists, and the relative contribution of each arm remains an area of active investigation.
Clinical development proceeded through large phase 3 programmes in type 2 diabetes and in obesity or overweight with at least one weight-related comorbidity. Regulatory approvals followed in several jurisdictions for both indications. Weekly subcutaneous dosing reflects an elimination half-life of roughly five days. Open questions include the durability of metabolic effects after treatment stops, long-term cardiovascular and hepatic outcomes beyond completed trials, and whether the dual mechanism confers benefits independent of total receptor occupancy. Published literature continues to expand on these points. Substantial uncertainty remains about interindividual variability in response.
Tirzepatide is a synthetic linear peptide of 39 amino acids that acts as a dual agonist at the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. Its sequence derives from native GIP but incorporates non-natural residues and a C20 fatty diacid moiety linked to a lysine side chain. The lipophilic chain promotes albumin binding, which slows renal clearance and extends circulation time. The unmodified peptide has a molecular formula of C225H348N48O68 and a molecular mass near 4,813 daltons.
| Property | Value | Notes |
|---|---|---|
| 分子类型 | 合成修饰肽 | 39 个氨基酸，含脂肪酸侧链 |
| 受体靶点 | GIP 与 GLP-1 受体 | 双重激动剂 |
| 分子量 | 约 4.8 kDa | 以游离肽计 |
| 外观 | 白色至类白色粉末 | 冻干形态常见 |
| 溶解性 | 可溶于水及水性缓冲液 | 溶解后宜低温保存 |
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.
The GIP receptor is expressed in pancreatic islets, adipose tissue, and the central nervous system, while GLP-1 receptors are found in pancreatic islets, the gastrointestinal tract, and the brain. Activation of both receptors can enhance glucose-dependent insulin secretion and reduce glucagon release. The relative contribution of each receptor to the overall pharmacological effect remains an area of ongoing investigation. Preclinical studies suggest that GIP receptor agonism may modulate appetite and energy balance, but the precise mechanisms in humans are not fully established.
Reported outcomes in large trials include dose-dependent weight reduction and improvements in glycemic markers over periods ranging from several months to more than a year. Whether the compound alters long-term cardiovascular or renal outcomes is being examined in dedicated outcome studies, so those questions remain open. Labeling describes gastrointestinal effects such as nausea and diarrhea, which tend to appear during dose escalation. Discontinuation rates and the durability of effects after treatment stops vary across study populations and are still debated.
Tirzepatide is a synthetic peptide developed as a dual agonist at the glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors. Its structure is built on a GIP-derived backbone with non-natural amino acid substitutions and a fatty diacid side chain that promotes albumin binding and slows clearance. That modification supports once-weekly subcutaneous dosing. Registrational trial programs reported reductions in body weight and glycated hemoglobin alongside the drug's glycemic effects.
Common degradation routes include hydrolysis of labile amide bonds, deamidation of asparagine and glutamine residues, oxidation of methionine and tryptophan, and non-covalent aggregation. Aggregates can form during freeze-thaw cycling, at elevated pH, or when peptide concentration is high. Each route produces characteristic chromatographic or mass shifts that are tracked during stability studies. Whether a given minor impurity alters biological activity is often an open question, and specification limits are typically set on identity and purity rather than on functional data for trace species.
Lyophilized material is generally held at -20 degrees Celsius or lower, desiccated and protected from light, where it remains stable for extended periods. Reconstituted or ready-to-use solution is usually kept at 2 to 8 degrees Celsius with minimal agitation. Repeated freeze-thaw cycles should be avoided because they promote aggregation and reduce the soluble monomer fraction. Shipment of frozen solid commonly uses dry ice, while refrigerated liquid moves with validated cold packs. Stability beyond documented periods is not established.
Characterization of the peptide relies on reversed-phase high-performance liquid chromatography for purity and related-substance profiling, with ultraviolet detection near 214 nanometers. Mass spectrometry confirms molecular mass and reveals modifications such as oxidation or deamidation. Peptide mapping after enzymatic digestion verifies the amino acid sequence, while amino acid analysis supplies compositional data. Circular dichroism and infrared spectroscopy are used to assess secondary structure, particularly the alpha-helical content that influences aggregation behavior in solution.
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.
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.
== Function == Fyn is a protein, present in the signaling pathway of integrins, which activates ras. Fyn is a tyrosine-specific phospho-transferase that is a member of the Src family of non-receptor tyrosine protein kinases. (This family also includes Abl, Src, focal adhesion kinase and Janus kinase.) Fyn is located downstream of several cell surface receptors, commonly associated with neuronal development and T-cell signaling. When fyn is activated it causes downstream activation of molecular signals that drive processes crucial to growth and motility of cells. Fyn is primarily localized to the cytoplasmic leaflet of the plasma membrane, where it phosphorylates tyrosine residues on key targets involved in a variety of different signaling pathways. Tyrosine phosphorylation of target proteins by Fyn serves to either regulate target protein activity, and/or to generate a binding site on the target protein that recruits other signaling molecules. Fyn also is a tumor suppressor. When this normal biology is compromised, the altered Fyn becomes involved in the neoplastic transformation of normal cells to cancerous ones following the pathway from pre-invasive, to invasive, and ultimately metastasis. Fyn also appears to play an important role in fertilization including in the rapid Inositol trisphosphate-mediated calcium signaling which occurs when oocyte and sperm interact. Fyn expression levels are much higher in oocytes than even neurons and T-cells and it has been suggested to be an 'oocyte-specific kinase'.
Radium is a chemical element; it has symbol Ra and atomic number 88. It is the sixth element in group 2 of the periodic table, also known as the alkaline earth metals. Pure radium is silvery-white, but it readily reacts with nitrogen (rather than oxygen) upon exposure to air, forming a black surface layer of radium nitride (Ra3N2). All isotopes of radium are radioactive, the most stable isotope being radium-226 with a half-life of 1,600 years. When radium decays, it emits ionizing radiation as a by-product, which can excite fluorescent chemicals and cause radioluminescence. For this property, it was widely used in self-luminous paints following its discovery. Of the radioactive elements that occur in quantity, radium is considered particularly toxic, and it is carcinogenic due to the radioactivity of both it and its immediate decay product radon as well as its tendency to accumulate in the bones. Radium, in the form of radium chloride, was discovered by Marie and Pierre Curie in 1898 from ore mined at Jáchymov. They extracted the radium compound from uraninite and published the discovery at the French Academy of Sciences five days later. Radium was isolated in its metallic state by Marie Curie and André-Louis Debierne through the electrolysis of radium chloride in 1910, and soon afterwards the metal started being produced on larger scales in Austria, the United States, and Belgium.
Stimulants (also called a central nervous system stimulant, psychostimulant, or colloquially an upper) are a class of psychoactive drugs that increase alertness. They are used for various purposes, such as enhancing attention, motivation, cognition, mood, and physical activity. Some stimulants occur in nature while others are synthetic. Common stimulants include caffeine, nicotine, cocaine, amphetamine, methamphetamine, methylphenidate, and modafinil. Some stimulants are subject to governmental regulation or prohibition because they can have adverse side effects including addiction, drug tolerance, drug withdrawal, psychosis, anxiety, insomnia, cardiovascular disease, and neurotoxicity. The misuse or abuse of stimulants can have serious adverse health and social consequences, such as overdose, substance dependence, crime, and violent behavior. Stimulants increase activity in the sympathetic nervous system. They often increase synaptic concentrations of excitatory neurotransmitters, particularly norepinephrine and dopamine. Other stimulants work by binding to the receptors of excitatory neurotransmitters (e.g., nicotine) or by blocking the activity of endogenous agents that promote sleep (e.g., caffeine). Stimulants can affect various functions, including arousal, attention, the reward system, learning, memory, and emotion. Effects range from mild stimulation to euphoria, depending on the specific drug, dose, route of administration, and inter-individual characteristics. Stimulants have a long history of use, both for medical and non-medical purposes.
George Szirtes (born 29 November 1948); poet and translator; opposes Boycott, Divestment and Sanctions movement and was a signatory to the Euston Manifesto; was judge for the 2017 Griffin Poetry Prize; has won a variety of prizes for his work, most recently the 2004 T. S. Eliot Prize, for his collection Reel, and the Bess Hokin Prize in 2008 for poems in Poetry magazine. His translations from Hungarian poetry, fiction and drama have also won numerous awards; has received an Honorary Fellowship from Goldsmiths College, University of London Arthur Waley (born Arthur David Schloss, 19 August 1889 – 27 June 1966); produced works on Theravada Tripiṭaka Sutta Piṭaka and Abhidhamma Piṭaka texts, as well as developing translations of works by Chuang Tzu, Lao Tzu, and writing his own perspectives and contemplations on the key Mahayana wisdom scriptures. Amongst his honours were the CBE in 1952, the Queen's Gold Medal for Poetry in 1953, and he was invested as a Companion of Honour in 1956. Humbert Wolfe, poet and civil servant
Sources: en.wikipedia.org
== Use in antibody-drug conjugates == A new antibody-drug conjugate (ADC) technology based on α-amanitin has shown activity in therapy-resistant tumor cells, e.g. cells expressing multi-drug resistant transporters, tumor-initiating cells and non-dividing cells at picomolar concentrations. The unique mode of action of α-amanitin seems to make the amanitin-based ADCs a suitable toxic payload. This toxin has a water-soluble structure, resulting in ADCs with low tendency for aggregation. Significant clinical advances occurred in 2025 and 2026 with Heidelberg Pharma’s lead candidate HDP-101 (pamlectabart tismanitin), a BCMA-targeted amanitin-based antibody-drug conjugate (ATAC) for relapsed or refractory multiple myeloma. In the ongoing Phase I/IIa trial (NCT04879043), dose escalation proceeded safely up to 218 µg/kg without reaching a maximum tolerated dose, and the recommended Phase IIa dose was selected in April 2026. The program received FDA Fast Track designation in October 2025. In the higher-dose cohorts (90–140 µg/kg), overall response rates reached 38–57 %, with several heavily pretreated patients, including those who had failed prior BCMA-directed therapies, achieving stringent complete remissions lasting more than one year. The safety profile remained favorable, with mostly mild-to-moderate and manageable adverse events and no clinically relevant hepatotoxicity, ocular toxicity, or renal impairment.
=== Lipids === An indication of the role of high-density lipoprotein (HDL) on atherosclerosis has been with the rare Apo-A1 Milano human genetic variant of this HDL protein. A small short-term trial using bacterial-synthesized human Apo-A1 Milano HDL in people with unstable angina produced a fairly dramatic reduction in measured coronary plaque volume in only six weeks vs. the usual increase in plaque volume in those randomized to placebo. The trial was published in JAMA in early 2006. Ongoing work starting in the 1990s may lead to human clinical trials—probably by about 2008. These may use synthesized Apo-A1 Milano HDL directly, or they may use gene-transfer methods to pass the ability to synthesize the Apo-A1 Milano HDLipoprotein. Methods to increase HDL particle concentrations, which in some animal studies largely reverse and remove atheromas, are being developed and researched. However, increasing HDL by any means is not necessarily helpful. For example, the drug torcetrapib is the most effective agent currently known for raising HDL (by up to 60%). However, in clinical trials, it also raised deaths by 60%. All studies regarding this drug were halted in December 2006. The actions of macrophages drive atherosclerotic plaque progression. Immunomodulation of atherosclerosis is the term for techniques that modulate immune system function to suppress this macrophage action.
=== Persian period === In 537–520 BCE, Zerubbabel became Yehud's governor and started work on the Second Temple, which was stopped. In 520–516 BCE, Haggai and Zechariah goaded the Judahites to resume work on the Temple. Upon completion, Joshua became its high priest. In 458–433 BCE, Ezra and Nehemiah led another group of Judahites to Yehud, with Artaxerxes's permission. Nehemiah rebuilt the temple after some unspecified disaster and removed foreign influence from the Judahite community. That said, some Judahites elected to stay in Persia, where they almost faced annihilation. This period is covered by the entirety of the Book of Ezra, Book of Nehemiah, the Book of Esther, the Book of Haggai, the Book of Zechariah, and the Book of Malachi.
Infliximab has adverse effects, some life-threatening, common to drugs in the class of TNF-inhibiting immunosuppressants (which also includes etanercept (Enbrel) and adalimumab (Humira)). Some of the most severe are:
Simon Khung, a social media influencer who eventually stopped taking drugs after the 2020 murder of his daughter Megan Khung (who was allegedly killed by her mother), told a newspaper in 2024 that he supported the death penalty for drug trafficking, as he felt that the drug situation in Singapore would grow worse in the absence of capital punishment and more people would become drug abusers and ruin their lives like he and the former abusers had in their pasts; Khung's stance was supported by other ex-abusers, and one of them, Bruce Mathieu (who overcame his drug addiction seven years prior), said that the death penalty had deterred him from resorting to drug smuggling. In the aftermath of several executions, there were discussions among the Singaporean public about the need for compassion for some death row inmates, owing to arguments that many death row inmates had come from low-income families or had drug addictions before ending up on death row. However, the public sentiments remained leaning towards capital punishment for drugs, owing to arguments concerning rampant rates of drug trafficking in the Golden Triangle in Southeast Asia, the effectiveness of the death penalty in maintaining Singapore's low crime rate, and the impact drugs have had on the addicts and their families. When 31-year-old Singaporean Shen Hanjie was sentenced to death for trafficking 34.94g of pure heroin in October 2022, a huge majority of the netizens showed support for the death sentence in Shen's case, with some expressing sympathy for his family, especially his parents.
Sources: en.wikipedia.org
All boards of certification now require that medical practitioners demonstrate, by examination, continuing mastery of the core knowledge and skills for a chosen specialty. Recertification varies by particular specialty between every seven and every ten years. In the United States there are hierarchies of medical specialties in the cities of a region. Small towns and cities have primary care, middle sized cities offer secondary care, and metropolitan cities have tertiary care. Income, size of population, population demographics, distance to the doctor, all influence the numbers and kinds of specialists and physicians located in a city.
In organic chemistry, thioesters are organosulfur compounds with the molecular structure R−C(=O)−S−R'. They are analogous to carboxylate esters (R−C(=O)−O−R') with the sulfur in the thioester replacing oxygen in the carboxylate ester, as implied by the thio- prefix. They are the product of esterification of a carboxylic acid (R−C(=O)−O−H) with a thiol (R'−S−H). In biochemistry, the best-known thioesters are derivatives of coenzyme A, e.g., acetyl-CoA. The R and R' represent organyl groups, or H in the case of R.
Retrolental tract: Extends posteriorly from the hyaloideocapsular ligament into central vitreous Coronary tract: External to the retrolental tract, and excluding posteriorly from a circular zone overlying the posterior 1/3rd of the ciliary processes Median tract: Extends back from a circular zone external to the coronary tract, at the anterior margin of the vitreous base Preretinal tract: Extends back from the ora serrata and vitreous base
=== Symbolic uses === The signs of the Western and Chinese zodiacs are based on animals. In China and Japan, the butterfly has been seen as the personification of a person's soul, and in classical representation the butterfly is also the symbol of the soul.
246Cm(12C,xn)258−xNo (4,5) This reaction was studied in 1958 by scientists at the LBNL using a 5% 246Cm curium target. They were able to measure 7.43 MeV decays from250Fm, associated with a 3 s 254No parent activity, resulting from the 4n channel. The 3 s activity was later reassigned to 252No, resulting from reaction with the predominant 244Cm component in the target. It could however not be proved that it was not due to the contaminant250mFm, unknown at the time. Later work in 1959 produced 8.3 MeV alpha particles with a half-life of 3 s and a 30% SF branch. This was initially assigned to 254No and later reassigned to 252No, resulting from reaction with the 244Cm component in the target. The reaction was restudied in 1967 and activities assigned to 254No and 253No were detected.
Sources: en.wikipedia.org
它属于合成修饰肽，同时激动 GIP 与 GLP-1 两种肠促胰素受体。这类分子通常被称为双重肠促胰素受体激动剂，与选择性 GLP-1 激动剂在靶点范围上不同。
分子上的脂肪酸侧链使其与血浆白蛋白结合增强，显著延长循环半衰期。半衰期延长后，稳定血药浓度可在较长的给药间隔内维持，因此常见用法为每周一次。
同时激活两条肠促胰素通路可能在胰岛素分泌、胃排空和食欲调节上产生叠加效应。与单靶点相比，临床研究中观察到的血糖与体重变化幅度通常更明显，但各通路的具体贡献比例尚无定论。
It is a dual GIP and GLP-1 receptor agonist, frequently grouped with incretin-based peptide therapeutics. It is a peptide rather than a small molecule and is given by subcutaneous injection.