Everything below concerns dual agonist. We keep the language plain, cite what the science says, and separate well-supported claims from open questions.
Updated 2025-08-03. Numbers and descriptions here follow the published literature rather than marketing material.
Tirzepatide 是一种由 39 个氨基酸组成的合成肽，分子结构上以 GIP 序列为骨架并引入脂肪酸侧链修饰，使其能够同时与葡萄糖依赖性促胰岛素多肽（GIP）受体和胰高血糖素样肽-1（GLP-1）受体结合。这种双重激动特性使它在同类肽类药物中区别于选择性 GLP-1 受体激动剂。该分子最早由一家制药公司在 2010 年代报道，随后进入糖尿病与体重管理领域的临床研究。
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。
Structural work on the molecule centers on a C20 fatty diacid moiety attached through a linker to the peptide backbone. This side chain promotes reversible binding to serum albumin, which slows renal clearance and supports a prolonged action profile. The peptide backbone incorporates aminoisobutyric acid substitutions that limit recognition by digestive enzymes. Together these modifications produce a molecule that is stable enough for subcutaneous delivery but still dependent on careful manufacturing control. Analytical characterization of the active pharmaceutical ingredient typically follows the conventions used for other synthetic peptides.
Tirzepatide is a synthetic peptide composed of 39 amino acids. It acts as a dual agonist at two incretin receptors, the glucose-dependent insulinotropic polypeptide receptor and the glucagon-like peptide-1 receptor. The molecule was designed by modifying the native sequence of glucose-dependent insulinotropic polypeptide to improve metabolic stability and extend its circulation time. Its structure includes several non-natural amino acid residues and a fatty acid side chain. These features distinguish it from earlier single-receptor incretin analogs studied in the same period.
The compound first appeared in the scientific literature as an investigational agent for type 2 diabetes. Clinical development proceeded through phase 1, phase 2, and phase 3 programs that measured glycemic control as a primary endpoint while recording body weight as a secondary outcome. Regulatory approval in the United States followed in 2022 for glycemic control, and a separate indication for chronic weight management was added later. Subsequent trials have examined cardiovascular outcomes in adults with elevated cardiovascular risk. Debates continue over how much of the observed effect derives from each receptor arm.
| 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 |
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.
An extended fatty diacid moiety promotes binding to serum albumin, which slows renal clearance and extends the circulating half-life to roughly five days. That property supports once-weekly administration and largely explains the dosing interval described in clinical reports. Published data come mainly from large randomised programmes that evaluated glycaemic control and body weight over periods of many months. Long-term outcomes beyond those trial windows, including what happens after treatment stops, remain an active area of investigation.
Tirzepatide is a synthetic peptide built from thirty-nine amino acids. Its sequence is derived from native glucose-dependent insulinotropic polypeptide, or GIP, with several non-natural residues and a fatty diacid side chain attached through a linker. The molecule behaves as a dual agonist at two incretin receptors, GIP and GLP-1, instead of targeting a single receptor. This dual engagement separates it from earlier single-receptor incretin compounds and underpins most of its reported pharmacological activity.
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.
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.
=== Box office === Dredd earned $27.6 million from markets outside of North America and $13.4 million from North America, for a total of $41 million. In the UK, Dredd grossed £1.05 million ($1.7 million) from 415 cinemas during its opening weekend. This made it the weekend's number-one film, the first film restricted to audiences over 18 years of age to do so since Saw 3D in 2010. In its second weekend, the film placed number five, earning £769,381. Dredd was primarily shown in 3D in the UK, and 2D screenings were notoriously limited as the distributor denied cinemas' requests for 2D prints; the decision was considered to have limited the film's audience where 2D was their preferred format. Dredd earned a total of $6.9 million in the UK. In North America, pre-release tracking estimated that the film would gross between $8 and $10 million during its opening weekend based on its adult rating and the poor reputation of the 1995 adaptation. The film earned $2.2 million on its opening day and finished the weekend in sixth place, grossing $6.3 million from 2,506 cinemas—an average of $2,514 per cinema. The largest demographic of the opening weekend audience was over the age of 25 (69%) and male (75%). The film's North American run ended on 1 November 2012, after 42 days. Outside of the UK and North America, Dredd had its most successful total gross takings in China ($4.5 million), Russia ($4 million), and Australia ($2 million). Urban criticised the film's marketing campaign, saying that the film had "zero audience awareness. Nobody knew the movie was being released.
The ELISA template, commonly used for performing immunoassays and other enzyme-based biochemical assays, has been adapted for use with the DMF platform for the detection of analytes such as IgE and IgG. In one example, a series of bioassays were conducted to establish the quantification capabilities of DMF devices, including an ELISA-based immunoassay for the detection of IgE. Superparamagnetic nanoparticles were immobilized with anti-IgE antibodies and fluorescently labeled aptamers to quantify IgE using an ELISA template. Similarly, for the detection of IgG, IgG can be immobilized onto a DMF chip, conjugated with horseradish-peroxidase (HRP)-labeled IgG, and then quantified through measurement of the color change associated with product formation of the reaction between HRP and tetramethylbenzidine. To further expand the capabilities and applications of DMF immunoassays beyond colorimetric detection (i.e., ELISA, magnetic bead-based assays), electrochemical detection tools (e.g., microelectrodes) have been incorporated into DMF chips for the detection of analytes such as TSH and rubella virus. For example, Rackus et al. integrated microelectrodes onto a DMF chip surface and substituted a previously reported chemiluminescent IgG immunoassay with an electroactive species, enabling detection of rubella virus. They coated magnetic beads with rubella virus, anti-rubella IgG, and anti-human IgG coupled with alkaline phosphatase, which in turn catalyzed an electron transfer reaction that was detected by the on-chip microelectrodes.
== See also == Attack rate Basic reproduction number Flatten the curve List of COVID-19 simulation models Mathematical modelling in epidemiology Modifiable areal unit problem Next-generation matrix Risk assessment
25 October – 485 people affiliated with the environmental group Bream Bay Guardians build sand sculptures to protest against a fast-tracked sand mining proposal in Bream Bay. 26 October: Police arrest an 18-year old Dunedin man in relation to a bomb threat against the Wellington Islamic Centre in Kilbirnie. Health NZ confirms a measles case at Wellington Girls' College. Four staff and 60 students are identified as possible contacts of the patient. 27 October: Two new measles cases are reported in Wellington, bringing the total number of cases to 10. One case were linked to international travel while seven were linked to a "high-risk exposure event" on a Bluebridge ferry on 3 October. Health NZ identifies several hundred close contacts at Wellington College. Waatea News reports that Te Pāti Māori members had voted to recommend the suspension of MP Mariameno Kapa-Kingi and that the Te Tai Tokerau electorate executive be "reset" at a meeting on 23 October. The New Zealand Government contributes NZ$150,000 to mayoral relief funds in Southland and Clutha District to assist with post-windstorm damage. Chinese citizens transiting through New Zealand become eligible for the New Zealand Electronic Travel Authority (NZETA). 28 October: The Labour Party unveils its capital gains tax policy to fund doctors' visits. Education Minister Erica Stanford releases the Government's full draft curriculum for Years 0–10 students for consultation. A power outage at a waste treatment plant in Warkworth contaminates oyster farms in the Mahurangi River.
== Z == Z-drugs A class of non-benzodiazepine medications (e.g., zolpidem, zaleplon, eszopiclone) used to treat insomnia. They act as GABA_A receptor agonists and influence sleep architecture. Zellweger syndrome A rare congenital disorder caused by peroxisomal dysfunction, affecting brain development, myelination, and motor function. Symptoms include hypotonia, seizures, and impaired neuronal migration. Zona incerta A small region of gray matter in the subthalamus involved in sensorimotor integration, attention, and limbic functions. Its precise role remains under investigation. Zygosity The genetic relationship between alleles. In neuroscience research, zygosity is important in twin studies exploring heritability of traits like intelligence, brain volume, and psychiatric disorders.
Sources: en.wikipedia.org
=== tif-tik === tifacogin (INN) tifemoxone (INN) tifenamil (INN) tifencillin (INN) tiflamizole (INN) tiflorex (INN) tifluadom (INN) tiflucarbine (INN) tiformin (INN) tifurac (INN) tifuvirtide (INN) Tigan tigapotide (USAN) tigatuzumab (USAN) tigecycline (USAN) tigemonam (INN) tigestol (INN) tigloidine (INN) Tiject-20 Tikosyn
=== Names === Methylephedrine is the generic name of the drug and its BANTooltip British Approved Name. In the case of the hydrochloride salt, its generic name is methylephedrine hydrochloride and this is its BANMTooltip British Approved Name. Brand names of methylephedrine include Metheph, Methy-F, and Tybraine, among others.
== Pharmacodynamics == In addition to its oxytocin receptor agonism, oxytocin has been found to act as a positive allosteric modulator (PAM) of the μ- and κ-opioid receptors and this may be involved in its analgesic effects.
immortalization The natural or artificial changing of a cell population with a normally finite lifespan into one with a hypothetically infinite lifespan, capable of dividing indefinitely without cellular senescence as long as essential nutrients are available and conditions are conducive for cell division. Cells that undergo such a change are said to be immortalized. Mutations that cause immortalization occur naturally in the neoplasms that cause cancer but can also be induced artificially, which makes it possible to culture certain cell lines in vitro for prolonged periods. Immortalized cell lines are thus broadly useful for experimental purposes and in many biotechnology applications. Immortalized eukaryotic cells are commonly obtained by isolating them from a naturally occurring neoplasm (as with the human HeLa cell line), or may be generated from normal cells by introducing viral genes (as with HEK 293 cells), by artificially overexpressing proteins required for immortality such as telomerase, or by fusing normal cells with cancer cells (as in the hybridoma technologies used in the commercial production of antibodies). Though stem cells are also capable of continuous self-renewal and are thus technically 'immortal', their immortalization is not abnormal because they are an ordinary part of the development of multicellular organisms.
Sources: en.wikipedia.org
Most analyzers directly measure the average size of red blood cells, which is called the mean cell volume (MCV), and calculate the hematocrit by multiplying the red blood cell count by the MCV. Some measure the hematocrit by comparing the total volume of red blood cells to the volume of blood sampled, and derive the MCV from the hematocrit and red blood cell count. The hemoglobin concentration, the red blood cell count and the hematocrit are used to calculate the average amount of hemoglobin within each red blood cell, the mean corpuscular hemoglobin (MCH); and its concentration, the mean corpuscular hemoglobin concentration (MCHC). Another calculation, the red blood cell distribution width (RDW), is derived from the standard deviation of the mean cell volume and reflects variation in cellular size.
=== Alkylation of carboxylic acids and their salts === Trimethyloxonium tetrafluoroborate can be used for esterification of carboxylic acids under conditions where acid-catalyzed reactions are infeasible:
=== PVA/PAMPS hydrogel === In 2020, developers combined a bacterial cellulose nanofiber network with a poly(vinyl alcohol) (PVA) - poly(2-acrylamido-2-methyl-1-propanesulfonic acid sodium salt) (PAMPS) double network hydrogel. The artificial cartilage displayed the same strength and modulus as natural cartilage in terms of tension and compression, and was the first lab-created option to exhibit cartilage-equivalent tensile fatigue strength. The hydrogel needs to undergo further lab testing before researchers determine if it can be moved to clinical use. PVA hydrogels prepared by several freezing-thawing, without an externally added crosslinking agent, have also exhibited great promises in terms of biocompatibility, wear resistance, shock absorption, friction coefficient, flexibility, and lubrication (due to uptake/excretion of body fluid). A two-year implantation of the PVA gels as artificial meniscus in rabbits showed that they remain intact without degradation, fracture, or loss of properties.
Étude basée en partie sur les spécimens recueillis par la Calypso". Annales de l'Institut Océanographique. 45: 233–254. Vink DL, von Cosel R (1985). "The Conus cedonulli complex: Historical review, taxonomy and biological observations". Revue suisse de Zoologie. 92: 525–603. doi:10.5962/bhl.part.81894.
Both trials enrolled participants 18 to 75 years old with moderate to severe glabellar lines. Participants received a single intramuscular injection of daxibotulinumtoxinA or placebo at five sites within the muscles between the eyebrows. The most common side effects of daxibotulinumtoxinA are headache, drooping eyelids, and weakness of facial muscles. LetibotulinumtoxinA (Letybo) was approved for medical use in the United States in February 2024. It is indicated to temporarily improve the appearance of moderate-to-severe glabellar lines. The FDA approved letibotulinumtoxinA based on evidence from three clinical trials (BLESS I [NCT02677298], BLESS II [NCT02677805], and BLESS III [NCT03985982]) of 1,271 participants with moderate to severe wrinkles between the eyebrows for efficacy and safety assessment. These trials were conducted at 31 sites in the United States and the European Union. All three trials enrolled participants 18 to 75 years old with moderate to severe glabellar lines (wrinkles between the eyebrows). Participants received a single intramuscular injection of letibotulinumtoxinA or placebo at five sites within the muscles between the eyebrows. The most common side effects of letibotulinumtoxinA are headache, drooping of eyelid and brow, and twitching of eyelid.
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 activates both the glucose-dependent insulinotropic polypeptide receptor and the glucagon-like peptide-1 receptor. This dual activity separates it from agents that act on only one of the two receptors. The relative contribution of each receptor to clinical effects remains an open area of study.