This is a working overview of dual agonist, written for readers who want more than a one-paragraph summary but less than a textbook.
Reviewed 2026-01-16. Anything still debated is marked as such rather than presented as settled.
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。
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。
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.
| 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 |
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.
At the receptor level, the compound binds both GIP and GLP-1 receptors and triggers downstream signalling that raises cyclic AMP in target cells. GLP-1 receptor activation is associated with glucose-dependent insulin release, slower gastric emptying, and reduced appetite signalling. GIP receptor activation contributes effects that are less completely characterised, and how much each receptor adds to the overall clinical response is still an open question. The two pathways appear to interact in a complementary rather than a purely additive way.
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.
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.
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 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.
=== Other uses === PVDF is used for specialty monofilament fishing lines, sold as fluorocarbon replacements for nylon monofilament. The surface is harder, so it is more resistant to abrasion and sharp fish teeth. Its refractive index is lower than nylon, which makes the line less discernible to fish eyes. It is also denser than nylon, making it sink faster towards fish. PVDF is used for specialty roofing coatings to improve UV resistance and increase roof color retention.
==== Officer of the Order of the British Empire (OBE) ==== Military Commander Trefor Morgan Fox, Royal Navy, C037045S. Commander Christopher Robert Hollingworth, Royal Navy, C041543F. Colonel Andrew Glenn David Lock, Royal Marines, N029023U. Commander Lucy Jane Ottley, Royal Navy, V030919T. Commander Ian Hayden Richardson, Royal Navy, C038366T. Commander Jamie Duncan Wells, Royal Navy, C039514F. Captain Allan Thomas Youp, Royal Navy, C038889U. Lieutenant Colonel Nicholas Paul Andrew, Royal Regiment of Artillery, 537949. Lieutenant Colonel Tracy-Louise Appleyard, Royal Army Medical Corps, 540495. Colonel Edward Hugh James Carter, 532335. Lieutenant Colonel Ewan Christian Noble Harris, The Royal Welsh, 545550. Lieutenant Colonel Timothy Matthew Holmes, Corps of Royal Electrical and Mechanical Engineers, 546527. Colonel Matthew Gordon Timothy Lewis, 554319. Lieutenant Colonel (now Acting Colonel) John Andrew Lyons, Royal Corps of Signals, 549561. Lieutenant Colonel Craig David Pope, Royal Army Medical Corps, 549180. Colonel Nigel Offley Crewe-Read, , 545207. Colonel Thomas Woolley, 551152. Colonel Nicholas George Charles Yardley, 544447. Wing Commander Erica Jane Ferguson, Royal Air Force, 2629012K. Wing Commander Matthew Elfed Lewis, Royal Air Force, 5208143G. Wing Commander Stephen McCleery, Royal Air Force, 2635078L. Wing Commander Alison Morton, Royal Air Force, W996632T. Air Commodore Patrick James Shea-Simonds, Royal Air Force, 5208323H. Group Captain Paul Andrew Weaver Smith, Royal Air Force, 8024057B.
== External links == Canadian Society for medical Laboratory Science U.S. Department of Labor information on clinical laboratory technologists and technicians American Association for Clinical Chemistry American Society of Clinical Pathology American Society of Clinical Laboratory Science National Credentialing Agency for laboratory personnel National Accrediting Agency for Clinical Laboratory Science Medical Technologist Continuing Education AIMS: Australian Institute of Medical Scientists New Zealand Institute of Medical Laboratory Science Greek Association of Medical Laboratory Technologists Clinical laboratory scientists at work
To avoid epimerization through the O-acylisourea intermediate formed when using a carbodiimide reagent, an amidinium- or phosphonium-reagent can be employed These reagents have two parts: an electrophilic moiety which deoxygenates the carboxylic acid (blue) and masked nucleophilic moiety (red). Nucleophilic attack of the carboxylic acid on the electrophilic amidinium or phosphonium moiety leads to a short lived intermediate which is rapidly trapped by the unmasked nucleophile to form the activated ester intermediate and either a urea or phosphoramide by-product. These cationic reagents have non-coordinating counteranions such as a hexafluorophosphate or a tetrafluoroborate. The identity of this anion is typically indicated by the first letter in the reagent's acronym, although the nomenclature can be inconsistent. For example HBTU is a hexafluorophosphate salt while TBTU is a tetrafluoroborate salt. In addition to HBTU and HATU other common reagents include HCTU (6-ClHOBt), TCFH (chloride) and COMU (ethyl cyano(hydroxyimino)acetate). Amidinium reagents incorporating hydroxybenzotriazole moieties can exist in an N-form (guanadinium) or an O-form (uronium), but the N-form is generally more stable. Phosphonium reagents include BOP (HOBt), PyBOP (HOBt) and PyAOP (HOAt). Although these reagents can lead to the same activated ester intermediates as a carbodiimide reagent, the rate of activation is higher due to the high electrophilicity of these cationic reagents.
These are made especially problematic due to the chemical solvents' ability to extract far greater amounts of the potentially toxic compounds than water. In the context of these concerns, the World Health Organization advises against the consumption of ethanolic and acetonic kavalactone extracts, and says that "products should be developed from water-based suspensions of kava". The government of Australia prohibits the sales of such kavalactone extracts, and only permits the sale of kava products in their natural form or produced with cold water.
Sources: en.wikipedia.org
Peukert wrote that the popular claim, made after the war, that the Nazi regime stayed in power only because of terror was incorrect. Peukert wrote though terror played a role in sustaining the Nazi regime, the majority of victims of the violence of that the German state inflicted in the Nazi era tended to be people considered to be "outsiders" in Germany like Jews, the Romany, "Marxists", the mentally ill, the disabled, homosexuals, Jehovah's Witnesses, and the "asocial", and that for the most part, the state in the Nazi era left ordinary Germans alone to live their lives as they pleased. Peukert wrote with the "popular experience" of most Germans in the Nazi era, there were no clear-cut "villains and victims" with the American historian David Crew writing that Peukert had presented "a complex, morally disturbing picture" of ordinary people adjusting to what Peukert called "the multiple ambiguities of ordinary people". Peukert wrote that most ordinary Germans lived in a "grey zone" choosing support, accommodation and nonconformity at various times, never totally supporting the Nazi regime, but willing to accommodate themselves to the regime provided it served their own self-interests.
A number of Singaporean writers such as Tan Swie Hian and Kuo Pao Kun have contributed work in more than one language. Singapore has a diverse music culture that ranges from pop and rock, to folk and classical. Western classical music plays a significant role in the cultural life in Singapore, with the Singapore Symphony Orchestra (SSO) instituted in 1979. Other notable western orchestras in Singapore include Singapore National Youth Orchestra and the community-based Braddell Heights Symphony Orchestra. Many orchestras and ensembles are also found in secondary schools and junior colleges. Various communities have their own distinct ethnic musical traditions: Chinese, Malays, Indians, and Eurasians. With their traditional forms of music and various modern musical styles, the fusion of different forms account for the musical diversity in the country. The nation's lively urban musical scene has made it a centre for international performances and festivals in the region. Some of Singapore's best known pop singers include Stefanie Sun, JJ Lin, Liang Wern Fook, Taufik Batisah and Dick Lee, who is famous for composing National Day theme songs, including Home.
== Security == A wallet may have known and unknown vulnerabilities. A supply chain attack or side-channel attack are ways of introducing vulnerabilities. In extreme cases a computer which is not connected to any network can be hacked. To mitigate the risk of crypto wallet hacking, one can choose for a cold wallet, which remains offline and disconnected from the internet. A cold wallet refers to a physical device, such as a pen drive, that is utilized as a secure storage medium for transferring money from a hot wallet. Cold wallets have also been hacked. In late July 2026, cold wallet manufacturer Coinkite disclosed that a bug in software used on its devices allowed hackers to access cold wallets. This hack has lead to losses of approximately $130 million as of early August 2026.
The Catholic Encyclopaedia stated that no definitive cases are known to have occurred before the thirteenth century. In his paper Hospitality and Pain, Christian theologian Ivan Illich states: "Compassion with Christ ... is faith so strong and so deeply incarnate that it leads to the individual embodiment of the contemplated pain." His thesis is that stigmata result from exceptional poignancy of religious faith and desire to associate oneself with the suffering Messiah. Differently from the Five Holy Wounds of Christ, some mystics like Francis of Assisi and father Pio of Petralcina reported a spontaneous regression and closure of their stigmata in the days following their death. Both of them claimed to have received the divine stigmata in their hands as well as in their feet.
Alpha-synuclein has been shown to interact with Dopamine transporter, Parkin (ligase), Phospholipase D1, SNCAIP, Tau protein. Beta amyloid Synuclein Contursi Terme - the village in Italy where a mutation in the α-synuclein gene led to a family history of Parkinson's disease Anti-α-synuclein drug Media related to Alpha-synuclein at Wikimedia Commons alpha-Synuclein at the U.S. National Library of Medicine Medical Subject Headings (MeSH) Human SNCA genome location and SNCA gene details page in the UCSC Genome Browser.
Sources: en.wikipedia.org
=== Sentinel-node identification === The radioactive properties of 99mTc can be used to identify the predominant lymph nodes draining a cancer, such as breast cancer or melanoma. This is usually performed at the time of biopsy or resection.99mTc-labelled filtered sulfur colloid or Technetium (99mTc) tilmanocept are injected intradermally around the intended biopsy site. The general location of the sentinel node is determined with the use of a handheld scanner with a gamma-sensor probe that detects the technetium-99m–labeled tracer that was previously injected around the biopsy site. An injection of Methylene blue or isosulfan blue is done at the same time to dye any draining nodes visibly blue. An incision is then made over the area of highest radionuclide accumulation, and the sentinel node is identified within the incision by inspection; the isosulfan blue dye will usually stain any lymph nodes blue that are draining from the area around the tumor.
Fisher formulate a zinc insulin mixture at Connaught Laboratories in Toronto and license it to Novo 1936 Hagedorn discovers that adding protamine to insulin prolongs the duration of action of insulin 1946 Nordisk formulates Isophane porcine insulin aka Neutral Protamine Hagedorn or NPH insulin 1946 Nordisk crystallizes a protamine and insulin mixture 1950 Nordisk markets NPH insulin 1953 Novo formulates Lente porcine and bovine insulins by adding zinc for longer lasting insulin 1955 Frederick Sanger determines the amino acid sequence of insulin 1965 Synthesized by total synthesis by Wang Yinglai, Chen-Lu Tsou, et al. 1969 Dorothy Crowfoot Hodgkin characterizes and describes the crystal structure of insulin by X-ray crystallography 1973 Purified monocomponent (MC) insulin is introduced 1973 The US officially "standardized" insulin sold for human use in the US to U-100 (100 units per milliliter). Prior to that, insulin was sold in different strengths, including U-80 (80 units per milliliter) and U-40 formulations (40 units per milliliter), so the effort to "standardize" the potency aimed to reduce dosage errors and ease doctors' job of prescribing insulin for people. Other countries also followed suit.
== Discovery == The presence of the nuclear membrane that sequesters the cellular DNA is the defining feature of eukaryotic cells. The nuclear membrane, therefore, separates the nuclear processes of DNA replication and RNA transcription from the cytoplasmic process of protein production. Proteins required in the nucleus must be directed there by some mechanism. The first direct experimental examination of the ability of nuclear proteins to accumulate in the nucleus was carried out by John Gurdon when he showed that purified nuclear proteins accumulate in the nucleus of frog (Xenopus) oocytes after being micro-injected into the cytoplasm. These experiments were part of a series that subsequently led to studies of nuclear reprogramming, directly relevant to stem cell research. The presence of several million pore complexes in the oocyte nuclear membrane and the fact that they appeared to admit many different molecules (insulin, bovine serum albumin, gold nanoparticles) led to the view that the pores are open channels and nuclear proteins freely enter the nucleus through the pore and must accumulate by binding to DNA or some other nuclear component. In other words, there was thought to be no specific transport mechanism. This view was shown to be incorrect by Dingwall and Laskey in 1982. Using a protein called nucleoplasmin, the archetypal ‘molecular chaperone’, they identified a domain in the protein that acts as a signal for nuclear entry.
=== Food additives === Potassium sodium tartrate (KNaC4H4O6, Rochelle salt) is a main constituent of some varieties of baking powder; it is also used in the silvering of mirrors. Potassium bromate (KBrO3) is a strong oxidizer (E924), used to improve dough strength and rise height. Potassium bisulfite (KHSO3) is used as a food preservative, for example in wine and beer-making (but not in meats). It is also used to bleach textiles and straw, and in the tanning of leathers.
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.