Everything below concerns Incretin. We keep the language plain, cite what the science says, and separate well-supported claims from open questions.
Updated 2026-03-28. Numbers and descriptions here follow the published literature rather than marketing material.
当前公开资料把 tirzepatide 归为肠促胰素类受体双重激动剂。它并非激素天然变体，而是经过序列改造的工程化肽。其分子量、等电点与疏水性等基础参数已在药典和化学数据库中收录，可作为分析检测和质量研究的参照。
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。
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 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.
| 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 |
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.
Verification of research-grade material involves checking purity, sequence and counter-ion content against a certificate of analysis. Reported purity figures usually reflect chromatographic area percentage and do not by themselves establish biological activity. Independent laboratories may repeat mass confirmation and peptide mapping to detect substitutions or truncations. Open questions concern how residual solvents, trace metals and subtle conformational variants affect measured behavior, and how consistently different suppliers define their specifications. Documentation of analytical methods matters as much as the headline purity number when results are compared across studies.
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.
Bulk peptide material is normally characterised by reversed-phase high-performance liquid chromatography, which separates the target sequence from truncation products and other closely related impurities. Ultraviolet detection near 214 nanometres is common because the peptide backbone absorbs in that region. Mass spectrometry, usually electrospray ionisation coupled to a mass analyser, is used to confirm the molecular mass. Because the molecule carries a lipophilic side chain, gradient methods often need a relatively high organic modifier fraction to elute it within a practical retention window.
Like most synthetic peptides of this size, the material is commonly supplied as a lyophilised powder that appears white to off-white. It dissolves in aqueous buffers and in mixtures of water with a small proportion of organic solvent, though the fatty acid portion reduces solubility in pure water relative to short peptides. Hygroscopic behaviour is reported for many peptide powders, so weighing is usually performed quickly and under controlled humidity. Working solutions are typically prepared fresh and kept cold.
Long-term storage of lyophilised peptide powder is generally at minus twenty degrees Celsius or colder, with desiccant and protection from light. Short-term storage at two to eight degrees Celsius is common during active use. In solution, stability depends strongly on pH, concentration, and the presence of preservatives, and hydrolysis or aggregation can develop over weeks. Published stability data specific to this molecule are limited, so recommended conditions for research material are usually extrapolated from general peptide handling practice rather than from a dedicated study.
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.
Tirzepatide is a synthetic peptide that activates both the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. This dual agonist profile distinguishes it from earlier incretin-based compounds that act on a single receptor. The molecule was engineered from the native GIP sequence and carries several non-natural residues that slow enzymatic breakdown. Researchers designed it to combine the insulinotropic effects of GIP signaling with the appetite and gastric-emptying effects associated with GLP-1 activation.
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=== Pharmacokinetics === The half-life of melarsoprol is less than one hour, but bioassays indicate a 35-hour half-life. This is commonly associated with pharmacologic agents that have active metabolites. One such metabolite, melarsen oxide, reaches maximum plasma levels about 15 minutes after melarsoprol injection. Melarsoprol clearance is 21.5 ml/min/kg and the half-life of melarsen oxide is approximately 3.9 hours.
Mescaline acts as an agonist of the serotonin 5-HT2A receptor to produce its psychedelic effects. Its EC50Tooltip half-maximal effective concentration at the serotonin 5-HT2A receptor is approximately 10,000 nM and at the serotonin 5-HT2B receptor is greater than 20,000 nM. How activating the 5-HT2A receptor leads to psychedelic effects is still unknown, but it is likely that somehow it involves excitation of neurons in the prefrontal cortex. In addition to the serotonin 5-HT2A and 5-HT2B receptors, mescaline is also known to bind to the serotonin 5-HT2C receptor and a number of other targets. The drug shows pronounced biased agonism at the serotonin 5-HT2C receptor. Mescaline lacks affinity for the monoamine transporters, including the serotonin transporter (SERT), norepinephrine transporter (NET), and dopamine transporter (DAT) (Ki > 30,000 nM). However, it has been found to increase levels of the major serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) at high doses in rodents. This finding suggests that mescaline might inhibit the reuptake and/or induce the release of serotonin at such doses. In any case, this possibility has not yet been further assessed or demonstrated. Besides serotonin, mescaline might also weakly induce the release of dopamine, but this is probably of modest significance, if it occurs. In accordance, there is no evidence of the drug showing addiction or dependence. Mescaline appears to be inactive in terms of norepinephrine release induction and indirect sympathomimetic activity.
Sources: en.wikipedia.org
The Constituent Assembly of India chose the official language of India's federal government in September 1949 after three years of debate between two opposing camps. Hindi language protagonists wanted Hindi in the Devanagari script to be the sole "national language" of India whereas delegates from South India preferred English to have a place in the Constitution. The compromise reached declared (i) Hindi to be the "official language" of India's federal government; (ii) English to be an associate official language for 15 years during which Hindi's formal lexicon would be developed; and (iii) the international form of Hindu–Arabic numerals to be the official numerals. The compromise resolution became articles 343–351 of India's constitution, which came into effect on 26 January 1950. In 1965, after bitter opposition from South India to Hindi becoming the sole official language, a compromise was reached whereby English would continue to be an "associate official language" indefinitely. The Eighth Schedule of India's Constitution also recognises 22 languages, including Hindi but not English, which the government must develop. These are sometimes called "scheduled languages". This list includes major regional languages, but also others—such as Sanskrit, which no longer has first language speakers in India, and Urdu, which is not region-specific—because of their value to India's cultural heritage. In 1950, there were 14 scheduled languages: Assamese, Bengali, Gujarati, Hindi, Kannada, Kashmiri, Malayalam, Marathi, Oriya, Punjabi, Sanskrit, Tamil, Telugu and Urdu.
===== Lung ===== In 2019, a method for printing alveoli was developed in which 2D slices of photosensitive hydrogel are successively cured to form a 3D structure of the alveoli. This produces a soft material that is able to easily expand and contract, while also maintaining biocompatibility. The level of curing for the hydrogel is controlled using additive food coloring which absorbs light and increases the curing at that location. This allows the curing to be directed to better form 3D shapes. This method was able to form functional and vascularized alveoli. In 2021, this technique was improved by using an inkjet printing method, which increased the accuracy and precision of alveolar structure. With this ink-jet method, researchers were able to create functional portions of alveolar tissue with increased stability and surfactant secretion.
== Enzymes that use NADP(H) as a substrate == In 2018 and 2019, the first two reports of enzymes that catalyze the removal of the 2' phosphate of NADP(H) in eukaryotes emerged. First the cytoplasmic protein MESH1 (Q8N4P3), then the mitochondrial protein nocturnin were reported. Of note, the structures and NADPH binding of MESH1 (5VXA) and nocturnin (6NF0) are not related.
The tenets of Sikhism do not advocate a particular stance on either vegetarianism or the consumption of meat, but leave the decision of diet to the individual. The tenth guru, Guru Gobind Singh, however, prohibited "Amritdhari" Sikhs, or those that follow the Sikh Rehat Maryada (the Official Sikh Code of Conduct) from eating Kutha meat, or meat which has been obtained from animals which have been killed in a ritualistic way. This is understood to have been for the political reason of maintaining independence from the then-new Muslim hegemony, as Muslims largely adhere to the ritualistic halal diet. "Amritdharis" that belong to some Sikh sects (e.g. Akhand Kirtani Jatha, Damdami Taksal, Namdhari and Rarionwalay, etc.) are vehemently against the consumption of meat and eggs (though they do consume and encourage the consumption of milk, butter and cheese). This vegetarian stance has been traced back to the times of the British Raj, with the advent of many new Vaishnava converts. In response to the varying views on diet throughout the Sikh population, Sikh Gurus have sought to clarify the Sikh view on diet, stressing their preference only for simplicity of diet. Guru Nanak said that over-consumption of food (Lobh, Greed) involves a drain on the Earth's resources and thus on life. Passages from the Guru Granth Sahib (the holy book of Sikhs, also known as the Adi Granth) say that it is "foolish" to argue for the superiority of animal life, because though all life is related, only human life carries more importance: "Only fools argue whether to eat meat or not.
Sources: en.wikipedia.org
The management of modafinil overdose involves supportive care, monitoring of vital signs, and treatment of specific complications. In cases of recent consumption, activated charcoal, gastric lavage (stomach pumping), or hemodialysis (blood filtering) may be used. There is no specific antidote for modafinil overdose. The main way to deal with modafinil overdose is supportive care, which includes sedating the patient and stabilizing their blood pressure, and muscle activity in case of manifestations such as agitation or tremor.
=== 23 March === Eleven people were killed in an RSF drone strike on the Radwan Mosque in Hilat Kuko in East Nile area of Khartoum. Eight people were killed by RSF shelling in El Fasher, while three others were killed by RSF shelling in Omdurman. Eighteen people were killed following three days of RSF attacks on villages in Gezira State northwest of Wad Madani. The RSF claimed to have taken Lagawa in West Kordofan.
== General overview == Pathologists' assistants work under the indirect or direct supervision of a board certified anatomical pathologist, who ultimately renders a diagnosis based on the PA's detailed gross examination and/or tissue submission for microscopic evaluation. Requirements to become a certified pathologists' assistant include graduation from a National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) accredited education program and successfully passing the American Society for Clinical Pathology (ASCP) certification exam, which is not legally required to perform gross examinations in most states. Some states such as West Virginia, Nevada, and New York require a license for pathologists' assistants. All pathologists' assistants are allied health workers who need to be CLIA 88 compliant to perform these high complexity tasks with indirect/direct supervision of a pathologist. With ongoing changes in health care, a growing population of retiring pathologists, and a decreasing number of pathology residents, well trained PAs are in high demand due to their extensive level of training and contribution to the overall efficiency of the pathology laboratory. In addition to the major responsibilities outlined above, a pathologists' assistant may also perform the following tasks (for a complete list, refer to AAPA Scope of Practice):
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 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.