Everything below concerns GLP-1 receptor agonist. We keep the language plain, cite what the science says, and separate well-supported claims from open questions.
Updated 2025-10-03. Numbers and descriptions here follow the published literature rather than marketing material.
The primary target is the GLP-1 receptor, a class B G protein-coupled receptor expressed on pancreatic beta cells, in the gut, and in several brain regions. Receptor activation raises intracellular cyclic AMP, which potentiates glucose-dependent insulin secretion and lowers glucagon release when blood glucose is elevated. Signalling in the hypothalamus and brainstem is associated with reduced appetite and slower gastric emptying. Because the insulinotropic effect depends on prevailing glucose levels, the hypoglycaemic risk of the peptide alone is described as low in most study settings. The relative contribution of peripheral and central actions remains an active research question.
Large randomised trials in adults with type 2 diabetes and in adults with obesity have reported reductions in body weight and improvements in several cardiovascular risk markers. One outcome trial found a lower incidence of major adverse cardiovascular events in participants with diabetes and established cardiovascular disease. Gastrointestinal effects such as nausea and vomiting are the most frequently reported adverse events and often diminish over time. Changes in lean body mass during weight loss are an area of ongoing investigation. Effects in adolescents and in pregnancy are less well characterised, and current labelling advises against use during pregnancy.
序列层面的改动同时解决了两个问题，即酶解稳定性与肾脏清除速度。天然 GLP-1 在循环中的半衰期仅约两分钟，主要被二肽基肽酶-4 迅速灭活。酰化侧链与白蛋白的可逆结合形成循环储库，使分子缓慢释放并持续激活受体。这种设计思路后来被广泛用于同类长效肽的开发，属于该类药物化学改造的典型范式。
Semaglutide 是一种经结构修饰的胰高血糖素样肽-1 类似物，其主链与内源性 GLP-1(7-36) 约有百分之九十四的序列一致性。第 8 位丙氨酸被 α-氨基异丁酸取代，使二肽基肽酶-4 无法识别原有切割位点。第 34 位赖氨酸换为精氨酸，进一步降低酶解速率。第 26 位赖氨酸经间隔基连接一条含十八个碳的二酸脂肪链，该侧链赋予分子与血浆白蛋白结合的能力。
| Property | Value | Notes |
|---|---|---|
| Molecular class | Acylated GLP-1 receptor agonist | 31-residue synthetic peptide |
| Molecular formula | C187H291N45O59 | established for the free peptide |
| Appearance | White to off-white powder | as supplied before formulation |
| Solubility | Freely soluble in water | aqueous buffers near neutral pH |
| Typical storage | 2 to 8 degrees Celsius, protected from light | powder and solution forms differ in shelf life |
Pharmacological activity arises from agonism at the glucagon-like peptide-1 receptor, a G protein-coupled receptor expressed in the pancreas, the gastrointestinal tract, and the brainstem. Receptor activation raises intracellular cyclic adenosine monophosphate and enhances insulin release in a glucose-dependent manner, an effect that diminishes when blood glucose concentration is low. Other effects include slowed gastric emptying and hypothalamic satiety signalling. These pathways are described well. Receptor desensitisation rates across tissues, relative to the endogenous hormone, are still under investigation, and reported findings differ between laboratories.
The company that developed the compound filed it as a long-acting analogue, and it gained first approval in 2017 for type 2 diabetes. Later authorisations from several regulators extended the indication to chronic weight management, and the World Health Organization added the glucagon-like peptide-1 receptor agonist drug class to its model list of essential medicines in 2023. Production uses solid-phase peptide synthesis followed by side-chain conjugation and chromatographic purification. Supply constraints and cost differences across regions are well documented. Literature on long-term outcomes continues to grow, with many trials reporting surrogate endpoints rather than hard clinical endpoints.
Semaglutide is a synthetic peptide of thirty-one amino acids that shares roughly ninety-four percent sequence identity with human glucagon-like peptide-1. Two substitutions resist enzymatic cleavage by dipeptidyl peptidase-4, and a fatty diacid side chain attached through a linker promotes binding to serum albumin. That albumin binding slows renal clearance and extends the circulating half-life from minutes to approximately one week. The structural changes are well established in the published literature. Whether the same modifications affect receptor signalling bias in ways that matter clinically remains an open question.
Lyophilized semaglutide is typically stored at temperatures between minus 20 and minus 80 degrees Celsius for long-term preservation. Short-term storage at 2 to 8 degrees Celsius is common for working aliquots. Repeated freeze-thaw cycles can degrade the peptide and are usually avoided. The molecule is hygroscopic in its solid form, so containers should remain sealed with desiccant. Solutions are less stable than powders and are generally prepared fresh. Light exposure is limited because aromatic residues can undergo photo-oxidation.
Semaglutide dissolves readily in water and in aqueous buffers near neutral pH. Solubility decreases near the isoelectric point, where net charge is minimal. Common laboratory solvents include phosphate-buffered saline and dilute ammonium bicarbonate. Strongly acidic or basic conditions may accelerate hydrolysis. Working concentrations are usually prepared by diluting a concentrated stock. Vial surfaces can adsorb small amounts of peptide at low concentrations, so carrier proteins or low-binding tubes are sometimes used.
Reverse-phase high-performance liquid chromatography is the standard method for purity assessment, separating the peptide from truncated or oxidized variants. Mass spectrometry confirms molecular mass and detects modifications, while ultraviolet absorbance near 280 nanometers supports concentration measurement through tryptophan and tyrosine residues. Circular dichroism can indicate secondary structure, though the peptide is largely helical in solution, and ion-exchange chromatography resolves charge variants. Purity values above 95 percent are typical for research-grade material. Stability studies track degradation over time under defined conditions.
Three structural changes define the molecule. At position 8 an alpha-aminoisobutyric acid residue replaces alanine, which blocks dipeptidyl peptidase-4 cleavage. At position 34 arginine replaces lysine, and at position 26 a lysine carries a C18 fatty diacid attached through a short linker. The fatty chain binds serum albumin, and this albumin association reduces renal filtration and enzymatic attack. The unchanged backbone retains the receptor contacts that produce signalling. The free base has the formula C187H291N45O59 and a molecular weight near 4114 daltons.
Receptor activation follows the canonical Gs pathway: binding increases intracellular cyclic AMP, which promotes protein kinase A activity. In pancreatic beta cells this amplifies glucose-dependent insulin release, so secretion rises when blood glucose is high and changes little when it is low. The same signalling suppresses glucagon release from alpha cells and slows gastric emptying. Receptors in the hypothalamus and brainstem are thought to contribute to reduced appetite and lower energy intake. Which of these effects dominates clinical outcomes remains an area of active study.
Semaglutide is a synthetic peptide analogue of glucagon-like peptide-1, a gut hormone released by intestinal L cells after food intake. The natural hormone acts on pancreatic and central receptors but is degraded within minutes by dipeptidyl peptidase-4 and other peptidases. Semaglutide belongs to the class of long-acting GLP-1 receptor agonists, a group distinguished by structural changes that slow breakdown and extend circulation time. Its development followed earlier short-acting analogues and reflects a general strategy in peptide drug design: preserve receptor activity while blocking proteolytic clearance.
Willis Carrier moved his facilities from New Jersey to Syracuse, New York, in the 1930s. During the late 20th century, when it was acquired by UTC, it was Central New York State's largest manufacturer. Due to increasing labor and union costs in the Central New York area, Carrier has substantially downsized its presence in Syracuse, with manufacturing work being moved to a variety of domestic and international locations. Meanwhile, managerial employees were moved closer to UTC's corporate headquarters in Farmington, Connecticut, which represented a challenge to the local economy in Syracuse. Over the course of 2011, the majority of the manufacturing buildings of the Syracuse campus were demolished at a cost of nearly $14 million. Despite the loss of manufacturing jobs, the suburban Syracuse Campus, in DeWitt, New York, remained the primary engineering and design center for Carrier products, with over 1,000 employees and contractors on site. This site also houses the Customer Care Call Center for Carrier branded products. In 1980, Carrier was allowed to name the Carrier Dome, the football and basketball arena at Syracuse University, after Mel Holm, the company's then-CEO chair of the university's board of trustees, gave the university $2.75 million toward the facility's construction. Despite being named for an air conditioner manufacturer, the Carrier Dome was not air-conditioned for the first four decades of its lifespan, only having it installed during renovations that were completed in 2022.
=== Death === The Culture has a relatively relaxed attitude towards death. Genetic manipulation and the continual benevolent surveillance of the Minds make natural or accidental death almost unknown. Advanced technology allows citizens to make backup copies of their personalities, allowing them to be resurrected in case of death. The form of that resurrection can be specified by the citizen, with personalities returning either in the same biological form, in an artificial form (see below), or even just within virtual reality. Some citizens choose to go into "storage" (a form of suspended animation) for long periods of time, out of boredom or curiosity about the future. Attitudes individual citizens have towards death are varied (and have varied throughout the Culture's history). While many, if not most, citizens make some use of backup technology, many others do not, preferring instead to risk death without the possibility of recovery (for example when engaging in extreme sports). These citizens are sometimes called "disposables", and are described in Look to Windward. Taking into account such accidents, voluntary euthanasia for emotional reasons, or choices like sublimation (abandoning physical reality), the average lifespan of humans is said in Excession to be around 350 to 400 years. Some citizens choose to forgo death altogether, although this is rarely done and is viewed as an eccentricity.
This is why managing waste generated by ORs is crucial to minimizing overall biomedical waste production. To reduce waste and cost of disposal, recycling and properly labeling waste are imperative. Reusing and repurposing products like gowns and instruments also limit costs and waste. Moreover, streamlining surgical trays and packaging of instruments also promotes a reduction in waste production. Energy saving methods in areas like HVAC systems and anesthesia must also be implemented to promote a "greener" healthcare industry. The reason ORs generate such an abundance of waste is because of a lack of education of surgeons regarding every surgical procedures' contribution to the carbon footprint. When asked in a survey, in a global cohort consisting of 1,024 surgeons, only 63% indicated that they regarded sustainability as an issue they felt motivated to change. Moreover, only 7.7% of surgeons could estimate the carbon footprint of a surgery, and only 6.5% could estimate their surgical supplies' carbon footprint. This shows an evident knowledge gap surgeons have in regards to the negative environmental effects of surgery and the need to rectify this through education.
Sources: en.wikipedia.org
Alphaprodine was sold under several brand names, mainly Nisentil and Prisilidine. It was most commonly used for pain relief during childbirth and dentistry, as well as for some minor surgical procedures. Alphaprodine has a duration of action of 1 to 2 hours, and 40 to 60 mg is equivalent to 10 mg of subcutaneous morphine. Prodine has broadly similar effects to other opioids, producing analgesia, sedation and euphoria. Side effects can include excessive itching, nausea, vomiting and potentially serious respiratory depression which can lead to life-threatening respiratory arrest. Respiratory depression can be a problem with alphaprodine even at normal therapeutic doses. Unlike pethidine, prodine does not produce toxic metabolites and is therefore more suitable for high-dose therapy.
Nigel Shaun Scrutton (born 2 April 1964) is a British biochemist and biotechnology researcher known for his work on enzyme catalysis, biophysics and synthetic biology. He is Director of the UK Future Biomanufacturing Research Hub, Director of the Fine and Speciality Chemicals Synthetic Biology Research Centre (SYNBIOCHEM), and Co-founder, Director and Chief Scientific Officer of the 'chemicals-from-biology' company C3 Biotechnologies Ltd. He is Professor of Enzymology and Biophysical Chemistry in the Department of Chemistry at the University of Manchester. He is a former Director of the Manchester Institute of Biotechnology (MIB) (2010 to 2020).
Cancers are usually named using -carcinoma, -sarcoma or -blastoma as a suffix, with the Latin or Greek word for the organ or tissue of origin as the root. For example, the most common cancer of the liver parenchyma ("hepato-" = liver), arising from malignant epithelial cells ("carcinoma"), would be called a hepatocarcinoma, while a malignancy arising from primitive liver precursor cells is called a hepatoblastoma. Similarly, a cancer arising from malignant fat cells would be termed a liposarcoma. For some common cancers, the English organ name is used. For example, the most common type of breast cancer is called ductal carcinoma of the breast. Benign tumors (which are not cancers) are usually named using -oma as a suffix with the organ name as the root. For example, a benign tumor of smooth muscle cells is called a leiomyoma (the common name of this frequently occurring benign tumor in the uterus is fibroid). Confusingly, some types of cancer use the -noma suffix, examples including melanoma and seminoma. Some types of cancer are named for the size and shape of the cells under a microscope, such as giant cell carcinoma, spindle cell carcinoma, and small-cell carcinoma.
Myozyme costs an average of US$300,000 a year and must be taken for the patient's entire life, so some American health insurers have refused to pay for it. In August 2006, Health Canada approved Myozyme for the treatment of Pompe disease. In June 2007, the Canadian Common Drug Review issued its recommendations regarding public funding for Myozyme therapy. Their recommendation was to provide funding to treat a tiny subset of Pompe patients (Infants less one year of age with cardiomyopathy). In May 2010, the FDA approved Lumizyme for the treatment of late-onset Pompe disease. Lumizyme and Myozyme have the same generic ingredient (alglucosidase alfa) and manufacturer (Genzyme Corporation). The difference between these two products is in the manufacturing process. Myozyme is made using a 160-L bioreactor, while Lumizyme uses a 4000-L bioreactor. Because of the difference in the manufacturing process, the FDA claims that the two products are biologically different. Myozyme is FDA approved for replacement therapy for infantile-onset Pompe disease. In July 2021, the European Medicines Agency (EMA) recommended the authorization of avalglucosidase alfa. Avalglucosidase alfa (Nexviazyme) was approved for medical use in the United States in August 2021, and in the European Union in June 2022. In December 2022, the EMA recommended the authorization of cipaglucosidase alfa. The approval was given in June 2023. In the EU, the therapy is available to all age groups without restrictions on weight of patients.
Sources: en.wikipedia.org
== Function == Phosphorylation of a protein by GSK-3 usually inhibits the activity of its downstream target. GSK-3 is active in a number of central intracellular signaling pathways, including cellular proliferation, migration, glucose regulation, and apoptosis. GSK-3 was originally discovered in the context of its involvement in regulating glycogen synthase. After being primed by casein kinase 2 (CK2), glycogen synthase gets phosphorylated at a cluster of three C-terminal serine residues, reducing its activity. In addition to its role in regulating glycogen synthase, GSK-3 has been implicated in other aspects of glucose homeostasis, including the phosphorylation of insulin receptor IRS1 and of the gluconeogenic enzymes phosphoenolpyruvate carboxykinase and glucose 6 phosphatase. However, these interactions have not been confirmed, as these pathways can be inhibited without the up-regulation of GSK-3. GSK-3 has also been shown to regulate immune and migratory processes. GSK-3 participates in a number of signaling pathways in the innate immune response, including pro-inflammatory cytokine and interleukin production. The inactivation of GSK3B by various protein kinases also affects the adaptive immune response by inducing cytokine production and proliferation in naïve and memory CD4+ T cells.
British Post Office scandal: Secretary of State for Justice Alex Chalk tells Parliament the UK government is giving "serious consideration" to introducing legislation to quash the convictions of the 700 or so sub post masters who were prosecuted as a result of the Horizon IT scandal. Former Post Office chief executive Paula Vennells announces that she will hand back her CBE after more than a million people signed a petition calling for her to do so. Liberal Democrat leader Ed Davey, who was Post Office minister during the scandal, comes under pressure to return his knighthood. 10 January British Post Office scandal: Prime Minister Rishi Sunak announces that emergency legislation will be brought through Parliament to "swiftly exonerate and compensate victims" of the Post Office scandal in England and Wales. First Minister of Scotland Humza Yousaf confirms those in Scotland convicted because of the scandal will also be cleared, and that he will work with the UK government to bring this about. Baroness Heather Hallett, chair of the UK COVID-19 Inquiry, confirms the inquiry will postpone the start of hearing evidence about the development of a vaccine as more time is needed to prepare for a separate investigation into the impact of COVID-19 on the NHS. Consequently, the vaccine evidence, which was due to begin being heard in Summer 2024 may not begin until after the next general election. HS2 Ltd releases a revised forecast for building the London to Birmingham leg of the High Speed 2 rail link, which is now estimated to total £65bn.
Protection: an anatomical barrier from pathogens and damage between the internal and external environment in bodily defense. (See Skin absorption.) Langerhans cells in the skin are part of the adaptive immune system. Sensation: contains a variety of nerve endings that jump to heat and cold, touch, pressure, vibration, and tissue injury (see somatosensory system and haptic perception). Thermoregulation: Eccrine (sweat) glands and dilated blood vessels (increased superficial perfusion) aid heat loss, while constricted vessels greatly reduce cutaneous blood flow and conserve heat. Erector pili muscles in mammals adjust the angle of hair shafts to change the degree of insulation provided by hair or fur. Control of evaporation: the skin provides a relatively dry and semi-impermeable barrier to reduce fluid loss. Storage and synthesis: acts as a storage center for lipids and water Absorption through the skin: Oxygen, nitrogen and carbon dioxide can diffuse into the epidermis in small amounts; some animals use their skin as their sole respiration organ (in humans, the cells comprising the outermost 0.25–0.40 mm of the skin are "almost exclusively supplied by external oxygen", although the "contribution to total respiration is negligible") Some medications are absorbed through the skin. Water resistance: The skin acts as a water resistant barrier so essential nutrients aren't washed out of the body. The nutrients and oils that help hydrate the skin are covered by the most outer skin layer, the epidermis.
Sources: en.wikipedia.org
Native GLP-1 is degraded within minutes by dipeptidyl peptidase-4 and neutral endopeptidases. Semaglutide carries a non-natural amino acid at position eight that blocks that cleavage, and a fatty diacid side chain that binds albumin. The result is a much longer duration of action than the native hormone.
The fatty diacid chain associates strongly with serum albumin, which keeps the peptide in circulation and shields it from rapid renal clearance. Bound peptide is released gradually, producing a sustained receptor signal. This mechanism also reduces the peak-to-trough variation seen with shorter-acting analogues.
The balance between peripheral receptor activation and signalling in the central nervous system is not fully resolved. The extent to which slowed gastric emptying accounts for reduced energy intake, compared with direct effects on appetite circuits, is debated. Long-term effects on lean mass and on tissues outside the gut and brain are still under study.
差别集中在三处：第 8 位残基被非天然氨基酸取代，第 34 位换成精氨酸，第 26 位增加一条脂肪酸侧链。前两处改动降低酶解速率，侧链则通过白蛋白结合延长循环时间。综合结果是半衰期从约两分钟延长到约一周。