A practical reference on dual agonist: what it is, how it behaves, what the literature reports, and where the honest uncertainties sit.
This page was last updated on 2026-04-03 and is reviewed periodically as new material appears.
Both receptors are class B G protein-coupled receptors that signal largely through Gs-mediated cyclic AMP production. Activation within pancreatic islets increases glucose-dependent insulin secretion and suppresses glucagon release when glucose is elevated. Outside the pancreas, signaling in the central nervous system and gut appears to influence appetite and gastric emptying. The relative contribution of each receptor to observed clinical effects remains under investigation, and the two pathways are not simply additive in practice.
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.
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.
| Property | Value | Notes |
|---|---|---|
| Molecular class | Synthetic 39-residue peptide | GIP-derived backbone with non-natural residues |
| Molar mass | Approximately 4.8 kDa | Peptide chain plus linker and lipid modifications |
| Appearance | White to off-white powder | Typical of lyophilized research material |
| Solubility | Soluble in water and aqueous buffer | Practically insoluble in nonpolar solvents |
| Storage temperature | Typically −20 °C for dry powder | Solutions usually held at 2–8 °C short term |
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.
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。
该化合物的名称与结构由国际非专利名称体系统一维持，不同文献中出现的同义写法主要在拼写顺序或盐形式描述上不同。研究者通常通过受体结合实验、细胞内环磷酸腺苷积累测定以及动物模型来确认其双激动活性。相当一部分分子层面的细节——例如两条受体通路之间的信号交叉作用——尚处于开放问题状态。
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。
Clinical research programs have evaluated tirzepatide in adults with type 2 diabetes and in adults with obesity or excess weight. Trials generally reported reductions in glycated hemoglobin and body weight across treatment periods of several months. Since these studies enrolled defined populations under controlled conditions, the findings describe group averages rather than individual outcomes. Open questions include the durability of effects after treatment stops, variation among subgroups, and the long-term consequences of sustained dual receptor stimulation. Published trial summaries should be consulted for exact measurements rather than secondary accounts.
Tirzepatide is a synthetic peptide built from 39 amino acid residues. Its backbone derives from the native glucose-dependent insulinotropic polypeptide sequence, altered at several positions to resist enzymatic cleavage. A fatty diacid group attached through a linker extends plasma residence time by promoting reversible binding to serum albumin. The molecule carries a net negative charge near physiological pH and has a reported molecular weight close to 4813 daltons. These features separate it from shorter incretin analogs and account for its prolonged dosing interval.
Pharmacologically, tirzepatide activates two distinct G protein-coupled receptors: the glucose-dependent insulinotropic polypeptide receptor and the glucagon-like peptide-1 receptor. Binding at each target triggers cyclic AMP accumulation and downstream signaling in pancreatic beta cells, adipose tissue and the central nervous system. Because the two pathways overlap only partially, the combined effect on insulin secretion, glucagon suppression and appetite signaling differs from that of selective single-receptor compounds. Affinity is not equal across the two targets, and the clinical meaning of that imbalance remains an area of active study.
In the 1950s, shipping costs made up 33% of the price of oil transported from the Persian Gulf to the United States, but with the development of supertankers in the 1970s, the cost of shipping dropped to 5% of the price of Persian oil in the US. The share of the shipping cost on the final cost of the delivered commodity was less than 3% in 2010.
=== Queen's Police Medal (QPM) === England and Wales Anthony Richard Bayliss, Detective Superintendent, Warwickshire Constabulary. Frank Joseph Breen, Detective Constable, Thames Valley Police. Michael Briggs, Commander, Metropolitan Police. Eileen Margaret Eggington, Detective Chief Superintendent, Metropolitan Police. Christopher Fox, Assistant Chief Constable (designated), Warwickshire Constabulary. William Griffiths, Commander, Metropolitan Police. Gareth Jones, lately Detective Superintendent, North Wales Police. David Robertson Kenworthy, Assistant Chief Constable (designated), Avon and Somerset Constabulary. Paul Joseph Scott-Lee, Assistant Chief Constable (designated), Suffolk Constabulary. Roger John Manning, Chief Superintendent, Staffordshire Police. Graham Moore, Assistant Chief Constable (designated), Cambridgeshire Constabulary. Terence Raymond Nicholls, Constable, Metropolitan Police. Robin Edgar Norman Oake, Chief Constable, Isle of Man Constabulary. Peter John Picken, Superintendent (Divisional Commander), West Mercia Constabulary. Colin Potts, Chief Inspector (Divisional Commander), Greater Manchester Police. Gordon Michael Rogers, lately Chief Superintendent, Wiltshire Constabulary. Roger Edward Sandall, Chief Superintendent (Divisional Commander), Norfolk Constabulary. Richard Owen Thomas, Assistant Chief Constable (designated), Gwent Constabulary. Scotland Andrew Gibson Brown, Assistant Chief Constable, Lothian and Borders Police. John Orr, , Chief Constable, Strathclyde Police. William Rae, Chief Constable, Dumfries and Galloway Constabulary.
Spironolactone may be more effective than birth-control pills in the treatment of acne, and the combination of spironolactone with a birth-control pill may have greater effectiveness for acne than either alone. In addition, some clinical research has found that flutamide is more effective than spironolactone in the treatment of acne. In one study, flutamide decreased acne scores by 80% within 3 months, whereas spironolactone decreased symptoms by only 40% in the same period. However, the use of flutamide for acne is limited by its liver toxicity. Bicalutamide is a potential alternative to flutamide for acne as well. Spironolactone can be considered as a first-line treatment for acne in those who have failed other standard treatments such as topical therapies and under certain other circumstances, although this is controversial due to the side effects of spironolactone and its teratogenicity. Insufficient clinical evidence exists to compare the effectiveness of spironolactone with other antiandrogens for female-pattern hair loss. The effectiveness of spironolactone in the treatment of both acne and hirsutism appears to be dose-dependent, with higher doses being more effective than lower doses. Higher doses also have greater side effects, such as menstrual irregularities.
=== 7 May === Mikhail Razvozhayev, the Russian-installed governor of Crimea, claimed that Russian forces stopped a Ukrainian drone attack using air defence and electronic warfare, downing three of the drones without property damage or casualties.
== Origin and foundations == Dora Kunz, a theosophy promoter and one-time president (1975–1987) of the Theosophical Society in America, and Dolores Krieger, now Professor Emerita of Nursing Science, New York University, developed therapeutic touch in the 1970s. According to Krieger, therapeutic touch has roots in ancient healing practices, such as the laying on of hands, although it has no connection with religion or with faith healing. Krieger states that, "in the final analysis, it is the healee (client) who heals himself. The healer or therapist, in this view, acts as a human energy support system until the healee's own immunological system is robust enough to take over." Justification for TT has been sought in two fields: Martha E. Rogers' contemporal "Science of Unitary Human Beings", and quantum mechanics, in particular Fritjof Capra's mystical interpretation of the latter. A 2002 review found that neither justification was tenable: Rogers's theories were found to be inconsistent with the tenets of TT, while the overlap in terminology between the two could be ascribed to a lack of precision in Rogers's works, making them multi-interpretable. The quantum physics justification holds that the possibility to heal at a distance is made possible by a "global interconnectivity" of the universe, which TT adherents ascribe to an interpretation of Bell's theorem and the possibility of quantum nonlocality; this interpretation is not supported by experimental evidence.
Sources: en.wikipedia.org
== Structure == CGB is composed of 165 amino acids, and has a molecular weight of 17.739 kDa. On this polypeptide, there are 7 total sites of glycosylation, encompassing 28 total N-linked glycans at 2 sites and 15 total O-linked glycans at 5 sites. The sites of N-glycoslylation occur at Asn33 and Asn50. The sites of O-glycoslyation occur at Ser138, Ser141, Ser147, Ser152, and Ser158. There are also three sites of phosphorylation, occurring at Ser86, Ser116, and Thr117. There are six disulfide pairings, occurring at 9-57, 23-72, 26-110, 34-88, 38-90, and 93-100. Additionally, there are 10 known locations of mutation on the CGB polypeptide, occurring at amino acid positions 33, 35, 50, 52, 137, 138, 141, 147, 152, and 158. There is an alpha helix from amino acid positions 1-15, and a turn from positions 115-117. There are also beta sheets from positions 47-60, 67-69, 75-88, 99-112, and 118-121. The polypeptide of CGB is also unusually flexible when compared to other polypeptides of similar structure and function. Its level of glycosylation has also been referred to as an 'extreme concentration', with baseline Human Chorionic Gonadotropin (hCG) being 30% glycosylated by weight, up to the 42% glycosylation of the 'hyperglocysolated hCG' by weight. The whole hCG protein hormone is a heterodimer, with an alpha and a beta subunit. The alpha subunit is identical in the hCG protein hormone, the Luteinizing Hormone (LH), the Follicle Stimulating Hormone (FSH), and the Thyroid Stimulating Hormone (TSH).
16 August – Documents relating to the Andrew Malkinson case show that another man's DNA was identified by investigators in 2007, raising questions as to why he was not granted a review by the Criminal Cases Review Commission much Allier than occurred. A member of staff at the British Museum has been dismissed and a police investigation launched over "missing, stolen or damaged" artefacts. 2023 FIFA Women's World Cup: England secure a place in their first World Cup Final after beating Australia 3–1. 20 August – 2023 FIFA Women's World Cup Final: England are defeated 1–0 by Spain. 22 August – Following trial and conviction at Wood Green Crown Court, former Metropolitan Police officer Adam Provan is sentenced to 16 years in prison for the rape of a fellow police officer and a teenage girl. He is also required to serve a further eight years on extended licence. Raymond Parry, a former Transport for London worker awarded an MBE as recognition for his heroism during the 7 July London bombings, has been stripped of the honour after he admitted sexually abusing a child. 24 August – Justice Secretary Alex Chalk announced the launch of a non-statutory inquiry to investigate the wrongful conviction of Andrew Malkinson, which will examine the role of the Crown Prosecution Service, Greater Manchester Police and the Criminal Cases Review Commission over their handling of the case. A court in Pakistan rules that police cannot detain relatives of the father of Sara Sharif, found dead at her family home in Woking on 10 August, in an attempt to locate him.
This field is highly localized at the nanoparticle and decays rapidly away from the nanoparticle/dielectric interface into the dielectric background, though far-field scattering by the particle is also enhanced by the resonance. Light intensity enhancement is a very important aspect of LSPRs and localization means the LSPR has very high spatial resolution (subwavelength), limited only by the size of nanoparticles. Because of the enhanced field amplitude, effects that depend on the amplitude such as magneto-optical effect are also enhanced by LSPRs.
Highland Council announces that Inverness's Hogmanay celebration will not take place in 2024–25 due to capacity and rising costs. 23 August – Edinburgh City Council votes to introduce a temporary fireworks ban around Bonfire Night in the city's Niddrie, Balerno, Seafield and Calton Hill districts, becoming the first Scottish council to implement such a ban. 25 August – BBC Scotland News reports that Scotland's local authorities are to divert money used to restore nature projects to pay for wage increases. 26 August – ASLEF suspends planned strike action for ScotRail drivers following a new pay offer, and will ballot its members on the offer. The Scottish Government confirms it will suspend the Connecting Scotland programme which provides iPads and laptops to people who are "digitally excluded" in order to pay for council pay rises. 28 August – Justice Secretary Angela Constance confirms that around 470 prisoners have been released under emergency provisions to release prisoners early from their sentences. 30 August – Cheyenne Naeb, an American philosophy student at the University of Dundee, who pushed a female member of railway staff in front of a stationary train at Glasgow Queen Street railway station in February 2023 after missing his train, is sentenced to 20 months in prison at Glasgow Sheriff Court. During a closed-door session at the SNP Party Conference, leader John Swinney tells delegates the party's losses at the election occurred because it spent too much time focusing on the "process of independence".
== Medical uses == Uses include angiography (imaging of blood vessels, including those of the brain and heart), arthrography (imaging of joints), urography (imaging of the urinary system), hysterosalpingography (imaging of the uterus and fallopian tubes), imaging of the gastrointestinal tract, and endoscopic retrograde cholangiopancreatography (ERCP; imaging of the biliary and pancreatic ducts).
Sources: en.wikipedia.org
It acts as an agonist at both the GIP and GLP-1 receptors, two related class B G protein-coupled receptors. This dual activity distinguishes it from single-receptor GLP-1 agonists. The clinical consequences of engaging both receptors are still being characterized.
It is given by subcutaneous injection, generally on a weekly schedule. Dosing usually begins low and increases in steps to limit gastrointestinal side effects. Formulated product is supplied as a ready-to-use pen or vial in most markets.
No. Receptor engagement is documented, but how central appetite circuits, gut signals, and insulinotropic effects combine is incompletely resolved. Investigators continue to separate GIP-driven from GLP-1-driven contributions in animal and human models.
It activates both GIP and GLP-1 receptors. This dual action differentiates it from selective GLP-1 agonists.