The short version of dual agonist fits in a sentence. The long version — which is the one that helps — is below.
This page was last updated on 2026-04-10 and is reviewed periodically as new material appears.
固体状态的 tirzepatide 通常以冻干粉形式保存，推荐在低温、避光、干燥条件下存放，常见区间为 2 至 8 摄氏度，长期保存可考虑更低温度并避免反复冻融。冻融循环会导致肽链聚集或析出，从而影响后续定量结果。容器密封性与湿度控制同样是稳定性研究中反复强调的因素。
溶解操作一般使用注射用水或适宜的水性缓冲液，必要时加入少量助溶剂以改善溶解速度，但应避免剧烈涡旋振荡，因为剪切力可能促进聚集。配制后的溶液在冷藏条件下的稳定时间通常短于固体形态，具体时限取决于浓度、缓冲体系与容器材质。是否加入防腐成分，则取决于用途是否为多次取样。
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.
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.
| Property | Value | Notes |
|---|---|---|
| 储存温度 | 2 至 8 摄氏度 | 固体粉末，避光密封 |
| 外观 | 白色至类白色冻干粉 | 溶解后为澄清至微乳光 |
| 溶解性 | 易溶于水性缓冲液 | 避免剧烈振荡 |
| 常规纯度方法 | 反相高效液相色谱 | 紫外或质谱检测 |
| 定量方法 | 液相色谱串联质谱 | 配合固相萃取前处理 |
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。
Research-grade material circulates through suppliers that differ widely in documentation and testing practice, so a certificate of analysis is a starting point rather than proof of quality. Independent verification typically repeats chromatographic purity and mass confirmation on the received lot, and compares results against a retained reference standard. Regulatory status varies by jurisdiction, and a substance cleared as a medicine is not interchangeable with a research chemical of the same name. Open questions include how closely non-pharmaceutical lots match approved material in impurity profile and in aggregate content.
Solid tirzepatide is handled as a lyophilised, hygroscopic peptide powder that should be kept desiccated, protected from light, and stored frozen, typically at or below minus twenty degrees Celsius for long-term retention. Material left at ambient temperature for extended periods can take up moisture, which promotes aggregation and deamidation. Commercial liquid presentations are kept refrigerated between two and eight degrees Celsius and are not frozen. Reconstituted laboratory solutions are generally held cold and used within a short window because hydrolysis and oxidation continue slowly in solution.
Identity and purity are usually established with reversed-phase high-performance liquid chromatography for the main peak and with mass spectrometry for the observed molecular mass. Peptide mapping after enzymatic digestion confirms the primary sequence, while amino acid analysis provides a quantitative composition check. Size-exclusion chromatography and ion-exchange chromatography are used to look for aggregates and charge variants. Water content, residual solvents, and counter-ion content are measured separately, since a lyophilised powder is often reported on an as-is basis unless a correction is applied.
Regulatory and quality discussions place the peptide within established guidance for synthetic peptides and biologics. Forced degradation studies, in which samples are exposed to heat, acid, base, peroxide, and light, identify likely degradation products and validate the selectivity of analytical methods. Reference standards allow comparison across laboratories and production batches. Purity specifications reported in the literature usually combine chromatographic purity with mass confirmation. Which impurity thresholds are meaningful for long-term behavior is still debated, and no single universal specification has been adopted across all jurisdictions.
Routine characterization of the peptide relies on reversed-phase high-performance liquid chromatography for purity assessment, usually with ultraviolet detection near 214 nanometers. Intact mass measurement by liquid chromatography coupled to mass spectrometry confirms molecular identity against a theoretical value. Sequence-level confirmation uses enzymatic digestion followed by tandem mass spectrometry, an approach known as peptide mapping. Amino acid analysis gives an independent check on composition. Circular dichroism spectra are used to estimate helical content in aqueous buffer.
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.
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.
=== Medical imaging === A physician may diagnose an inguinal hernia, as well as the type, from medical history and physical examination. For confirmation or in uncertain cases, medical ultrasonography is the first choice of imaging, because it can both detect the hernia and evaluate its changes with for example pressure, standing and Valsalva maneuver. When assessed by ultrasound or cross sectional imaging with CT or MRI, the major differential in diagnosing indirect inguinal hernias is differentiation from spermatic cord lipomas, as both can contain only fat and extend along the inguinal canal into the scrotum. On axial CT, lipomas originate inferior or lateral to the cord, and are located inside the cremaster muscle, while inguinal hernias lie anteromedial to the cord and are not intramuscular. Large lipomas may appear nearly indistinguishable as the fat engulfs anatomic boundaries, but they do not change position with coughing or straining.
Eli Lilly also markets fluoxetine in a fixed-dose combination with olanzapine as olanzapine/fluoxetine (Symbyax), which was approved by the US Food and Drug Administration (FDA) for the treatment of depressive episodes of bipolar I disorder in 2003 and for treatment-resistant depression in 2009.
Side effects from therapeutic use can be much more varied depending on the location of injection and the dose of toxin injected. In general, side effects from therapeutic use can be more serious than those that arise during cosmetic use. These can arise from paralysis of critical muscle groups and can include arrhythmia, heart attack, and in some cases, seizures, respiratory arrest, and death. Additionally, side effects common in cosmetic use are also common in therapeutic use, including trouble swallowing, muscle weakness, allergic reactions, and flu-like syndromes. In response to the occurrence of these side effects, in 2008, the US Food and Drug Administration (FDA) notified the public of the potential dangers of the botulinum toxin as a therapeutic. Namely, the toxin can spread to areas distant from the site of injection and paralyze unintended muscle groups, especially when used for treating muscle spasticity in children treated for cerebral palsy. In 2009, the FDA announced that boxed warnings would be added to available botulinum toxin products, warning of their ability to spread from the injection site. However, the clinical use of botulinum toxin A in children with cerebral palsy has been proven to be safe with minimal side effects. Additionally, the FDA announced name changes to several botulinum toxin products, to emphasize that the products are not interchangeable and require different doses for proper use.
Sources: en.wikipedia.org
==== History ==== Kelp tea is thought to have been drunk from quite a long time ago because "the Japanese have incorporated kelp and seaweed into their diets for 1,500 years". It is said that, in 951, Kūya made a statue of the Ekādaśamukha to cure an epidemic that was spreading in the capital and went around the city giving oo-buku-cha to the sick. Tea using kelp already existed in Edo period (1603–1868) at the latest, and people in these days drank it by pouring boiling water over chopped kelp.
Though once thought of as scavengers, Neanderthals are now considered apex predators. They appear to have eaten predominantly what was abundant within their immediate surroundings, consequently consuming across their range a wide array of meats and plants, the relative proportion of which varied substantially geographically. Cro-Magnons, in contrast, seem to have maintained a more diverse diet even in settings where certain foods would have been harder to procure; for example, Neanderthals living in forests ate about the same proportion of foodplants as Cro-Magnons, but Neanderthals on open steppe (where foodplants are harder to find) ate far less foodplants. In many European sites, prey items include red deer, reindeer, horse, aurochs, ibex, and steppe bison. Neanderthals in Southwest Asia more commonly hunted mountain gazelle, Persian fallow deer, wild goat, and camels. They may have less frequently taken down larger Pleistocene megafauna whenever locally abundant, such as woolly mammoth and woolly rhinoceros. At the 125,000 year old Neumark-Nord site, Germany, there is evidence of regular hunting of straight-tusked elephants maybe every 5 to 6 years. Some waterside communities ate fish and shellfish—and at Vanguard Cave, Gibraltar, dolphin and Mediterranean monk seal. Neanderthals also hunted small game, and some caves show evidence of regular rabbit and tortoise consumption. At Gibraltar sites, there are butchered remains of 143 different bird species, many ground-dwelling such as the common quail, corn crake, woodlark, and crested lark.
==== Adaptation to a single environment ==== Given the slow rate of evolution of the genus, Ginkgo possibly represents a pre-angiosperm strategy for survival in disturbed streamside environments. Ginkgo evolved in an era before flowering plants, when ferns, cycads, and cycadeoids dominated disturbed streamside environments, forming low, open, shrubby canopies. Ginkgo's large seeds and habit of "bolting" – growing to a height of 10 meters before elongating its side branches – may be adaptations to such an environment. Modern-day G. biloba grows best in environments that are well-watered and drained, and the extremely similar fossil Ginkgo favored similar environments: The sediment record at the majority of fossil Ginkgo localities indicates it grew primarily in disturbed environments, such as along streams. Ginkgo, therefore, presents an "ecological paradox" because while it possesses some favorable traits for living in disturbed environments (clonal reproduction) many of its other life-history traits are the opposite of those exhibited by modern plants that thrive in disturbed settings (slow growth, large seed size, late reproductive maturity).
== Prevention == In the past, the prophylactic use of dantrolene was recommended for MH-susceptible patients undergoing general anesthesia. However, multiple retrospective studies have demonstrated the safety of trigger-free general anesthesia in these patients in the absence of prophylactic dantrolene administration. The largest of these studies looked at the charts of 2214 patients who underwent general or regional anesthesia for an elective muscle biopsy. About half (1082) of the patients were muscle biopsy positive for MH. Only five of these patients exhibited signs consistent with MH, four of which were treated successfully with parenteral dantrolene, and the remaining one recovered with only symptomatic therapy. After weighing its questionable benefits against its possible adverse effects (including nausea, vomiting, muscle weakness and prolonged duration of action of nondepolarizing neuromuscular blocking agents), experts no longer recommend the use of prophylactic dantrolene prior to trigger-free general anesthesia in MH-susceptible patients.
Sources: en.wikipedia.org
== Taxonomy and evolution == The family name Formicidae is derived from the Latin formīca ("ant") from which the words in other Romance languages, such as the Portuguese formiga, Italian formica, Spanish hormiga, Romanian furnică, and French fourmi are derived. The family belongs to the order Hymenoptera, which also includes sawflies, bees, and wasps. Ants evolved from a lineage within the stinging wasps, and a 2013 study suggests that they are a sister group of the Apoidea. However, since Apoidea is a superfamily, ants must be upgraded to the same rank. A more detailed basic taxonomy was proposed in 2020. Three species of the extinct mid-Cretaceous genera Camelomecia and Camelosphecia were placed outside of the Formicidae, in a separate clade within the general superfamily Formicoidea, which, together with Apoidea, forms the higher-ranking group Formicapoidina. Fernández et al. (2021) suggest that the common ancestors of ants and apoids within the Formicapoidina probably existed as early as in the end of the Jurassic period, before divergence in the Cretaceous.
Busby WH, Quackenbush GE, Humm J, Youngblood WW, Kizer JS (1987). "An enzyme(s) that converts glutaminyl-peptides into pyroglutamyl-peptides. Presence in pituitary, brain, adrenal medulla, and lymphocytes". J. Biol. Chem. 262 (18): 8532–6. doi:10.1016/S0021-9258(18)47446-7. PMID 3597387. Fischer WH, Spiess J (1987). "Identification of a mammalian glutaminyl cyclase converting glutaminyl into pyroglutamyl peptides". Proc. Natl. Acad. Sci. U.S.A. 84 (11): 3628–32. Bibcode:1987PNAS...84.3628F. doi:10.1073/pnas.84.11.3628. PMC 304928. PMID 3473473. Messer M; Ottesen M (1965). "Isolation and properties of glutamine cyclotransferase of dried papaya latex". C. R. Trav. Lab. Carlsberg. 35 (1): 1–24. PMID 5846578.
Aagenaes syndrome Acroangiodermatitis (acroangiodermatitis of Mali, Mali acroangiodermatitis, Pseudo-Kaposi's sarcoma) Acrocyanosis Acute hemorrhagic edema of infancy (acute hemorrhagic edema of childhood, Finkelstein's disease, infantile postinfectious iris-like purpura and edema, medallion-like purpura, purpura en cocarde avec oedema, Seidlmayer syndrome) Arterial insufficiency ulcer (ischemic ulcer) Arteriosclerosis obliterans Bier spots Blueberry muffin baby Bonnet–Dechaume–Blanc syndrome (Wyburn–Mason syndrome) Bullous lymphedema Bullous small vessel vasculitis (bullous variant of small vessel vasculitis) Calciphylaxis Caput succedaneum Cholesterol embolus (warfarin blue toe syndrome) Cobb syndrome Corona phlebectatica Cryofibrinogenemic purpura Cryoglobulinemic purpura Cryoglobulinemic vasculitis Cutaneous small-vessel vasculitis (cutaneous leukocytoclastic angiitis, cutaneous leukocytoclastic vasculitis, cutaneous necrotizing venulitis, hypersensitivity angiitis) Deep venous thrombosis Disseminated intravascular coagulation Doucas and Kapetanakis pigmented purpura Drug-induced purpura Drug-induced thrombocytopenic purpura Eczematid-like purpura of Doucas and Kapetanakis Epidemic dropsy Erythema elevatum diutinum Erythromelalgia (acromelalgia, erythermalgia) Factitial lymphedema (hysterical edema) Fibrinolysis syndrome (defibrinating syndrome, hypofibrinogenemia) Food-induced purpura Generalized essential telangiectasia (general essential telangiectasia) Giant-cell arteritis Gougerot–Blum syndrome (pigmented purpuric lichenoid dermatitis, pigmented purpuric lichenoid dermatitis of Gougerot and Blum) Granulomatosis with polyangiitis Harlequin color change Hematopoietic ulcer Hennekam syndrome (Hennekam lymphangiectasia-lymphedema syndrome, intestinal lymphagiectasia-lymphedema-mental retardation syndrome) Henoch–Schönlein purpura (anaphylactoid purpura, purpura rheumatica, Schönlein–Henoch purpura) Hereditary hemorrhagic telangiectasia (Osler's disease, Osler–Weber–Rendu disease) Idiopathic thrombocytopenic purpura (autoimmune thrombocytopenic purpura, Werlhof's disease) IgA vasculitis Kawasaki's disease (mucocutaneous lymph node syndrome) Levamisole-induced vasculitis Lichen aureus (lichen purpuricus) Livedo racemosa Livedo reticularis Livedoid dermatitis (embolia cutis medicamentosa, Nicolau syndrome) Livedoid vasculopathy (atrophie blanche, livedo reticularis with summer ulceration, livedoid vasculitis, PURPLE syndrome, segmental hyalinizing vasculitis) Lymphedema praecox Lymphedema–distichiasis syndrome Maffucci syndrome Majocchi's disease (purpura annularis telangiectodes, purpura annularis telangiectodes of Majocchi) Malignant atrophic papulosis (Degos' disease) Marshall–White syndrome Meige lymphedema Microscopic polyangiitis (microscopic polyarteritis, microscopic polyarteritis nodosa) Mondor's disease (Mondor's syndrome of superficial thrombophlebitis) Neuropathic ulcer (mal perforans) Njolstad syndrome Nonne–Milroy–Meige syndrome (hereditary lymphedema, Milroy disease) Obstructive purpura Orthostatic purpura (stasis purpura) Painful bruising syndrome (autoerythrocyte sensitization, Gardner–Diamond syndrome, psychogenic purpura) Parkes Weber syndrome Paroxysmal hand hematoma (Achenbach syndrome) Paroxysmal nocturnal hemoglobinuria Polyarteritis nodosa (panarteritis nodosa, periarteritis nodosa) Postcardiotomy syndrome Perinatal gangrene of the buttock Pigmentary purpuric eruptions (progressive pigmentary dermatosis, progressive pigmenting purpura, purpura pigmentosa chronica) Postinflammatory lymphedema Postmastectomy lymphangiosarcoma (Stewart–Treves syndrome) Purpura fulminans (purpura gangrenosa) Purpura secondary to clotting disorders Purpuric agave dermatitis Raynaud phenomenon Raynaud's disease (primary Raynaud's phenomenon) Reactive angioendotheliomatosis Schamberg's disease (progressive pigmentary dermatosis of Schamberg, purpura pigmentosa progressiva, Schamberg's purpura) Secondary lymphedema Septic thrombophlebitis Sinusoidal hemangioma Sneddon's syndrome (idiopathic livedo reticularis with cerebrovascular accidents) Solar purpura (actinic purpura, senile purpura) Stasis dermatitis (congestion eczema, gravitational dermatitis, gravitational eczema, stasis eczema, varicose eczema) Superficial thrombophlebitis Takayasu arteritis (aortic arch syndrome, pulseless disease) Temporal arteritis (cranial arteritis, Horton's disease) Thromboangiitis obliterans (Buerger's disease) Thrombotic thrombocytopenic purpura (Moschcowitz syndrome) Traumatic purpura Trousseau's syndrome Unilateral nevoid telangiectasia (nevoid telangiectasia) Urticarial vasculitis (chronic urticaria as a manifestation of venulitis, hypocomplementemic urticarial vasculitis syndrome, hypocomplementemic vasculitis, unusual lupus-like syndrome) Venous insufficiency ulceration Waldenström hyperglobulinemic purpura (purpura hyperglobulinemica) Waldenström macroglobulinemia Yellow nail syndrome (primary lymphedema associated with yellow nails and pleural effusion)
=== Insulin interactions === D-chiro-inositol is known to be an important secondary messenger in insulin signal transduction. It accelerates the dephosphorylation of glycogen synthase and pyruvate dehydrogenase, rate limiting enzymes of non-oxidative and oxidative glucose disposal. Exogenous DCI may act to bypass defective normal epimerization of myo-inositol to DCI associated with insulin resistance and at least partially restore insulin sensitivity and glucose disposal. In clinical practice, it improves insulin signaling, thus restoring physiological insulin levels in resistant subjects.
== Elected or appointed female chief executives == This list includes women who were appointed by a governing committee or parliament where heads of state or government are not directly elected by citizens. The list does not include women chosen by a hereditary monarch. Interim heads of state or government are listed in italics.
Sources: en.wikipedia.org
建议在低温、避光、干燥环境中密封保存，常见条件为 2 至 8 摄氏度，长期存放可置于更低温度。应避免反复冻融，并尽量减少容器开启次数。
溶解后的稳定时间通常短于固体形态，受浓度、缓冲液和容器材质影响。冷藏条件下一般只能维持较短时间，具体期限应通过实际稳定性实验确认。
反相高效液相色谱用于纯度与含量测定，液相色谱串联质谱用于生物基质中的定量，体积排阻色谱用于检测聚集体。多种方法结合才能较完整地表征样品。
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.