If you have been reading about Dipeptidyl peptidase-4 and want a single page that covers the useful parts, this is it: definitions, context, how it is studied, and the questions that come up repeatedly.
Last reviewed on 2026-03-20. Where a claim depends on a specific study, the study is described rather than over-claimed.
Whether the drug improves hard clinical outcomes is not settled. No completed trial has shown a reduction in heart attacks or strokes among treated patients, although a dedicated cardiovascular outcomes study has been discussed in the literature. Investigators have also examined hepatic fat in people with HIV and fatty liver disease, cognitive measures in small cohorts, and changes in bone density. Regulatory labeling emphasizes monitoring of insulin-like growth factor 1 because supraphysiologic levels raise questions about tissue growth, and the clinical significance of that signal remains an open question rather than a demonstrated harm.
Binding of tesamorelin to the growth hormone-releasing hormone receptor on anterior pituitary somatotrophs activates a Gs protein pathway, raises cyclic AMP, and triggers release of stored growth hormone into the bloodstream. Because the analogue resists dipeptidyl peptidase-4, its plasma residence time exceeds that of native GHRH, producing a larger and more sustained secretory signal. The released growth hormone then acts on the liver and peripheral tissues to raise insulin-like growth factor 1, which feeds back on the hypothalamus and pituitary. This axis explains both the intended effects on fat distribution and the biological markers used to track them.
A Phase 3 program led to regulatory approval in the United States in 2010 for reduction of excess visceral abdominal fat in adults with HIV and lipodystrophy. Subsequent studies examined effects on liver fat, muscle area, and metabolic markers, with mixed findings for some endpoints. Long-term cardiovascular outcomes and effects on mortality remain uncertain because most trials were relatively short and focused on imaging-based fat measurements. Use in populations without HIV has been studied experimentally but is not part of the approved indication.
Tesamorelin is a synthetic analog of growth hormone-releasing hormone, a peptide hormone produced by the hypothalamus. The molecule retains the 44-amino-acid sequence of human GHRH and carries a trans-3-hexenoyl modification at its N-terminus. This modification increases resistance to enzymatic degradation and extends the peptide's functional stability relative to native GHRH. The compound is supplied as a lyophilized powder for reconstitution and subcutaneous administration in clinical settings. Its development code was TH9507, and it belongs to the GHRH analog class. It is not a growth hormone product; instead, it acts upstream to stimulate endogenous growth hormone release.
| Property | Value | Notes |
|---|---|---|
| Appearance | White to off-white powder | Lyophilized cake in single-use vials |
| Solubility class | Freely soluble in water | Reconstituted with sterile diluent before injection |
| Typical storage temperature | 2 to 8 degrees Celsius | Before reconstitution; protect from light |
| Typical analytical method | Reversed-phase high-performance liquid chromatography | Purity and related-substance testing |
| Identity confirmation | Mass spectrometry | Observed mass near 5.1 kDa for the intact peptide |
Pharmacodynamic studies show that tesamorelin reduces visceral adipose tissue more than subcutaneous adipose tissue in the studied population. This selectivity may relate to differences in blood flow and hormone sensitivity between fat depots. Effects on glucose metabolism and insulin sensitivity have been investigated, with some trials reporting modest changes and others showing stability. The precise relationship between growth hormone exposure, IGF-1 levels, and visceral fat loss remains an active area of analysis.
Tesamorelin binds to growth hormone-releasing hormone receptors on somatotroph cells in the anterior pituitary. Receptor activation increases intracellular cyclic AMP and promotes synthesis and secretion of growth hormone. Because the peptide mimics endogenous GHRH, it amplifies the normal pulsatile release of growth hormone rather than providing exogenous growth hormone directly. This upstream action distinguishes tesamorelin from recombinant growth hormone preparations and from growth hormone secretagogues that act at different receptors.
Stimulated growth hormone release leads to hepatic production of insulin-like growth factor 1, a key mediator of many growth hormone effects. In clinical studies, tesamorelin increased IGF-1 levels in a dose-dependent manner, although the response varies among individuals. The drug's effect on visceral fat is thought to involve growth hormone-mediated lipolysis and altered adipocyte metabolism. Muscle mass and lean body mass have also been assessed as secondary outcomes, but changes are generally smaller and less consistent than fat reductions.
监管记录显示，特沙莫瑞林于 2010 年在美国首次获得批准，用于人类免疫缺陷病毒感染相关的脂肪营养不良患者。批准依据来自降低内脏脂肪的临床试验，而非体重或瘦体重的普遍改善。后续出现了不同制剂版本，但其核心适应症保持一致。关于长期心血管结局和死亡率影响，现有证据仍不充分。
在临床研究之外，特沙莫瑞林常被讨论为生长激素分泌促进剂，但这一说法需要限定。它并不等同于生长激素本身，也不属于普通减重药物。部分研究关注其减少腹部脂肪和改善脂质谱的潜力，另一些研究则关注胰岛素抵抗和 IGF-1 升高等信号。这些效应的临床意义仍在评估中，尚未形成统一结论。
特沙莫瑞林是一种合成肽，其序列与人生长激素释放激素的 44 个氨基酸形式相关。它在 N 端带有反式-3-己烯酰基修饰，这一改动可减缓二肽基肽酶 IV 的降解。该化合物属于生长激素释放激素受体激动剂，可刺激垂体释放生长激素。研究文献通常将其归入合成肽类药物，而非小分子化合物。
质量控制项目一般包括外观、身份、纯度、含量、有关物质、水分和微生物限度。身份确认可通过肽图谱、氨基酸分析和质谱完成，纯度则用面积归一化法计算。研究级材料与药品级材料的要求不同，前者常缺少完整药典验证。不同批次间杂质谱是否影响活性，仍是一个需要具体数据回答的问题。
特沙莫瑞林的检测通常依赖反相高效液相色谱和质谱联用。反相色谱可分离肽主峰与缺失序列、氧化产物等杂质，质谱则提供精确质量以确认身份。对于复杂基质中的定量，常采用液相色谱-串联质谱，并配合固相萃取或蛋白沉淀。生物样品中的肽易降解，因此采集和处理条件会影响结果。
Binding of tesamorelin to GHRH receptors on pituitary somatotroph cells triggers cyclic AMP signaling and the release of growth hormone into circulation. Because the peptide acts upstream of the growth hormone axis, its effects are partly mediated by hepatic insulin-like growth factor 1 (IGF-1) production. The pulsatile character of endogenous growth hormone secretion is preserved rather than replaced. Whether amplified signaling produces effects beyond those of native GHRH remains an area of ongoing investigation.
A documented effect of tesamorelin is a reduction in visceral adipose tissue in some study populations. Researchers have reported decreases in trunk fat measured by computed tomography alongside changes in lipid markers. The mechanism is thought to involve growth hormone-mediated lipolysis, though the precise contribution of direct versus indirect pathways is not fully resolved. Studies have generally examined defined groups over finite periods, so long-term outcomes are less well characterized. Findings have not been uniform across all trials.
Baker's yeast – used as a leavening agent in baked foods such as breads, cakes, and pies. Bouillon cubes – are dehydrated bouillon (French for broth) or stock formed into small cubes about 15 mm per side. They are typically made by dehydrating vegetables, meat stock, a small portion of fat, salt, and seasonings, and shaping the resulting solids into small cubes. Vegetarian and vegan types are also made. Instant breakfast – typically refers to breakfast food products manufactured in a powdered form, which are generally prepared with the addition of milk and then consumed as a beverage. An example is Carnation Instant Breakfast, introduced in 1964.
Extreme UV (EUV or sometimes XUV) is characterized by a transition in the physics of interaction with matter. Wavelengths longer than about 30 nm interact mainly with the outer valence electrons of atoms, while wavelengths shorter than that interact mainly with inner-shell electrons and nuclei. The long end of the EUV spectrum is set by a prominent He+ spectral line at 30.4 nm. EUV is strongly absorbed by most known materials, but synthesizing multilayer optics that reflect up to about 50% of EUV radiation at normal incidence is possible. This technology was pioneered by the NIXT and MSSTA sounding rockets in the 1990s, and it has been used to make telescopes for solar imaging. See also the Extreme Ultraviolet Explorer satellite.
After opening his shop Thomas Lipton began travelling the world for new items to stock. Tea, historically a rare and expensive luxury, doubled in sales from £40 million in the late 1870s to £80 million by the mid-1880s. In 1890 Lipton purchased tea gardens in Ceylon, now Sri Lanka, from where he packaged and sold the first Lipton tea. He arranged packaging and shipping at low cost, and sold his tea in packets by the pound (454g), half-pound (227g), and quarter-pound (113g), with the advertising slogan: "Direct from the tea gardens to the teapot." Lipton teas were an immediate success in the United States. The Lipton tea business was acquired by consumer goods company Unilever in a number of separate transactions, starting with the purchase of the United States and Canadian Lipton business in 1938. The company owned 12% of the Lipton holding company, Allied Suppliers, a retail holding company, but had 33.7% of the voting rights. In 1972, Unilever sold its shares in Allied Supplies to Sir James Goldsmith's Cavenham Foods group for £10.4 million, on the understanding they could buy Lipton's tea business back at a price agree by an independent adjucator. The fee set was £18.5 million which Unilever completed the purchase of in August 1972. In 1991, Unilever created a joint venture with PepsiCo, the Pepsi Lipton Tea Partnership (PLTP), for the marketing of ready to drink teas in North America. This was followed in 2003 by a second joint venture, Pepsi Lipton International (PLI), covering many non-North American markets.
There was a lingering ambiguity in the general notion of "diabetes", especially as it manifests very differently in diabetes mellitus and in diabetes insipidus. In 1843, William Prout aptly summarized the general notion of diabetes of the time as follows:The term diabetes, implying simply an increased flow of urine, is applicable to any disease in which that symptom is present in a remarkable degree. This general use of the term, however, has caused a great deal of confusion; as a variety of diseases differing altogether in their nature, except in the accidental circumstances of being accompanied by diuresis, or a large flow of urine, have in consequence been confounded with one another. To prevent this confusion in future, I would recommend that the term be restricted to those affections in which the urine is saccharine. Hence I define Diabetes to be a disease in which a saccharine state of the urine is the characteristic symptom.
Knowing that there are a few studies about the genomic data of the tyrosinase gene, there are only a handful of studies on the mutations in albino amphibians. Miura et al. (2018) investigates the amino acid mutations in the tyrosinase gene in three albino frogs: Pelophylax nigromaculatus (pond frog), Glandirana rugosa (wrinkled frog) and Fejervarya kawamurai (rice frog). In total, five different populations were studied of which three were P. nigromaculatus and one each of G. rugosa and F. kawamurai. In two of the three P. nigromaculatus populations, there was a frameshift mutation because of the insertion of a thymine within exons 1 and 3, and the third population lacked three nucleotides that encoded a Lysine in exon 1. The population of G. rugosa had a missense mutation where there was an amino acid substitution from a Glycine to Aspartic acid, and the mutation of F. kawamurai was also an amino acid substitution from Glycine to Arginine. The mutation for G. rugosa and F. kawamurai occurs in exons 1 and 3. The mutations of the third population of P. nigromaculatus, and the mutations of G. rugosa and F. kawamurai occurred in areas that are highly conserved among vertebrates which could result in a dysfunctional tyrosinase gene.
Sources: en.wikipedia.org
=== Electromagnetic cloaking principles for seismic metamaterials === For seismic metamaterials to protect surface structures, the proposal includes a layered structure of metamaterials, separated by elastic plates in a cylindrical configuration. A prior simulation showed that it is possible to create concealment from electromagnetic radiation with concentric, alternating layers of electromagnetic metamaterials. That study is in contrast to concealment by inclusions in a split-ring resonator designed as an anisotropic metamaterial. The configuration can be viewed as alternating layers of homogeneous isotropic dielectric material. Each dielectric material is much thinner than the radiated wavelength. As a whole, such a structure is an anisotropic medium. The layered dielectric materials surround a conducting cylinder. The layered dielectric materials radiate outward, in a concentric fashion, and the cylinder is encased in the first layer. The other layers alternate and surround the previous layer all the way to the first layer. Electromagnetic wave scattering was calculated and simulated for the layered (metamaterial) structure and the split-ring resonator anisotropic metamaterial, to show the effectiveness of the layered metamaterial.
The right to join a union, freely associate and take action including strikes, are universal rights in international law, enshrined after the experience of mass war and dictatorship. Australian law provides minimal protection, and has been consistently criticised by the International Labour Organization. There is a basic right to join a union, yet the High Court has made protection for discrimination against union members weak by enabling employers to argue they did not intend to target union members with adverse action. There is a right to collective bargaining, but only within "single-employer" enterprises, creating major legal obstacles to sectoral collective bargaining found in other prosperous countries. Key to this is the prohibition on the right to take solidarity action, i.e. workers of one employer striking with workers of another employer to get a multi-employer deal, especially to prevent anti-productive competition. There is a limited right to take collective action, to get a collective agreement with a single employer. Australia has a significant history of workers voting for representation on boards of directors of the corporations or other governing bodies where they work, particularly in New South Wales, and in federal public services such as the ABC and Australia Post. However Australia has not yet passed a general federal law, like a majority of wealthier OECD countries, to protect the right to vote for directors at work.
== Early life == Phang grew up in the San Francisco Bay Area. She was born in Berkeley, California and is of mixed Chinese Malaysian and Vietnamese heritage. She graduated from Pomona College with a Bachelor of Arts in Media Studies, and also graduated from the American Film Institute with a Masters of Fine Arts (M.F.A.) in Film Directing. She has also participated in the San Francisco Film Society Women Filmmaker Fellowship. In 2008, Phang was named as one of the "25 new Faces of Independent Film" by Filmmaker Magazine. In 2015, she was selected as one of six Women at Sundance Fellows. In 2016 she was also selected for the Warner Bros. Television Directors' Workshop where she met the director/producer of Breaking Bad and Game of Thrones, Michelle MacLaren, who became her mentor.
== See also == Estradiol dibutyrate/hydroxyprogesterone heptanoate/testosterone caproate Estradiol diundecylate/hydroxyprogesterone heptanoate/testosterone cyclohexylpropionate Estrapronicate/hydroxyprogesterone heptanoate/nandrolone undecanoate Progesterone/hydroxyprogesterone heptanoate/α-tocopherol palmitate
This is the largest division of the Society. It marked its 100th anniversary in 2008. The first Chair of the Division was Edward Curtis Franklin. The Organic Division played a part in establishing Organic Syntheses, Inc. and Organic Reactions, Inc. and it maintains close ties to both organizations. The Division's best known activities include organizing symposia (talks and poster sessions) at the biannual ACS National Meetings, for the purpose of recognizing promising Assistant Professors, talented young researchers, outstanding technical contributions from junior-level chemists, in the field of organic chemistry. The symposia also honor national award winners, including the Arthur C. Cope Award, Cope Scholar Award, James Flack Norris Award in Physical Organic Chemistry, Herbert C. Brown Award for Creative Research in Synthetic Methods. The Division helps to organize symposia at the international meeting called Pacifichem and it organizes the biennial National Organic Chemistry Symposium (NOS) which highlights recent advances in organic chemistry and hosts the Roger Adams Award address. The Division also organizes corporate sponsorships to provide fellowships for PhD students and undergraduates. It also organizes the Graduate Research Symposium and manages award and travel grant programs for undergraduates.
Sources: en.wikipedia.org
It mimics a natural hypothalamic signal that tells the pituitary to release growth hormone. The result is a rise in circulating growth hormone and, indirectly, in insulin-like growth factor 1. Over weeks of treatment this shift is associated with a selective decrease in fat stored inside the abdomen.
The primary measure is usually a cross-sectional abdominal scan that separates internal fat from fat just under the skin. Waist circumference and body weight are recorded as secondary measures because they are easy to obtain but do not distinguish the two fat compartments. Hormone and metabolic blood tests are collected alongside the imaging.
Available follow-up data indicate that visceral fat drifts back toward pretreatment levels once injections stop. The change is therefore best described as treatment-dependent rather than permanent. Investigators continue to debate whether intermittent or repeated courses would preserve any benefit.
It is a synthetic peptide analog of human growth hormone-releasing hormone. It is used clinically to reduce excess visceral abdominal fat in adults with HIV-associated lipodystrophy. It works by stimulating pituitary growth hormone release.