This is a working overview of incretin, written for readers who want more than a one-paragraph summary but less than a textbook.
Reviewed 2026-06-04. Anything still debated is marked as such rather than presented as settled.
Clinical development has progressed through phase 2 trials in adults with obesity and type 2 diabetes, with phase 3 programs reported as ongoing. Reported outcomes include reductions in body weight and improvements in glycemic measures over defined treatment periods. Whether these effects translate into durable benefits after treatment ends remains an open question. Long-term safety data across broad populations are not yet complete, and regulatory decisions have not been announced.
Retatrutide is an investigational synthetic peptide engineered to activate three distinct hormone receptors within a single molecule. It targets the glucose-dependent insulinotropic polypeptide receptor, the glucagon-like peptide-1 receptor, and the glucagon receptor simultaneously. This triagonist design distinguishes it from earlier incretin-based compounds that act on one or two of these pathways. Structural modifications relative to native gut hormones extend its residence time in circulation. The molecule remains under clinical evaluation and is not approved for any indication.
Receptor activation produces downstream effects that differ by tissue. GLP-1 receptor signaling influences appetite regulation and insulin secretion in a glucose-dependent manner. GIP receptor activity contributes to metabolic handling of nutrients and may modulate adipose tissue. Glucagon receptor engagement raises energy expenditure and promotes hepatic lipid turnover, though the balance among these actions in humans is still being characterized. Preclinical models showed reductions in body weight and improved glycemic markers.
化学修饰延长了分子在体内的停留时间，使较低频次的给药安排成为可能。脂肪酸侧链通过与白蛋白结合延缓清除，非天然氨基酸则降低酶解速率。这些修饰同时改变分子的溶解性与稳定性，需要在制剂设计和储存条件中一并考虑。修饰引入的免疫原性风险也属于开发过程中需要评估的项目。
该化合物处于临床试验阶段，尚未在多数地区取得上市许可。公开信息主要来自企业公告、学术会议摘要与试验注册平台记录，完整数据仍在逐步披露。关于长期疗效与安全性的判断，需要等待规模更大、随访更久的研究结果，目前不宜对最终结论作出预判。
retatrutide 是一种人工合成的多肽，设计目标是同时作用于 GIP、GLP-1 与胰高血糖素三种受体。这种三重激动设计试图把多条代谢通路的调节整合进单一分子，而不是只依赖一种肠促胰素受体。分子骨架以天然肽序列为基础，经过非天然氨基酸替换和脂肪酸侧链修饰，以获得更长的作用时间。该方向属于多受体激动剂研究的一部分，与双重激动剂的工作并行推进。
| Property | Value | Notes |
|---|---|---|
| Receptor targets | GIP, GLP-1, glucagon | One molecule activates all three pathways |
| Research identifier | LY3437943 | Code used in published trial reports |
| Development stage | Phase 3, reported as ongoing | Not approved by any regulatory agency |
| Route studied | Subcutaneous | Administration form used in clinical trials |
| Studied populations | Adults with obesity or type 2 diabetes | Enrollment criteria vary between trials |
Development has progressed from single- and multiple-ascending-dose studies in healthy volunteers into larger randomized trials in adults with obesity, type 2 diabetes, and fatty liver disease. Early reports describe dose-dependent reductions in body weight and improvements in glycemic markers over treatment periods of several months. Whether the glucagon arm adds tolerability cost without added benefit is still debated. Long-term cardiovascular outcomes, effects after treatment stops, and performance in older or comorbid populations are open questions rather than settled findings. Approval status may change, so the current investigational label should be confirmed against regulatory sources.
Retatrutide is an investigational synthetic peptide developed under the code LY3437943, with a backbone derived from glucose-dependent insulinotropic polypeptide. Several non-proteinogenic residues, including alpha-aminoisobutyric acid, appear in that backbone, and a fatty diacid side chain attached through a linker extends circulation time. The molecule carries roughly thirty-nine amino acid units and a total mass near 4.7 kilodaltons. Administration is by subcutaneous injection once weekly. Published work uses both the name retatrutide and the code LY3437943.
Dissolution behavior depends on the amino acid sequence, the counterion content, and the buffer chosen. Many peptides disperse readily in water or mild aqueous buffers, while others require a small amount of organic co-solvent or a change in pH. Adsorption to plastic and glass surfaces can reduce the concentration of a solution over time, particularly at low concentrations. Filtration before analysis removes particulates, and aliquoting limits repeated freeze-thaw cycles that stress the material.
Research-grade peptide material is commonly supplied as a lyophilized powder, a form that limits degradation during transport and storage. Standard practice keeps such material cold and protected from light and moisture, with tighter conditions used for long-term archives. Once dissolved, solutions are generally considered less stable than the dry powder and are handled on shorter timescales. These established conventions derive largely from general peptide chemistry rather than from compound-specific evidence alone.
Human evidence remains limited to controlled studies. A phase 2 trial in adults with obesity reported large, dose-dependent reductions in body weight over 48 weeks, with gastrointestinal events as the most frequently recorded adverse effect. Phase 3 programs designated TRIUMPH, for obesity, and TRANSCEND, for type 2 diabetes, are intended to confirm efficacy and to characterize safety in larger populations. Related studies are examining conditions such as knee osteoarthritis in people with obesity and metabolic liver disease. Open questions include long-term tolerability, effects on lean mass, and what happens after treatment is stopped.
Retatrutide is an investigational synthetic peptide that acts on three receptor targets at once: glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1, and glucagon. It is developed by Eli Lilly and appears in the literature and in trial registries under the code LY3437943. The molecule belongs to a class of engineered peptides designed to resist rapid breakdown and permit infrequent subcutaneous administration. No regulatory agency has approved it for clinical use, and all available human data come from controlled trials rather than from routine practice.
The intended pharmacology combines three signals in one molecule. GLP-1 receptor activation reduces appetite and slows gastric emptying, effects already exploited by approved incretin-based therapies. GIP receptor engagement is associated with improved insulin sensitivity and with direct effects on adipose tissue, although how much it contributes to overall outcomes is still debated. Glucagon receptor agonism raises energy expenditure and supports hepatic lipid handling, a mechanism that also tends to increase glucose output. The triple profile is hypothesized to produce a larger metabolic effect than single or dual agonism, but the relative weight of each receptor in humans is not settled.
Identity and purity are established with reversed-phase high-performance liquid chromatography and mass spectrometry. Chromatographic profiles reveal related impurities, truncated sequences, and oxidation products, while mass measurement confirms the expected molecular mass. Purity values for research material are typically reported as a percentage by peak area. Reference standards help calibrate retention behavior across instruments. Independent laboratories emphasize method suitability because results depend heavily on column chemistry, gradient, and detection wavelength. Batch-to-batch comparison relies on the same validated method.
Investigational peptide material is commonly distributed as a lyophilized powder in sealed vials. The solid form appears as a white to off-white cake or powder and is hygroscopic once opened. Peptides of this size are sensitive to moisture, repeated freeze-thaw cycles, and prolonged exposure to ambient light. Handling practices therefore emphasize desiccation, minimal vial opening, and cold storage. Working aliquots are often prepared to avoid repeatedly warming the bulk container.
Solid material is generally held at -20 °C or colder, while reconstituted solutions are kept at 2-8 °C and used within a short window. Buffers that maintain a slightly acidic to neutral pH tend to improve short-term peptide stability. Repeated warming and cooling of stock solutions promotes aggregation and should be avoided. Container closures should remain intact, since adsorption to some plastics can reduce the amount of peptide in solution.
Negative ions are formed by resonance capture of a near-thermal energy electron, dissociative capture of a low energy electron and via ion-molecular interactions such as proton transfer, charge transfer and hydride transfer. Compared to the other methods involving negative ion techniques, NCI is quite advantageous, as the reactivity of anions can be monitored in the absence of a solvent. Electron affinities and energies of low-lying valencies can be determined by this technique as well.
gametogenesis The process by which eukaryotic precursor germ cells divide and differentiate into haploid gametes. Depending on the organism, gametes may be generated from haploid germ cells by mitosis or diploid germ cells by meiosis.
Morphine is the most abundant opiate found in opium, the dried latex extracted by shallowly scoring the unripe seedpods of the Papaver somniferum poppy. Morphine is generally 8–14% of the dry weight of opium. Przemko and Norman cultivars of the opium poppy, are used to produce two other alkaloids, thebaine and oripavine, which are used in the manufacture of semi-synthetic and synthetic opioids like oxycodone and etorphine. P. bracteatum does not contain morphine or codeine, or other narcotic phenanthrene-type, alkaloids. This species is rather a source of thebaine. Occurrence of morphine in other Papaverales and Papaveraceae, as well as in some species of hops and mulberry trees has not been confirmed. Morphine is produced most predominantly early in the life cycle of the plant. Past the optimum point for extraction various processes in the plant produce codeine, thebaine, and in some cases negligible amounts of hydromorphone, dihydromorphine, dihydrocodeine, tetrahydro-thebaine, and hydrocodone (these compounds are rather synthesized from thebaine and oripavine). In the brains of mammals, morphine is detectable in trace steady-state concentrations. The human body also produces endorphins, which are chemically related endogenous opioid peptides that function as neuropeptides and have similar effects to morphine.
Telenursing is experiencing significant growth globally due to factors such as the need to reduce healthcare costs, an increasing aging and chronically ill population, and expanded healthcare coverage to distant, rural, small, or sparsely populated regions. Telenursing can help address nurse shortages, reduce travel time and distances, and minimize hospital admissions. Telepalliative care is a remote approach to optimising quality of life and relieving suffering for people with serious, complex and often fatal illnesses. The World Health Organization (WHO) recommends integrating palliative care as early as possible for any chronic and fatal illness. Telepalliative care typically utilizes telecommunication technologies like video conferencing, messaging for follow-ups, and digital symptom assessments through questionnaires that generate alerts for healthcare professionals. Telepharmacy involves delivering pharmaceutical care via telecommunications to patients in locations where direct contact with a pharmacist may not be possible or difficult. Telepsychiatry (telemental health) uses telecommunications technology to provide remote psychiatric care for individuals with mental health conditions. Telepsychology is the use of communication technology for the remote administration of psychological tests and psychotherapy. Teleneurotherapy utilizes computers and communications technology to deliver neurotherapy remotely.
Sources: en.wikipedia.org
== Side effects == Side effects of the tablet form in conjunction with levodopa include, in decreasing order of frequency, nausea, hallucinations, confusion, depression, loss of balance, insomnia, increased involuntary movements, agitation, slow or irregular heart rate, delusions, hypertension, new or increased angina pectoris, and syncope. Most of the side effects are due to a high dopamine levels, and can be alleviated by reducing the dose of levodopa. Selegiline can also cause cardiovascular side effects such as orthostatic hypotension, hypertension, atrial fibrillation, and other types of cardiac arrhythmias. The main side effects of the patch form for depression include application-site reactions, insomnia, dry mouth, dizziness, nervousness, and abnormal dreams. The selegiline patch carries a black box warning about a possible increased risk of suicide, especially for young people, as do all antidepressants since 2007. Side effects of selegiline that have been identified as occurring significantly more often than with placebo in meta-analyses for psychiatric disorders have included dry mouth (RRTooltip Risk ratio = 1.58), insomnia (RR = 1.61, NNHTooltip Number needed to harm = 19), and application site reactions with the transdermal form (RR = 1.81, NNH = 7). No significant diarrhea, headache, dizziness, nausea, sexual dysfunction, or weight gain were apparent in these meta-analyses. Selegiline, including in its oral, ODT, and patch forms, has been found to cause hypotension or orthostatic hypotension in some individuals.
In his private life, he was a sportsman, cross-country skiing and skating in winter time, during his regular visits to Switzerland and Norway; deprived of these winter sports during the First World War he started climbing. Between the ages of 20 and 25 he spent a large part of his spare time cycling. With the invention of motorised vehicles he constructed a combustion engine of his own in 1902 and participated in the Gordon Bennett auto race in Ireland in 1903. Not content with these sports he also engaged in swimming, golf, especially with Rutherford and other colleagues in Cambridge, tennis, winning some prizes at open tournaments in England, Wales and Ireland and learning surfing in Honolulu in 1909. Coming from a musical family, he was capable of playing the piano, violin and cello at a level such that he regularly played in concerts at Cambridge. He visited many places around the globe on extensive travel tours starting from 1908 with a trip to Australia and New Zealand which he visited again in 1938–1939. Aston was a skilled photographer and interested in astronomy. He joined several expeditions to study solar eclipses in Benkoeben in 1925, Sumatra in 1932, Magog in Canada on 31 August 1932 and Kamishari Hokkaido, Japan on June19th 1936. He also planned to attend expeditions to South Africa in 1940 and Brazil in 1945 in later life. He never married. Aston died in Cambridge on 20 November 1945 at the age of 68.
Therefore, the sutta states that "good qualities flow on and fill up from one to the other, for going from the near shore to the far shore." The process begins with the cultivation of ethics, using the following formula which is then applied to each further factor sequentially: "Mendicants, an ethical person, who has fulfilled ethical conduct, need not make a wish: 'May I have no regrets!' It's only natural that an ethical person has no regrets...etc."
On 27 October, the Catalan parliament voted in a secret ballot to unilaterally declare independence from Spain, with most deputies of the opposition boycotting a vote considered illegal for violating the decisions of the Constitutional Court of Spain, as the lawyers of the Parliament of Catalonia warned. As a result, the government of Spain invoked the Constitution to remove the regional authorities and enforce direct rule the next day, with a regional election being subsequently called for 21 December 2017 to elect a new Parliament of Catalonia. Puigdemont and part of his cabinet fled to Belgium after being ousted, as the Spanish Attorney General pressed for charges of sedition, rebellion and misuse of public funds against them. The trial of Catalonia independence leaders began on 12 February 2019 in the Supreme Court of Spain, in which 12 people were tried, including the previous vice president Oriol Junqueras of the regional government and most of the cabinet as well as political activists Jordi Sànchez and Jordi Cuixart and the former speaker of the Parliament of Catalonia Carme Forcadell. Nine of the 12 accused received prison sentences for the crimes of sedition; of them, four were also found guilty of misuse of public funds. Their sentences ranged from 9 to 13 years. The remaining three accused were found guilty of disobedience and were sentenced to pay a fine but received no prison term. The court dismissed the charges of rebellion. The verdict delivered by the Supreme Court sparked multiple protests across the region.
Cyanobacteria are the simplest organisms that have been observed demonstrating circadian rhythms.(2)(3) The primitiveness and simplicity make the KaiC phosphorylation model invaluable to circadian rhythm research. While it is much simpler than models for eukaryotic circadian rhythm generators, the principles are largely the same. In both systems the circadian period is dependent on the interactions between proteins within the cell, and when the genes for those proteins are mutated, the expressed period changes. (1)(2) This model of circadian rhythm generation also has implications for the study of circadian “evolutionary biology”. Given the simplicity of cyanobacteria and of this circadian system, it may be safe to assume that eukaryotic circadian oscillators are derived from a system similar to that present in cyanobacterium. (1) Bacterial circadian rhythm
Sources: en.wikipedia.org
Californium exhibits oxidation states of 4, 3, or 2. It typically forms eight or nine bonds to surrounding atoms or ions. Its chemical properties are predicted to be similar to other primarily 3+ valence actinide elements and the element dysprosium, which is the lanthanide above californium in the periodic table. Compounds in the +4 oxidation state are strong oxidizing agents and those in the +2 state are strong reducing agents. The element slowly tarnishes in air at room temperature, with the rate increasing when moisture is added. Californium reacts when heated with hydrogen, nitrogen, or a chalcogen (oxygen family element); reactions with dry hydrogen and aqueous mineral acids are rapid. Californium is only water-soluble as the californium(III) cation. Attempts to reduce or oxidize the +3 ion in solution have failed. The element forms a water-soluble chloride, nitrate, perchlorate, and sulfate and is precipitated as a fluoride, oxalate, or hydroxide. Californium is the heaviest actinide to exhibit covalent properties, as is observed in californium borate.
Newer varieties are now pending regulatory approval in the US which are designed to work rapidly, but retain the same genetic structure as regular human insulin. Short-acting insulin includes regular insulin, which begins working within 30 minutes and is active about 5 to 8 hours. Intermediate-acting insulin includes NPH insulin, which begins working in 1 to 3 hours and is active for 16 to 24 hours. Long-acting insulin includes the analogues glargine U100 and detemir, each of which begins working within 1 to 2 hours and continues to be active, without major peaks or dips, for about 24 hours, although this varies in many individuals. Ultra-long acting insulin includes the analogues insulin glargine U300 and degludec, which begin working within 30 to 90 minutes and continues to be active for greater than 24 hours. Newer long-acting insulins, like insulin icodec and insulin efsitora alfa, are designed for once-weekly use. Studies show they provide similar blood sugar control to daily insulins, with a comparable risk of hypoglycemia, while offering a simpler dosing routine. Combination insulin products combine fast- and short-acting insulin with a longer-acting insulin like NPH insulin. The combination products begin to work with the shorter-acting insulin (5–15 minutes for fast-acting, and 30 minutes for short-acting), and remain active for 16–24 hours. There are several variations with different proportions of the mixed insulins (e.g., Novolog Mix 70/30 contains 70% aspart protamine [akin to NPH], and 30% aspart).
==== Issue of citizenship ==== The report further stated that Russian citizenship, given to the vast part of Abkhaz and Ossetians can not be considered "legally binding under international law" and "the purportedly naturalised persons from South Ossetia and Abkhazia are not Russian nationals in terms of international law." The commission concluded that Abkhaz and South Ossetians legally were citizens of Georgia since 1993, and had not lost their Georgian citizenship at the time of the conflict. The commission also concluded: "The large-scale naturalisations of residents of South Ossetia and Abkhazia with no other factual connection to Russia must be equated to so-called collective (ex lege) naturalisations of foreign residents", which was prohibited. The commission concluded that the creation of Russian citizens in Georgia massively "may be a basis (or rather a pretext) for military intervention", and would amount as a violation of Georgia's sovereignty. The commission concluded that some parts of the Russian Law on Citizenship violated a territorial sovereignty of Georgia. The commission made conclusions that Russian "passportisation" was a meddling in Georgian affairs and demonstrated that Russia was the bad neighbour. The commission stated that humanitarian obstacles caused by Russia to the residents of Abkhazia and South Ossetia "do not justify the large-scale naturalisation of Georgian citizens." The commission stated that "Russia is not allowed under international law to issue passports directly in South Ossetia and Abkhazia, and to pay pensions there".
=== Validation === Validation is intended to ensure a product, service, or system (or portion thereof, or set thereof) results in a product, service, or system (or portion thereof, or set thereof) that meets the operational needs of the user. For a new development flow or verification flow, validation procedures may involve modeling either flow and using simulations to predict faults or gaps that might lead to invalid or incomplete verification or development of a product, service, or system (or portion thereof, or set thereof). A set of validation requirements (as defined by the user), specifications, and regulations may then be used as a basis for qualifying a development flow or verification flow for a product, service, or system (or portion thereof, or set thereof). Additional validation procedures also include those that are designed specifically to ensure that modifications made to an existing qualified development flow or verification flow will have the effect of producing a product, service, or system (or portion thereof, or set thereof) that meets the initial design requirements, specifications, and regulations; these validations help to keep the flow qualified. It is a process of establishing evidence that provides a high degree of assurance that a product, service, or system accomplishes its intended requirements. This often involves acceptance of fitness for purpose with end users and other product stakeholders. This is often an external process.
== Society and culture == Multiple black market sellers of the peptide emerged before approval of the Lilly drug, leading to multiple lawsuits with Lilly as the plaintiff. Eli Lilly sued six entities: Lone Star Peptide Co., Aesthetic Envy Cosmetic Centers, Striker Pharmacy, Texas Peptides, Astra LLC (Astra Peptides), and Legendary Peptides.
Sources: en.wikipedia.org
It is a synthetic peptide triagonist that engages GIP, GLP-1, and glucagon receptors. Investigational compounds in this class are studied for metabolic conditions rather than for a single organ system.
No regulatory agency has approved it for any indication. It remains an investigational product studied within controlled clinical trial programs.
A dual agonist engages two receptor targets, typically GIP and GLP-1. A triagonist adds glucagon receptor activity, which is intended to influence energy expenditure alongside appetite and glucose handling.
指同一个分子能激活 GIP、GLP-1 和胰高血糖素三类受体。它与只激活一到两种受体的同类分子在设计思路上有所区别。这种设计的目的在于覆盖更多代谢调节通路。