取代环丁烷结构的非肽类胰高血糖素样肽-1受体激动剂

应用胰高血糖素样肽-1（glucagon-like peptide-1,GLP-1）及其类似物治疗2型糖尿病是代谢性疾病研究领域近年来的热点,尤其是胰高血糖素样肽-1独特的作用机制倍受业界的关注。它能同时作用于2型糖尿病的多个发病环节,在有效降低血糖的同时,避免低血糖的发生并能减轻体重。但这类药物因其多肽性质而存在诸多的使用限制（如需反复注射）。简要介绍一类取代环丁烷结构的新型非肽类胰高血糖素样肽-1受体小分子激动剂的发现过程、基本药理学特征和体内抗糖尿病和抗肥胖症效应。     

利拉鲁肽治疗2型糖尿病的临床研究进展

利拉鲁肽是一种新型胰高糖素样肽-1 GLP-1类似物,能迅速、高效、持久地降低血糖及糖化血红蛋白,具有改善胰岛β细胞功能、调节收缩压、保护心血管、降低血脂、减轻体重、延迟胃排空、增加饱腹感等作用。此外,利拉鲁肽具有葡萄糖依赖的促胰岛素分泌作用,仅在机体血糖水平高时刺激胰岛素的释放,但当患者体内血糖浓度恢复至正常时,GLP-1分泌促胰岛素的作用便消退,因而发生低血糖事件的几率较低,能有效地改善糖尿病患者的病情,已成为目前2型糖尿病治疗领域的研究热点。本文主要就利拉鲁肽治疗2型糖尿病的临床研究进展进行综述。     

2型糖尿病患者早期使用胰高血糖素样受体激动剂

糖尿病目前已成为继心血管疾病和肿瘤之后的第三位主要非传染性疾病,其中90%为2型糖尿病患者。胰高血糖素样肽-1类似物(GLP-I类似物)作为一种新型的降糖药物,具有降低体重、降低收缩压、改善胰岛细胞功能,已成为2型糖尿病治疗的新热点。艾塞那肽和利拉鲁肽作为肠促胰素激素,与人体内天然GLP-1保持了高度同源性(97%)。近几年来受到人们广泛关注。本综述针对2型糖尿病患者早期使用胰岛素样受体激动剂艾塞那肽和利拉鲁肽的安全性和有效性进行评估。     

胰高血糖素样肽-1在构建胰岛样细胞中的应用

糖尿病治疗的主要方向之一是胰岛细胞的替代疗法,但供体来源不足成为阻碍其临床应用的难题。胰高血糖素样肽-1是体内的一种促胰岛素激素,对胰岛β细胞的增殖、分化均起重要作用。目前,利用胰高血糖素样肽-1构建多种细胞成胰岛样细胞,以作为移植胰岛细胞替代物成为研究的热点。     

sGLP-1对GK糖尿病大鼠治疗效果的研究

目的研究人工合成胰高血糖素样截短肽（sGLP-1）对II型糖尿病大鼠的治疗效果。方法GKⅡ型糖尿病大鼠随机分为三组,以合成的GLP-1为阳性对照,观察sGLP-1对GKⅡ型糖尿病大鼠血糖水平、胰岛素分泌以及糖耐量的影响。结果与GLP-1相比sGLP-1能够长效控制的血糖水平,明显改善糖尿病大鼠的糖耐量（P〈0.01）。结论sGLP-1控制血糖的长效能力优于GLP-1,可能从刺激胰岛素分泌方面对Ⅱ型糖尿病具有治疗作用。     

胰高血糖素样肽-1及其类似物与Ⅱ型糖尿病治疗

胰高血糖素样肽-1（GIP-1）是人体内强有力的促胰岛素分泌的肽类激素,对Ⅱ型糖尿病有潜在的治疗作用。但是GIP-1在体内很快被二肽酰基肽酶Ⅳ降解,血浆半寿期很短,因而限制了其临床应用。目前人们已开发了多种GIP-1的衍生物,希望能将其用于临床对Ⅱ型糖尿病进行治疗。     

胰高血糖素样肽-1与Ⅰ型糖尿病治疗

近年来研究表明,胰高血糖素样肽-1（GLP-1）对胰岛β细胞的分化、增殖均起重要作用,包括抑制β细胞凋亡、刺激β细胞增生、诱导干细胞分化为胰腺内分泌细胞,从而使被破坏的胰岛细胞恢复分泌胰岛素的功能,这些作用为其治疗Ⅰ型糖尿病提供了证据,使其成为Ⅰ型糖尿病治疗领域研究的热点。     

用抗糖尿病药物GLP-1及其类似物治疗阿尔茨海默病

流行病学和基础研究表明阿尔茨海默病（Alzheimert＇s disease,AD）与2型糖尿病（type 2 diabetes mellitus,T2DM）存在密切关联：T2DM是AD的危险因素之一;而AD脑内也出现胰岛素信号异常、胰岛素抵抗状态,因而被称为“第3类型的糖尿病”。近年来治疗T2DM的新药——胰高血糖素样肽-1（glucagon-1ike peptide-1,GLP-1）及其类似物,已被证实具有神经保护作用,且能改善AD模型的记忆和认知功能,为AD治疗药物的研究提供了新的策略。     

Exendin-4的研究进展

Exendin-4是从希拉毒蜥唾液中分离的一种多肽激素,由39个氨基酸残基组成,与胰高血糖素样肽1（GLP-1）有53%的同源性.Exendin-4具有高度的组织特异性,仅在希拉毒蜥的唾液腺中表达.Exendin-4首先翻洋成N端多余45个氨基酸残基的前体,然后在激素原转化酶催化下分解产生具有生物活性的Exendin-4.Exendin-4的N端是一段不规则卷曲,第7～28氨基酸残基形成α螺旋,C端是不规则亲水片段.Exendin-4的受体是G蛋白,N端是激活受体信号转导途径的关键区域,中间部位和C端是受体结合域.Exendin-4与GLP-1类似,可提高胰岛素基因的转录水平,刺激胰岛素的释放,从而控制血糖浓度,但GLP-1的半衰期2分钟,Exendin-4半衰期却长达9.57小时,因而在治疗Ⅱ型糖尿病方面具有广阔的前景.     

新型降糖药物Exenatide研究进展及前景展望

Exenatide是胰高血糖素样肽-1（GLP-1）受体的一种激动剂,可模拟人体自身激素GLP-1的功能,具有促进胰腺p-细胞增殖、改善其功能,以及促进胰岛素分泌,增加机体对胰岛素的敏感性和延缓胃排空等作用,因而有着传统治疗糖尿病药物不可比拟的优点,近年来已经成为糖尿病治疗领域的研究热点,应用前景非常广阔。简要介绍了Exenatide的生物活性、作用机理和临床应用现状,并对Exenatide长效降糖方面的研究进行了展望。     

胰高血糖素样肽-1与受体相互作用研究进展

胰高血糖素样肽-1(GLP-1)具有促胰岛素分泌、抑制胰高血糖素分泌、刺激胰岛β细胞的增殖和分化、抑制β细胞凋亡、抑制胃排空等作用,近年来成为治疗糖尿病药物研究中的热点。GLP-1与受体的相互作用一直备受关注,我们从4个方面对GLP-1与受体相互作用的研究进行了综述:GLP-1的二级结构、GLP-1单个残基改变及残基间的相互作用、GLP-1不同残基片段对GLP-1结合并激活受体的影响和GLP-1受体的相互作用模式。     

胰高血糖素样肽1受体--治疗糖尿病新药的研究热点

胰高血糖素样肽l(glucagon—like peptide—l,GLP-1)与胰岛素分泌和糖代谢调节密切相关。GLP-1与其受体(GLP-1receptor,GLP-1R)结合后,主要通过cAMP和P13K两条信号途径,促进胰岛素的分泌,刺激胰岛β细胞的增殖和分化。对GLP-1R结构和信号传导机制的研究,有助于了解其在糖尿病病理进程中的作用,为开发新型糖尿病治疗药物指明方向。     

Loureirin B activates GLP-1R and promotes insulin secretion in Ins-1 cells

Loureirin B (LB) is a natural product derived from Sanguis draconis, which has hypoglycaemic effects. In order to research the possible target of LB in the treatment of diabetes, molecular docking was used to simulate the interaction between LB and potential targets, and among them, glucagon-like peptide-1 receptor (GLP-1R) had the optimal results. Further, spectroscopy and surface plasmon resonance (SPR) experiments were applied to detect the interaction between LB and GLP-1R. Ultimately, after GLP-1R siRNA interfering the expression of GLP-1R in Ins-1 cell, the promoting insulin secretion of LB was weaken, which directly proved that GLP-1R plays an important role. These results show that LB promotes insulin secretion of Ins-1 cells through GLP-1R. Hence, the strategy of LB as a prodrug will provide a potential approach for non-peptide GLP-1R agonist.     

长效促胰岛素降糖酵母的构建及其对糖尿病模型小鼠的治疗效果

益生菌生物药物是指通过口服表达药用多肽(蛋白)的重组益生菌活细胞达到治疗疾病的新型口服给药系统。为了构建一种能有效防治2型糖尿病的酵母生物药物,文章首先构建了酿酒酵母(S.cerevisiae)整合型表达载体pNK1-PGK,并且通过绿色荧光蛋白(GFP)证明其表达功能正常,利用该载体将10×GLP-1 (Glucagon-like peptide-1)基因转化到酿酒酵母INVSc1中,通过营养缺陷型和Western blotting成功筛选出表达10×GLP-1的长效促胰岛素降糖酵母(Long-acting GLP-1 hypoglycemic yeast, LHY)。该酵母生长迅速,外源基因10×GLP-1表达稳定,表达量达到1.56 mg/g细胞湿重。通过链脲佐菌素和高脂高糖饮食联合诱导的方法构建了2型糖尿病小鼠模型,用LHY对其进行口服灌胃治疗,证明LHY具有较好疗效,明显降低血糖水平。     

New screening strategy and analysis for identification of allosteric modulators for glucagon-like peptide-1 receptor using GLP-1 (9-36) amide

The glucagon-like peptide-1 receptor (GLP-1R) is an important physiologic regulator of insulin secretion and a major therapeutic target for diabetes mellitus. GLP-1 (7-36) amide (active form of GLP-1) is truncated to GLP-1 (9-36) amide, which has been described as a weak agonist of GLP-1R and the major form of GLP-1 in the circulation. New classes of positive allosteric modulators (PAMs) for GLP-1R may offer improved therapeutic profiles. To identify these new classes, we developed novel and robust primary and secondary high-throughput screening (HTS) systems in which PAMs were identified to enhance the GLP-1R signaling induced by GLP-1 (9-36) amide. Screening enabled identification of two compounds, HIT-465 and HIT-736, which possessed new patterns of modulation of GLP-1R. We investigated the ability of these compounds to modify GLP-1R signaling enhanced GLP-1 (9-36) amide- and/or GLP-1 (7-36) amide-mediated cyclic adenosine monophosphate (cAMP) accumulation. These compounds also had unique profiles with regard to allosteric modulation of multiple downstream signaling (PathHunter β-arrestin signaling, PathHunter internalization signaling, microscopy-based internalization assay). We found allosteric modulation patterns to be obviously different among HIT-465, HIT-736, and Novo Nordisk compound 2. This work may enable the design of new classes of drug candidates by targeting modulation of GLP-1 (7-36) amide and GLP-1 (9-36) amide.     

GLP-1 receptor agonists (GLP-1RAs): cardiovascular actions and therapeutic potential

Type 2 diabetes mellitus (T2DM) is closely associated with cardiovascular diseases (CVD), including atherosclerosis, hypertension and heart failure. Some anti-diabetic medications are linked with an increased risk of weight gain or hypoglycemia which may reduce the efficacy of the intended anti-hyperglycemic effects of these therapies. The recently developed receptor agonists for glucagon-like peptide-1 (GLP-1RAs), stimulate insulin secretion and reduce glycated hemoglobin levels without having side effects such as weight gain and hypoglycemia. In addition, GLP1-RAs demonstrate numerous cardiovascular protective effects in subjects with or without diabetes. There have been several cardiovascular outcomes trials (CVOTs) involving GLP-1RAs, which have supported the overall cardiovascular benefits of these drugs. GLP1-RAs lower plasma lipid levels and lower blood pressure (BP), both of which contribute to a reduction of atherosclerosis and reduced CVD. GLP-1R is expressed in multiple cardiovascular cell types such as monocyte/macrophages, smooth muscle cells, endothelial cells, and cardiomyocytes. Recent studies have indicated that the protective properties against endothelial dysfunction, anti-inflammatory effects on macrophages and the anti-proliferative action on smooth muscle cells may contribute to atheroprotection through GLP-1R signaling. In the present review, we describe the cardiovascular effects and underlying molecular mechanisms of action of GLP-1RAs in CVOTs, animal models and cultured cells, and address how these findings have transformed our understanding of the pharmacotherapy of T2DM and the prevention of CVD.     

A novel GLP-1 analog exhibits potent utility in the treatment of type 2 diabetes with an extended half-life and efficient glucose clearance in vivo

The multiple physiological characterizations of glucagon-like peptide-1 (GLP-1) make it a promising drug candidate for the therapy of type 2 diabetes. However, the half-life of GLP-1 is short in vivo due to degradation by dipeptidyl peptidase-IV (DPP-IV) and renal clearance. Therefore, the stabilization of GLP-1 is critical for its utility in drug development. Based on our previous research, a GLP-1 analog that contained an intra-disulfide bond exhibited a prolonged biological half-life. In this study, we improved upon previous analogs with a novel GLP-1 analog that contained a tryptophan cage-like sequence for an improved binding affinity to the GLP-1 receptor. The binding capacities and the stabilities of GLP715a were investigated, and the physiological functions of the GLP715a were compared to those of the wild-type GLP-1 in animals. The results demonstrated that the new GLP-1 analog (GLP715a) increased its biological half-life to approximately 48 h in vivo; GLP715a also exhibited a higher binding affinity to the GLP-1 receptor than the wild-type GLP-1. The increased binding capacity of GLP715a to its receptor resulted in a quick response to glucose administration. The long-acting anti-diabetic property of GLP715a was revealed by its increased glucose tolerance, higher HbA_1c reduction, more efficient glucose clearance and quicker insulin stimulation upon glucose administration compared to the wild-type GLP-1 in rodents. The improved physiological characterizations of GLP715a make it a possible potent anti-diabetic drug in the treatment of type 2 diabetes mellitus.