长效化Exendin-4的研究进展

Exendin-4是一种新型GLP-1类似物,已被用于2型糖尿病的治疗。由于其优良的药学特性成为糖尿病治疗的亮点,而进一步开发设计长效Exendin-4药物成为近年2型糖尿病药物研究的热点。本文就长效Exendin-4药物的国内外研究进展、作用机制以及药效学性质做一综述。     

长效GLP-1受体激动剂的研发进展

胰高血糖素样肽-1(glucagon-like Peptide-1,GLP-1)是机体在葡萄糖等刺激下释放的一类肠促胰岛素。GLP-1具有促进葡萄糖依赖性胰岛素分泌,促进胰岛β细胞增殖并抑制其凋亡、抑制摄食、减慢胃排空和减轻体重等作用。GLP-1在体内极不稳定,易被二肽基肽酶-IV(dipeptidyl peptidase-IV,DPP-IV)降解,半衰期短。从墨西哥巨蜥蜴唾液中分离得到GLP-1的天然类似物Exendin-4与其有着相似的作用,且不易被DPP-IV降解。以GLP-1及Exendin-4为基础,研发长效GLP-1受体激动剂,已成为研发新型糖尿病治疗药物的热点之一。本文就长效GLP-1受体激动剂的研发现状予以综述。     

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.     

艾塞那肽长效化的研究进展

艾塞那肽(Exendin-4),一种胰高血糖素样肽(GLP-1)受体激动剂,由39个氨基酸组成,能够刺激机体产生胰岛素,主要用于治疗2型糖尿病。为了延长Exendin-4在机体内的作用时间,国内外已经做了大量研究,本文主要就近年来Exendin-4长效化的研究进行综述。     

Exendin-4的固相化学合成及鉴定

Exendin-4是首个获准上市的肠促胰素类似物药物,可模拟人体自身激素GLP-1的功能,不仅改善血糖,还能促进胰岛β细胞新生、增殖,抑制β细胞凋亡,改善β细胞功能,促进胰岛素分泌,增加机体对胰岛素的敏感性。根据Exendin-4的潜在市场价值,以Fmoc固相合成策略为基础,NMP为反应溶剂,以HOBt/DIC为缩合剂,添加盖帽程序,优化合成工艺条件。肽树脂裂解采用TFA/Phenol/TIS裂解液,并应用高效液相色谱和四级杆-飞行时间串联质谱对其进行分析鉴定和纯化,最终获得Exendin-4,产率为21%,纯度为99.4%。活性测定结果显示,合成的Exendin-4显著提高胰岛瘤细胞的活性,并呈一定剂量依赖性。     

阿必鲁肽：一种超长效Ⅱ型糖尿病治疗新药

阿必鲁肽(Albiglutide)为新型GLP-1受体激动剂,可通过与胰岛β细胞表面的GLP-1受体结合,激活由细胞膜偶联G蛋白调控的胞内信号传导系统,修复及促进胰岛β细胞功能,增加胰岛素的分泌,从而降低血糖浓度及糖化血红蛋白(Hb A1c)水平,是治疗Ⅱ型糖尿病的理想药物。目前开发的各种长效GLP-1受体激动剂成为近二十年糖尿病药物的研究热点。本文对一种极具市场潜力的新型GLP-1受体激动剂阿必鲁肽(Albiglutide)的分子结构、作用机制、剂量研究、药代动力学、药效学以及副作用等临床试验研究进展进行综述。     

ADSCs联合Exendin-4治疗糖尿病大鼠创面愈合的机制研究

摘要 目的：探究ADSCs联合Exendin-4治疗糖尿病大鼠创面愈合的效果及可能机制。方法：通过高脂饲料喂养和腹腔注射链脲佐菌素（STZ,45 mg/kg）建立糖尿病SD大鼠模型。使用直径1 cm的皮肤打孔活检器在大鼠背部制作创面。将72只建模成功的大鼠随机分为糖尿病组、ADSCs组、Exendin-4组和ADSCs+Exendin-4组,每组18只。未建模的20只大鼠作为对照组。皮肤创伤后1天,按照指定给药方案进行给药,每天给药1次,共14天。检测治疗后大鼠的血糖、创面愈合率、微血管密度、创面组织学改变和血管生成因子（VEGF-A、VEGFR-2、PDGF-BB、PDGFR-β和HIF-1α）的蛋白表达水平。另外,将HUVEC细胞分为对照组、高糖组、ADSCs组、Exendin-4组和ADSCs+Exendin-4组,并对各组细胞进行相应的处理。检测了ADSCs和Exendin-4对缺氧和高糖培养的HUVEC的增殖、迁移和血管生成的影响。结果：ADSCs和/或Exendin-4治疗组大鼠的血糖水平与糖尿病组无显著差异（P>0.05）。与单独治疗组相比,ADSCs+Exendin-4组的创面愈合率、微血管密度和创面组织中VEGF-A、VEGFR-2、PDGF-BB、PDGFR-β和HIF-1α的蛋白表达水平显著升高（P<0.05）。与单独治疗组的HUVEC相比,ADSCs+Exendin-4组的HUVEC的增殖、迁移和血管生成能力显著提高,并且血管生成因子的表达水平明显上调（P<0.05）。结论：对糖尿病大鼠创面组织局部施用ADSCs和Exendin-4可明显促进创面愈合。ADSCs和Exendin-4通过促进内皮细胞的增殖、迁移及血管生成因子的分泌来促进血管生成和创面愈合。     

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。     

抗糖尿病药物有助于治疗阿尔茨海默病和帕金森病(英文)

2型糖尿病已被证实是阿尔茨海默病(Alzheimer’s disease,AD)和帕金森病(Parkinson’s disease,PD)的一个危险因素。已有报道表明,AD和PD患者脑内的胰岛素信号转导受到损害。这一发现使抗糖尿病药物的应用有了新的研究,并显示出良好效应。临床前期试验表明,胰岛素或长效肠促胰岛素肽(incretin peptide)类似物具有良好的神经保护作用。在AD和PD转基因模型动物中,胰高血糖素样肽1(GLP-1,一种肠促胰岛素的类似物)阻止了神经退行性变进程,改善了神经元和突触的功能,并减轻了疾病的症状。在AD转基因小鼠模型中,GLP-1类似物阻止了淀粉样斑块的沉积、突触的丧失以及认知功能的损害;在PD动物模型中,GLP-1类似物改善了多巴胺能神经传递和运动功能。在此基础上,临床试验也在进行之中,并显示出令人鼓舞的结果。在AD患者中的初步研究表明,鼻腔给予胰岛素可改善患者的认知功能并减少脑内的AD标志物。对PD患者的初步研究也表明,目前已经上市用于治疗2型糖尿病的一种GLP-1受体激动剂(exendin-4,Byetta)对PD病人具有良好的疗效。另一种上市用于治疗糖尿病的GLP-1类似物(liraglutide,Victoza)也正在AD患者中进行临床测试。最近,第三种GLP-1受体激动剂(Lixisenatide,Lyxumia)已经在欧洲被批准上市,该药物也显示了良好的神经保护作用。本文将就以上抗糖尿病药物的神经保护作用进行归纳。可见,GLP-1类似物所显示的神经保护乃至神经再生作用为AD和PD提供了一种新的治疗手段,这些作用是当前其它药物所不具备的。     

GLP-1及其受体激动剂在缺血再灌注损伤中的研究进展

GLP-1受体激动剂是一种新型的降糖药物,具有有效降低糖化血红蛋白、减轻体重和避免低血糖的发生等特点,目前在2型糖尿病的临床治疗中应用越来越广泛.近年来,许多临床前和人体生理研究已经证明GLP-1受体激动剂对多种组织器官的缺血再灌注损伤具有保护作用.本文主要就GLP-1及其在心、脑、肾脏及肝脏等重要脏器缺血再灌注损伤中...     

Exendin-4, a GLP-1 receptor agonist, directly induces adiponectin expression through protein kinase A pathway and prevents inflammatory adipokine expression

Exendin-4 (Ex-4) is a glucagon-like peptide-1 receptor (GLP-1R) agonist that has been used as a drug injected subcutaneously for treatment of type 2 diabetes. Many studies have revealed molecular targets of Ex-4, but its influence on adipokines has not been determined. Our study showed that Ex-4 induced secretion of adiponectin into the culture medium of 3T3-L1 adipocytes. This effect of Ex-4 is due to increased adiponectin mRNA level through the GLP-1R. Both forskolin and 3-isobutyl-1-methylxanthine (IBMX), which may finally elevate cyclic adenosine monophosphate (cAMP) concentration, prevented the induction of adiponectin expression by Ex-4. Moreover, H89, a protein kinase A inhibitor, blocked the effect of Ex-4 on adiponectin. On the other hand, Ex-4 decreased the mRNA levels of inflammatory adipokines. The results indicate that Ex-4 directly promotes adiponectin secretion via the protein kinase A pathway in 3T3-L1 adipocytes and may ameliorate insulin resistance.     

Expression and purification of exendin-4, a GLP-1 receptor agonist, in Escherichia coli

Exendin-4 is a 39 amino acid peptide isolated from salivary secretions of Gila monster (Heloderma suspectum). It shows 53% sequence similarity to glucagon-like peptide-1 (GLP-1), which is evaluated for the regulation of plasma glucose in type 2 diabetes. Exendin-4 is a potent and long-acting agonist of GLP-1 receptor. In the present study, the exendin-4 gene obtained by PCR with an enterokinase site at N-terminus and a termination codon at C-terminus was expressed in Escherichia coli strain BL21 (DE3) harboring pET32a(+). The fusion protein was purified by chromatography on Ni-NTA-agarose column. Recombinant exendin-4 was obtained by enterokinase cleavage of the fusion protein and subsequent purification. The yield of recombinant exendin-4 was 3.15mg/10g bacteria. The obtained recombinant exendin-4 shows glucose-lowering action in vivo.     

Exendin-4, a glucagon-like peptide-1 receptor agonist, inhibits cell apoptosis induced by lipotoxicity in pancreatic β-cell line

Lipotoxicity plays an important role in the underlying mechanism of type 2 diabetes mellitus. Prolonged exposure of pancreatic β-cells to elevated concentrations of fatty acid is associated with β-cell apoptosis. Recently, glucagon-like peptide-1 (GLP-1) receptor agonists have been reported to have direct beneficial effects on β-cells, such as anti-apoptotic effects, increased β-cell mass, and improvement of β-cell function. The mechanism of GLP-1 receptor agonists' protection of pancreatic β-cells against lipotoxicity is not completely understood. We investigated whether the GLP-1 receptor agonist exendin-4 promoted cell survival and attenuated palmitate-induced apoptosis in murine pancreatic β-cells (MIN6). Exposure of MIN6 cells to palmitate (0.4mM) for 24h caused a significant increase in cell apoptosis, which was inhibited by exendin-4. Exposure of MIN6 cells to exendin-4 caused rapid activation of protein kinase B (PKB) under lipotoxic conditions. Furthermore, LY294002, a PI3K inhibitor, abolished the anti-lipotoxic effect of exendin-4 on MIN6 cells. Exendin-4 also inhibited the mitochondrial pathway of apoptosis and down-regulated Bax in MIN6 cells. Exendin-4 enhanced glucose-stimulated insulin secretion in the presence of palmitate. Our findings suggest that exendin-4 may prevent lipotoxicity-induced apoptosis in MIN6 cells through activation of PKB and inhibition of the mitochondrial pathway.     

Exendin-4 inhibits structural remodeling and improves Ca2+ homeostasis in rats with heart failure via the GLP-1 receptor through the eNOS/cGMP/PKG pathway

The glucagon-like peptide-1 receptor (GLP-1R) agonist exendin-4 is a long-acting analog of GLP-1, which stimulates insulin secretion and is clinically used in the treatment of type 2 diabetes. Previous studies have demonstrated that GLP-1 agonists and analogs serve as cardioprotective factors in various conditions. Disturbances in calcium cycling are characteristic of heart failure (HF); therefore, the aim of this study was to investigate the effect of exendin-4 (a GLP-1 mimetic) on the regulation of calcium handling and to identify the underlying mechanisms in an HF rat model after myocardial infarction (MI). Rats underwent surgical ligation of the left anterior descending coronary artery or sham surgery prior to infusion with vehicle, exendin-4, or exendin-4 and exendin9-39 for 4 weeks. Exendin-4 treatment decreased MI size, suppressed chamber dilation, myocyte hypertrophy, and fibrosis and improved in vivo heart function in the rats subjected to MI. Exendin-4 resulted in an increase in circulating GLP-1 and GLP-1R in ventricular tissues. Additionally, exendin-4 activated the eNOS/cGMP/PKG signaling pathway and inhibited the Ca²⁺/calmodulin-dependent kinase II (CaMKII) pathways. Myocytes isolated from exendin-4-treated hearts displayed higher Ca²⁺ transients, higher sarcoplasmic reticulum Ca²⁺ content, and higher l-type Ca²⁺ current densities than MI hearts. Exendin-4 treatment restored the protein expression of sarcoplasmic reticulum Ca²⁺ uptake ATPase (SERCA2a), phosphorylated phospholamban (PLB) and Cav1.2 and decreased the levels of phosphorylated ryanodine receptor (RyR). Moreover, the favorable effects of exendin-4 were significantly inhibited by exendin9-39 (a GLP-1 receptor antagonist). Exendin-4 treatment of an HF rat model after MI inhibited cardiac and cardiomyocytes progressive remodeling. In addition, Ca²⁺ handling and its molecular modulation were also improved by exendin-4 treatment. The beneficial effects of exendin-4 on cardiac remodeling may be mediated through activation of the eNOS/cGMP/PKG pathway.     

Exendin-4 对糖尿病脑缺血再灌注大鼠脑组织中MMP-9 表达的影响

目的:通过观察Exendin-4对糖尿病大鼠脑缺血再灌注后脑梗死体积百分比及脑组织中金属基质蛋白酶-9及基质金属蛋白酶抑制剂-1的变化,探讨Exendin-4对糖尿病大鼠脑缺血再灌注损伤的保护作用机制。方法:选用SD大鼠,给予链脲佐菌素(streptozocin,STZ)建立糖尿病大鼠模型后,随机分为A组:糖尿病对照组(n=6);B组:模型组(n=6);C组:Exendin-4低剂量组(n=6);D组:Exendin-4中剂量组(n=6);E组:Exendin-4高剂量组(n=6)。常规喂养6周后,A组给予假手术处理,B、C、D及E组采用线栓法制作大鼠大脑中动脉缺血90 min再灌注模型,24 h后处死大鼠取脑组织,采用2,3,5一氯化三苯四唑(2,3,5-triphenyltetrazolium chloride,TTC)染色测算脑梗死体积百分比;同时分别采用Western Blot法及RT-PCR测量脑组织中的MMP-9及TIMP-1表达量。结果:脑缺血再灌注能致脑组织中MMP-9及TIMP-1表达量增高,各组与A组比较,有显著差异(P<0.05);给予Exendin-4处理后脑组织中MMP-9及TIMP-1表达增高程度及脑梗死体积百分比明显降低,与B组比较有显著差异(P<0.05)。结论:Exendin-4对糖尿病大鼠脑缺血再灌注损伤有保护作用,其机制可能与抑制MMP-9及TIMP-1的表达有关。     

GLP-1 analogs containing disulfide bond exhibited prolonged half-life in vivo than GLP-1

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. This indicates that the stabilization of GLP-1 is critical for its utility in drug development. In this study, we developed a cluster of GLP-1 mutants containing an inter-disulfide bond that is predicted to increase the half-life of GLP-1 in vivo. Exendin-4 was also mutated with a disulfide bond similar to the GLP-1 analogs. In this study, the binding capacities of the mutants were determined, the stabilities of the mutants were investigated and the physiological functions of the mutants were compared with those of wild-type GLP-1 and exendin-4 in animals. The results indicated that the mutants remarkably raised the half-life in vivo; they also showed better glucose tolerance and higher HbA_1c reduction than GLP-1 and exendin-4 in rodents. These results suggest that GLP-1 and exendin-4 mutants containing disulfide bonds might be utilized as possible potent anti-diabetic drugs in the treatment of type 2 diabetes mellitus.     

Glucagon-like peptide 1 (7-36) amide (GLP-1) and exendin-4 stimulate serotonin release in rat hypothalamus

Glucagon-like peptide 1 (7-36) amide (GLP-1) and exendin-4 are gastrointestinal hormones as well as neuropeptides involved in glucose homeostasis and feeding regulation, both peripherally and at the central nervous system (CNS), acting through the same GLP-1 receptor. Aminergic neurotransmitters play a role in the modulation of feeding in the hypothalamus and we have previously found that peripheral hormones and neuropeptides, which are known to modulate feeding in the central nervous system, are able to modify catecholamine and serotonin release in the hypothalamus. In the present paper we have evaluated the effects of GLP-1 and exendin-4 on dopamine, norepinephrine, and serotonin release from rat hypothalamic synaptosomes, in vitro. We found that glucagon-like peptide 1 (7-36) amide and exendin-4 did not modify either basal or depolarization-induced dopamine and norepinephrine release; on the other hand glucagon-like peptide 1 (7-36) amide and exendin-4 stimulated serotonin release, in a dose dependent manner. We can conclude that the central anorectic effects of GLP-1 agonists could be partially mediated by increased serotonin release in the hypothalamus, leaving the catecholamine release unaffected.