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Unimolecular dual incretins maximize metabolic benefits in rodents, monkeys, and humans.
Sci. Transl. Med. 5:209ra151 (2013)
We report the discovery and translational therapeutic efficacy of a peptide with potent, balanced co-agonism at both of the receptors for the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). This unimolecular dual incretin is derived from an intermixed sequence of GLP-1 and GIP, and demonstrated enhanced antihyperglycemic and insulinotropic efficacy relative to selective GLP-1 agonists. Notably, this superior efficacy translated across rodent models of obesity and diabetes, including db/db mice and ZDF rats, to primates (cynomolgus monkeys and humans). Furthermore, this co-agonist exhibited synergism in reducing fat mass in obese rodents, whereas a selective GIP agonist demonstrated negligible weight-lowering efficacy. The unimolecular dual incretins corrected two causal mechanisms of diabesity, adiposity-induced insulin resistance and pancreatic insulin deficiency, more effectively than did selective mono-agonists. The duration of action of the unimolecular dual incretins was refined through site-specific lipidation or PEGylation to support less frequent administration. These peptides provide comparable pharmacology to the native peptides and enhanced efficacy relative to similarly modified selective GLP-1 agonists. The pharmacokinetic enhancement lessened peak drug exposure and, in combination with less dependence on GLP-1-mediated pharmacology, avoided the adverse gastrointestinal effects that typify selective GLP-1-based agonists. This discovery and validation of a balanced and high-potency dual incretin agonist enables a more physiological approach to management of diseases associated with impaired glucose tolerance.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
Dependent Insulinotropic Polypeptide ; Gastric-inhibitory Polypeptide ; High-fat Diet ; Pancreatic Beta-cells ; Glucose-intolerance ; Enteroinsular Axis ; Lipoprotein-lipase ; Glycemic Control ; Peptide Yy3-36 ; Body-weight
ISSN (print) / ISBN
1946-6234
e-ISSN
1946-6242
Zeitschrift
Science Translational Medicine
Quellenangaben
Band: 5,
Heft: 209,
Artikelnummer: 209ra151
Verlag
American Association for the Advancement of Science (AAAS)
Begutachtungsstatus
Peer reviewed