This is a working overview of Phase 3 trial, written for readers who want more than a one-paragraph summary but less than a textbook.
This page was last updated on 2025-12-25 and is reviewed periodically as new material appears.
Tesamorelin is a synthetic peptide that belongs to the growth hormone-releasing hormone family and contains the same forty-four amino acid sequence as endogenous GHRH, extended at the amino terminus by a trans-3-hexenoyl group. That small fatty acid modification protects the peptide from rapid cleavage by dipeptidyl peptidase-4, the enzyme that shortens the half-life of native GHRH to only a few minutes. Chemically the compound is produced by solid-phase peptide synthesis, purified by chromatography, and supplied as a sterile lyophilized powder for reconstitution.
Regulatory approval in the United States came in 2010, when the Food and Drug Administration cleared the peptide for the reduction of excess abdominal fat in adults with HIV infection and associated lipodystrophy. The decision rested mainly on two randomized phase 3 trials that enrolled roughly eight hundred patients and ran for twenty-six weeks. Participants receiving active drug showed substantially greater declines in visceral adipose tissue than those receiving placebo, while total body weight changed comparatively little. A reformulated presentation was later approved, and the product has remained a niche therapy rather than a general weight-loss agent.
作用位置在垂体前叶。tesamorelin 与 GHRH 受体结合后激活腺苷酸环化酶，升高细胞内 cAMP，再经蛋白激酶 A 通路促进生长激素的合成与释放。由于它作用于内源调控节点，生长激素仍以脉冲方式分泌，而不是被持续抬升到固定水平。生长激素随后在肝脏等组织诱导胰岛素样生长因子 1 产生，构成完整的生长激素轴响应。
研究背景集中在特定人群的体成分改变，尤其是与脂肪分布异常相关的内脏脂肪堆积。不同地区对它的监管状态与获批适应症并不一致，部分市场仅限特定诊断人群使用。在一般人群中的长期效应、与其他激素的相互作用以及停药后的维持情况仍属开放问题，现有数据不足以给出普遍结论。
| Property | Value | Notes |
|---|---|---|
| Peptide class | Synthetic GHRH analogue | 44 residues; N-terminal trans-3-hexenoyl group |
| First approval year | 2010 | United States; HIV-associated abdominal fat accumulation |
| Administration route | Subcutaneous injection | Abdominal site; clinician-administered or self-injected |
| Common synonyms | TH9507; tesamorelin acetate | Development code and acetate salt form |
| Originator | Canadian biotechnology firm | Original developer and regulatory sponsor |
Clinical investigation has focused on HIV-associated lipodystrophy, a condition in which antiretroviral therapy contributes to abnormal fat distribution. Excess visceral adipose tissue accumulates in the abdomen while peripheral fat may be lost. Tesamorelin was evaluated for reducing this visceral fat depot, with trials measuring changes in abdominal fat by imaging rather than by body weight alone. The rationale rests on the known lipolytic effects of growth hormone. Effects on visceral fat are documented, while long-term outcomes regarding cardiovascular risk remain less clearly established.
Tesamorelin is a synthetic peptide analog of growth hormone-releasing hormone, composed of 44 amino acids. It was designed to retain the biological activity of the native hormone while resisting rapid enzymatic degradation. The compound is classified as a growth hormone secretagogue and belongs to the broader family of hypothalamic releasing factors. In research and clinical settings, it is studied for its ability to stimulate pituitary growth hormone release. Its structure includes a modification at the N-terminus that contributes to an extended half-life relative to native growth hormone-releasing hormone.
Tesamorelin binds to growth hormone-releasing hormone receptors on the surface of pituitary somatotroph cells. This binding activates adenylate cyclase, raising intracellular cyclic AMP levels and triggering the release of growth hormone into circulation. The elevated growth hormone then stimulates hepatic production of insulin-like growth factor 1. Because the effect is mediated through the endogenous axis, secretion remains subject to feedback regulation. This distinguishes it from direct growth hormone administration, which bypasses pituitary control entirely.
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.
== Computing == Opus (audio format), an audio coding format Opus (microkernel), an operating system kernel Opus-CBCS, a computer bulletin board system Directory Opus, a file manager program OPUS (software), digital repository software Claude Opus, a version of the Claude (language model)
Reptilian skin is covered in a horny cornified epidermis, making it watertight and enabling reptiles to live on dry land, in contrast to amphibians. Compared to mammalian skin, that of reptiles is rather thin and lacks the thick dermal layer that produces leather in mammals. The scaly skin typical of reptiles was likely inherited from the mutual common ancestor of amniotes, as early synapsids (as well as close relatives of amniotes like diadectomorphs) also had scaly reptile-like skin. This epidermis has differentiated alpha- and beta-keratin layers. Reptile skin varies from being highly pliable (snakes, geckoes) to inflexible (crocodilians, many turtles, many lepidosaurs) and the scales from highly overlapping (skinks and snakes) to having very little overlap (crocodilians, geckoes and agamids). Some areas of the body may not covered in scales (such as large areas of the body in turtles), but still generally have a rough appearance. Large plate-like scales, such as those covering the shells of turtles and the bodies of crocodilians, are referred to as scutes. The tips of reptile digits are generally capped with hard, curved cornified claws.
Marion Walwyn, a cousin who first met Banting in 1901, recalled that "we sat together in the swing in our yard. In an hour he didn't say one word." He continued to struggle in school and stubbornly resisted being disciplined there. After one incident, he resolved never to continue his education but was convinced otherwise by his father. Banting's grandfather, John Banting, had urged his own children to be educated; the philosophy had influenced William, who offered to provide a fund to his sons when they turned twenty-one. In contrast to his brothers, who spent the inheritance towards their own farms, Frederick would use it towards matriculation. In his late teenage years, Banting grew into a tall man with engagements in school football and baseball teams. Both his mother and father hoped that he would find a vocation in the Methodist ministry. He passed physics and chemistry during junior matriculation examinations in 1909, but repeated English and was required to undertake French and Latin. The next year, he narrowly passed Latin but failed French and, for a second time, English composition. The principal later remembered his repeated efforts: "We would not have picked him for one on whom fame should settle. He was a white boy, a right boy."
Jake Melksham (born 29 August 1991) is a former professional Australian rules footballer who played for Melbourne Football Club and the Essendon Football Club in the Australian Football League (AFL). A midfielder, 1.86 metres (6 ft 1 in) tall and weighing 83 kilograms (183 lb), Melksham also has the ability to play as a defender, primarily as a half-back flanker. Growing up in Glenroy, Victoria, he played top-level football early when he joined the Calder Cannons' under 18 side in the TAC Cup at the age of sixteen. He spent three years playing for the Calder Cannons, winning a premiership in his final junior year. His achievements as a junior include state representation and the TAC Medal as the best player on the ground in the TAC Cup Grand Final. Melksham's late surge in his draft year saw him recruited by the Essendon Football Club with the tenth selection in the 2009 AFL draft. He made his AFL debut in the 2010 season and was rewarded with an AFL Rising Star nomination. He spent six seasons with Essendon, which peaked with a fifth-place finish in the best and fairest, and after 114 games with the club, he was traded to the Melbourne Football Club during the 2015 trade period. Before he could play his first match with Melbourne, he was suspended for the 2016 season for his involvement in the Essendon Football Club supplements saga; he was the last remaining player involved in the saga at the time of his retirement in 2026. In November 2023 he was delisted by the Melbourne Football Club, then re-listed in the subsequent rookie draft.
Sources: en.wikipedia.org
Boyer, P.D., Lardy, H. and Myrback, K. (Eds.), The Enzymes, 2nd ed., vol. 7, Academic Press, New York, 1963, p. 85-96. Brosemer RW, Kuhn RW (1969). "Comparative structural properties of honeybee and rabbit alpha-glycerophosphate dehydrogenases". Biochemistry. 8 (5): 2095–105. doi:10.1021/bi00833a047. PMID 4307630. O'Brien SJ, MacIntyre RJ (1972). "The -glycerophosphate cycle in Drosophila melanogaster. I Biochemical and developmental aspects". Biochem. Genet. 7 (2): 141–61. doi:10.1007/BF00486085. PMID 4340553. S2CID 22009695. Warkentin DL, Fondy TP (1973). "Isolation and characterization of cytoplasmic L-glycerol-3-phosphate dehydrogenase from rabbit-renal-adipose tissue and its comparison with the skeletal-muscle enzyme". Eur. J. Biochem. 36 (1): 97–109. doi:10.1111/j.1432-1033.1973.tb02889.x. PMID 4200180. Albertyn J, van Tonder A, Prior BA (1992). "Purification and characterization of glycerol-3-phosphate dehydrogenase of Saccharomyces cerevisiae". FEBS Lett. 308 (2): 130–2. Bibcode:1992FEBSL.308..130A. doi:10.1016/0014-5793(92)81259-O. PMID 1499720. S2CID 39643279. Koekemoer TC, Litthauer D, Oelofsen W (1995). "Isolation and characterization of adipose tissue glycerol-3-phosphate dehydrogenase". Int. J. Biochem. Cell Biol. 27 (6): 625–32. doi:10.1016/1357-2725(95)00012-E. PMID 7671141.
Some genetically modified plants are purely ornamental. They are modified for flower color, fragrance, flower shape and plant architecture. The first genetically modified ornamentals commercialized altered color. Carnations were released in 1997, with the most popular genetically modified organism, a blue rose (actually lavender or mauve) created in 2004. The roses are sold in Japan, the United States, and Canada. Other genetically modified ornamentals include Chrysanthemum and Petunia. As well as increasing aesthetic value there are plans to develop ornamentals that use less water or are resistant to the cold, which would allow them to be grown outside their natural environments. It has been proposed to genetically modify some plant species threatened by extinction to be resistant to invasive plants and diseases, such as the emerald ash borer in North American and the fungal disease, Ceratocystis platani, in European plane trees. The papaya ringspot virus devastated papaya trees in Hawaii in the twentieth century until transgenic papaya plants were given pathogen-derived resistance. However, genetic modification for conservation in plants remains mainly speculative. A unique concern is that a transgenic species may no longer bear enough resemblance to the original species to truly claim that the original species is being conserved. Instead, the transgenic species may be genetically different enough to be considered a new species, thus diminishing the conservation worth of genetic modification.
Structural analogues of psilocybin (4-PO-DMT; O-phosphorylpsilocin) and psilocin (4-HO-DMT) include 4-hydroxytryptamine (4-HT), dimethyltryptamine (DMT), serotonin (5-hydroxytryptamine; 5-HT), bufotenin (5-HO-DMT), 6-hydroxy-DMT, 7-hydroxy-DMT, 4-AcO-DMT (psilacetin; O-acetylpsilocin), 4-PrO-DMT (O-propionylpsilocin), psilomethoxin (4-HO-5-MeO-DMT; 5-methoxypsilocin), 4-MeO-DMT (O-methylpsilocin; PSOM), 4-methyl-DMT, ethocybin (4-PO-DET), baeocystin (4-PO-NMT), aeruginascin (4-PO-TMT), and norbaeocystin (4-PO-T), among others.
The third and final season of the American psychological drama television series Euphoria, inspired by Ron Leshem's miniseries of the same name, premiered on HBO on April 12, 2026. Series creator Sam Levinson serves as showrunner for the season. The season centers on recovering addict young adult Rue Bennett navigating her faith while also being drawn into the illegal drug trade. Zendaya stars as Rue alongside an ensemble cast consisting of Hunter Schafer, Jacob Elordi, Sydney Sweeney, Alexa Demie, Maude Apatow, Eric Dane, Adewale Akinnuoye-Agbaje, Martha Kelly, Chloe Cherry, and Toby Wallace. In February 2022, Euphoria was renewed for a third season. Filming commenced in February 2025 and wrapped in November. The season consists of eight episodes and received mixed reviews from critics. At the 78th Primetime Emmy and Creative Arts Awards the season was nominated seven times with Zendaya receiving her third nomination for Outstanding Lead Actress in a Drama Series. On May 31, 2026, the same day that the final episode of the third season was released, HBO confirmed that the series had concluded after three seasons.
Most CPP-nucleic acid complexes that have been proposed so far are formed through covalent bonding. A range of CPP-nucleic acid complexes have been synthesized through different chemistries that are either stable or cleavable linkages. And the most widely used method in publication is cleavable disulfide linkages through total stepwise solid-phase synthesis or solution-phase or solid-phase fragment coupling. Some other strategies like stable amide, thiazolidine, oxime and hydrazine linkage have also been developed. However, those covalent linking methods are limited by the concern that the synthetic covalent bond between CPP and nucleic acid may alter the biological activity of the latter. Thus, a new non-covalent strategy requiring no chemical modification with short amphipathic CPPs, like MPG and Pep-1 as carriers has been successfully applied for delivery of cargoes. These non-covalent conjugates are formed through either electrostatic or hydrophobic interactions. With this method, cargoes such as nucleic acids and proteins could be efficiently delivered while maintaining full biological activity.
Sources: en.wikipedia.org
=== Biosynthesis === The biogenic origin of salvinorin A synthesis has been elucidated using nuclear magnetic resonance and ESI-MS analysis of incorporated precursors labeled with stable isotopes of carbon (carbon-13 13C) and hydrogen (deuterium 2H). It "is biosynthesized via the 1-deoxy-d-xylulose-5-phosphate pathway", rather than the classic mevalonate pathway, consistent with the common plastidial localization of diterpenoid metabolism. Terpenoids are biosynthesized from two 5-carbon precursors, isopentenyl diphosphate (IPP) and dimethylallyl diphosphate (DMAPP). The NMR and MS study by Zjawiony suggested that the biosynthesis of salvinorin A proceeds via the 1-deoxy-d-xylulose-5-phosphate pathway. In the deoxyxylulose phosphate pathway, D-glyceraldehyde 3-phosphate and pyruvate, the intermediates of the glycolysis, are converted into 1-deoxy-D-xylulose 5-phosphate via decarboxylation. Subsequent reduction with NADPH generates 2C-methyl-D-erythritol 2,4-cyclodiphosphate, via the intermediates 4-diphosphocytidyl-2-C-methyl-D-erythritol and 4-diphosphocytidyl-2c-methyl-d-erythritol-2-phosphate, which then lead to IPP and DMAPP.
== Pharmacology == In contrast to ketamine and norketamine, HNK is inactive as an anesthetic and psychostimulant. In accordance, it has only very weak affinity for the NMDA receptor (Ki = 21.19 μM and > 100 μM for (2S,6S)-HNK and (2R,6R)-HNK, respectively). However, HNK does still show biological activity, having been found to act as a potent and selective negative allosteric modulator of the α7-nicotinic acetylcholine receptor (IC50 < 1 μM). Moreover, (2S,6S)-HNK was tested and found to increase the function of the mammalian target of rapamycin (mTOR), a marker of the antidepressant activity of ketamine, far more potently than ketamine itself (0.05 nM for (2S,6S)-HNK, 10 nM for (S)-norketamine, and 1,000 nM for (S)-ketamine (esketamine), respectively), an action that was observed to correlate closely with their ability to inhibit the α7-nicotinic acetylcholine receptor. This finding has led to a call of reassessment of the understanding of the rapid antidepressant effects of ketamine and their mechanisms. However, subsequent research has found that dehydronorketamine, which is a potent and selective antagonist of the α7-nicotinic acetylcholine receptor similarly to HNK, is inactive in the forced swim test at doses up to 50 mg/kg in mice, and this is in contrast to ketamine and norketamine, which are effective at doses of 10 mg/kg and 50 mg/kg, respectively.
A survey of primary care physicians in the United States found that although clinical guidelines do not consider overweight to be a risk factor that increases mortality, physicians often report believing that being overweight increases all-cause mortality. Canada developed and published evidence-based practice guidelines in 2006. The guidelines attempt to address the prevention and management of obesity at both the individual and population levels in both children and adults. The European Union published clinical practice guidelines in 2008 in an effort to address the rising rates of obesity in Europe. Australia came out with practice guidelines in 2004.
X-ray crystallography: This technique allows for the 3D determination of molecular structures. Various forms of spectroscopy: Ultraviolet-visible spectroscopy: Historically, this has been an important tool, since many inorganic compounds are strongly colored NMR spectroscopy: Besides 1H and 13C many other NMR-active nuclei (e.g., 11B, 19F, 31P, and 195Pt) can give important information on compound properties and structure. The NMR of paramagnetic species can provide important structural information. Proton (1H) NMR is also important because the light hydrogen nucleus is not easily detected by X-ray crystallography. Infrared spectroscopy: Mostly for absorptions from carbonyl ligands Electron nuclear double resonance (ENDOR) spectroscopy Mössbauer spectroscopy Electron-spin resonance: ESR (or EPR) allows for the measurement of the environment of paramagnetic metal centres. Electrochemistry: Cyclic voltammetry and related techniques probe the redox characteristics of compounds.
Sources: en.wikipedia.org
It is a laboratory-made peptide of forty-four amino acids whose sequence matches human growth hormone-releasing hormone, with a modified amino terminus. The modification is a short unsaturated fatty acid chain attached to the first residue. This change slows enzymatic breakdown and lengthens the time the peptide stays active in circulation.
The clinical program was designed around HIV-associated lipodystrophy, a condition in which fat accumulates abnormally around the internal organs. Trials enrolled that specific population, so the evidence base covers it rather than the general population. Regulators approved the drug for the studied indication only, and promotion outside it is not permitted.
Growth hormone therapy supplies the finished hormone directly, while this peptide acts upstream and asks the pituitary to secrete its own. That difference means the response depends on a functioning pituitary and on the body's normal feedback loops. It also means the circulating hormone profile is pulsatile rather than a flat, injected level.
tesamorelin 属 GHRH 类似物，作用于垂体受体以促进内源生长激素释放；生长激素本身是直接补充的外源激素。两者在给药逻辑、作用位点和反馈调控路径上并不相同。