If you have been reading about Dipeptidyl peptidase-4 and want a single page that covers the useful parts, this is it: definitions, context, how it is studied, and the questions that come up repeatedly.
Last reviewed on 2025-11-14. Where a claim depends on a specific study, the study is described rather than over-claimed.
Pharmacodynamic studies show that tesamorelin reduces visceral adipose tissue more than subcutaneous adipose tissue in the studied population. This selectivity may relate to differences in blood flow and hormone sensitivity between fat depots. Effects on glucose metabolism and insulin sensitivity have been investigated, with some trials reporting modest changes and others showing stability. The precise relationship between growth hormone exposure, IGF-1 levels, and visceral fat loss remains an active area of analysis.
Tesamorelin binds to growth hormone-releasing hormone receptors on somatotroph cells in the anterior pituitary. Receptor activation increases intracellular cyclic AMP and promotes synthesis and secretion of growth hormone. Because the peptide mimics endogenous GHRH, it amplifies the normal pulsatile release of growth hormone rather than providing exogenous growth hormone directly. This upstream action distinguishes tesamorelin from recombinant growth hormone preparations and from growth hormone secretagogues that act at different receptors.
Clinical interest in tesamorelin arose from the need to address visceral adiposity in people living with HIV. Antiretroviral therapy improved survival but was associated in some patients with central fat accumulation, altered lipid profiles, and metabolic complications. This condition, often called HIV-associated lipodystrophy, involves excess visceral adipose tissue that is difficult to manage through diet and exercise alone. Investigators evaluated tesamorelin because GHRH analogs can stimulate growth hormone secretion and influence fat distribution without direct liposuction or invasive procedures.
A Phase 3 program led to regulatory approval in the United States in 2010 for reduction of excess visceral abdominal fat in adults with HIV and lipodystrophy. Subsequent studies examined effects on liver fat, muscle area, and metabolic markers, with mixed findings for some endpoints. Long-term cardiovascular outcomes and effects on mortality remain uncertain because most trials were relatively short and focused on imaging-based fat measurements. Use in populations without HIV has been studied experimentally but is not part of the approved indication.
Tesamorelin is a synthetic analog of growth hormone-releasing hormone, a peptide hormone produced by the hypothalamus. The molecule retains the 44-amino-acid sequence of human GHRH and carries a trans-3-hexenoyl modification at its N-terminus. This modification increases resistance to enzymatic degradation and extends the peptide's functional stability relative to native GHRH. The compound is supplied as a lyophilized powder for reconstitution and subcutaneous administration in clinical settings. Its development code was TH9507, and it belongs to the GHRH analog class. It is not a growth hormone product; instead, it acts upstream to stimulate endogenous growth hormone release.
| Property | Value | Notes |
|---|---|---|
| Primary target | Growth hormone-releasing hormone receptor | Located on anterior pituitary somatotroph cells. |
| Receptor class | G protein-coupled receptor | Activation increases intracellular cyclic AMP. |
| Main downstream hormone | Growth hormone and insulin-like growth factor 1 | Growth hormone release precedes IGF-1 elevation. |
| Primary studied effect | Reduction in visceral adipose tissue | Measured by computed tomography in clinical trials. |
| Approximate half-life | 26–38 minutes after subcutaneous administration | Values vary by assay and study population. |
Binding of tesamorelin to the growth hormone-releasing hormone receptor on anterior pituitary somatotrophs activates a Gs protein pathway, raises cyclic AMP, and triggers release of stored growth hormone into the bloodstream. Because the analogue resists dipeptidyl peptidase-4, its plasma residence time exceeds that of native GHRH, producing a larger and more sustained secretory signal. The released growth hormone then acts on the liver and peripheral tissues to raise insulin-like growth factor 1, which feeds back on the hypothalamus and pituitary. This axis explains both the intended effects on fat distribution and the biological markers used to track them.
Studies of the compound rely on imaging and laboratory endpoints rather than on symptoms alone. Visceral adipose tissue is usually quantified by computed tomography or magnetic resonance imaging at the level of the abdomen, with waist circumference serving as a cheaper but less specific proxy. Blood work tracks insulin-like growth factor 1, fasting glucose, glycated hemoglobin, and lipid fractions. In the pivotal trials the imaging endpoint fell by roughly fifteen to twenty percent over six months, subcutaneous fat changed little, and the visceral fat returned toward baseline after treatment stopped, a pattern that shapes how clinicians discuss durability.
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.
Tesamorelin occupies a narrow position among agents that act on the growth hormone axis. Unlike growth hormone itself, which is given as replacement, it stimulates the pituitary to release the hormone in pulses, so the downstream increase in insulin-like growth factor 1 depends on intact somatotroph function. Other peptides in the same family include shorter GHRH fragments and synthetic secretagogues with different stability profiles. Several points remain unresolved, including whether the reduction in visceral fat translates into fewer cardiovascular events, what happens to metabolic markers after long-term use, and how the drug compares with lifestyle or surgical approaches.
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.
Questions remain about how much of the observed fat reduction reflects direct GHRH-receptor signaling versus the downstream growth hormone and IGF-1 surge. It is also unclear whether the compound produces meaningful benefit in populations without lipodystrophy, since trials in cognitive impairment did not reach their stated goals. Long-term effects on glucose metabolism and on cardiovascular outcomes are not fully characterized. Published work generally describes effects on surrogate markers rather than on hard clinical endpoints, and independent replication of some findings is limited.
Tesamorelin acts on the growth hormone-releasing hormone receptor, a G-protein-coupled receptor found on somatotroph cells in the anterior pituitary. Binding triggers a rise in intracellular cyclic AMP, which in turn opens ion channels and raises calcium concentrations, leading to release of stored growth hormone into the bloodstream. Because the peptide works through the same receptor as the body's own GHRH, the resulting secretion follows a pulsatile pattern rather than a continuous elevation. The N-terminal modification slows enzymatic breakdown, so the signal persists longer than it would with the unmodified hormone.
Growth hormone released from the pituitary stimulates the liver and other tissues to produce insulin-like growth factor 1, a stable circulating protein that serves as a practical marker of activity. Clinical studies therefore track IGF-1 concentrations alongside the hormone itself, and they commonly measure body composition with imaging rather than relying on body weight alone. Visceral adipose tissue, the fat surrounding abdominal organs, is quantified by computed tomography in the studies that supported approval. Adverse effects reported in trials include injection-site reactions, joint pain, and increases in blood glucose, which is why monitoring accompanies use.
Since AlphaFold outputs protein coordinates directly, AlphaFold produces predictions in graphics processing unit (GPU) minutes to GPU hours, depending on the length of protein sequence. The European Bioinformatics Institute together with DeepMind have constructed the AlphaFold – EBI database for predicted protein structures.
where μ is the dynamic viscosity of the fluid. In the above equation, the left-hand side is only a function of r and the right-hand side term is only a function of x, implying that both terms must be the same constant. Evaluating this constant is straightforward. If we take the length of the pipe to be L and denote the pressure difference between the two ends of the pipe by Δp (high pressure minus low pressure), then the constant is simply
== Further reading == Garber, Megan (27 November 2013). "The Edible Instagram". The Atlantic. New York. Retrieved 9 March 2015. Beck, Laura (30 November 2013). "Get Your Instagram Photos Printed on Marshmallows". Cosmopolitan. New York: Hearst Communications. Retrieved 9 March 2015. Jacobs, Alexandra (14 November 2014). "James Middleton Will Put a Happy Face on Your S'mores". New York Times. Retrieved 9 March 2015. Schwiegershausen, Erica (30 May 2014). "James Middleton on Marshmallows, and Being a 'New Age Willy Wonka'". New York. New York. Retrieved 9 March 2015.
=== Medications === Certain medications increase the risk of hyperglycemia, including: corticosteroids, octreotide, beta blockers, epinephrine, thiazide diuretics, niacin, pentamidine, protease inhibitors, L-asparaginase, statins and antipsychotics. The administration of amphetamines initially produces hyperglycemia but later produces hypoglycemia. Thiazides are used to treat hypertension in type 2 diabetes but also may cause hyperglycemia.
Sources: en.wikipedia.org
Digital agriculture, sometimes known as smart farming or e-agriculture, are tools that digitally collect, store, analyze, and share electronic data and/or information in agriculture. The Food and Agriculture Organization of the United Nations has described the digitalization process of agriculture as the digital agricultural revolution. Other definitions, such as those from the United Nations Project Breakthrough, Cornell University, and Purdue University, also emphasize the role of digital technology in the optimization of food systems. Digital agriculture includes (but is not limited to) precision agriculture. Unlike precision agriculture, digital agriculture impacts the entire agri-food value chain before, during, and after on-farm production. Therefore, on-farm technologies like yield mapping, GPS navigation, and tracking, and variable-rate application, fall under the domain of precision agriculture and digital agriculture. On the other hand, digital technologies involved in e-commerce platforms, e-extension services, warehouse receipt systems, blockchain-enabled food traceability systems, tractor rental apps, etc. fall under the umbrella of digital agriculture but not precision agriculture.
This was his life. He speaks with authority that has been extremely hard won." The following month, Dreher posted about his theories about why liberals loved the book. New York Post columnist and editor of Commentary John Podhoretz described the book as among the year's most provocative. However, other journalists criticized Vance for generalizing too much from his personal upbringing in suburban Ohio. Jared Yates Sexton of Salon criticized Vance for his "damaging rhetoric" and for endorsing policies used to "gut the poor". He argues that Vance "totally discounts the role racism played in the white working class's opposition to President Obama." Sarah Jones of The New Republic mocked Vance as "the false prophet of Blue America," dismissing him as "a flawed guide to this world" and the book as little more than "a list of myths about welfare queens repackaged as a primer on the white working class." Historian Bob Hutton wrote in Jacobin that Vance's argument relied on circular logic and eugenics, ignored existing scholarship on Appalachian poverty, and was "primarily a work of self-congratulation." Sarah Smarsh with The Guardian noted that "most downtrodden whites are not conservative male Protestants from Appalachia" and called into question Vance's generalizations about the white working class from his personal upbringing. The book was discussed in an episode of the podcast If Books Could Kill.
The resulting dried plasma package came in two tin cans containing 400 mL bottles. One bottle contained enough distilled water to reconstitute the dried plasma contained within the other bottle. In about three minutes, the plasma would be ready to use and could stay fresh for around four hours. Charles R. Drew was appointed medical supervisor, and he was able to transform the test-tube methods into the first successful technique for mass production. Another important breakthrough came in 1937–40 when Karl Landsteiner (1868–1943), Alex Wiener, Philip Levine, and R.E. Stetson discovered the Rhesus blood group system, which was found to be the cause of the majority of transfusion reactions up to that time. Three years later, the introduction by J.F. Loutit and Patrick L. Mollison of acid–citrate–dextrose (ACD) solution, which reduced the volume of anticoagulant, permitted transfusions of greater volumes of blood and allowed longer-term storage. Carl Walter and W.P. Murphy Jr. introduced the plastic bag for blood collection in 1950. Replacing breakable glass bottles with durable plastic bags made from PVC allowed for the evolution of a collection system capable of safe and easy preparation of multiple blood components from a single unit of whole blood. In the field of cancer surgery, the replacement of massive blood-loss became a major problem. The cardiac-arrest rate was high. In 1963 C. Paul Boyan and William S. Howland discovered that the temperature of the blood and the rate of infusion greatly affected survival rates, and introduced blood warming to surgery.
Sources: en.wikipedia.org
Vitamin K is a family of structurally similar, fat-soluble vitamers found in foods and marketed as dietary supplements. The human body requires vitamin K for post-synthesis modification of certain proteins that are required for blood coagulation ("K" from Danish koagulation, for "coagulation") and for controlling binding of calcium in bones and other tissues. The complete synthesis involves final modification of these so-called "Gla proteins" by the enzyme gamma-glutamyl carboxylase that uses vitamin K as a cofactor. Vitamin K is used in the liver as the intermediate VKH2 to deprotonate a glutamate residue and then is reprocessed into vitamin K through a vitamin K oxide intermediate. The presence of uncarboxylated proteins indicates a vitamin K deficiency. Carboxylation allows them to bind (chelate) calcium ions, which they cannot do otherwise. Without vitamin K, blood coagulation is seriously impaired, and uncontrolled bleeding occurs. Research suggests that deficiency of vitamin K may also weaken bones, potentially contributing to osteoporosis, and may promote calcification of arteries and other soft tissues. Chemically, the vitamin K family comprises 2-methyl-1,4-naphthoquinone derivatives at position 3. Vitamin K includes two natural vitamers: vitamin K1 (phylloquinone) and vitamin K2 (menaquinone). Vitamin K2, in turn, consists of several related chemical subtypes, with differing lengths of carbon side chains made of isoprenoid groups of atoms. The two most studied are menaquinone-4 (MK-4) and menaquinone-7 (MK-7).
NK1: SP > NKA > NKB NK2: NKA > NKB > SP NK3: NKB > NKA > SP Antagonists of neurokinin-1 (NK1) receptors (NK1 receptor antagonists), through which substance P acts, have been proposed to belong to a new class of antidepressants, while NK2 antagonists have been proposed as anxiolytics and NK3 antagonists have been proposed as antipsychotics.
The morphological structure of the human breast is identical in males and females until puberty. For pubescent girls in thelarche (the breast-development stage), the female sex hormones (principally estrogens) in conjunction with growth hormone promote the sprouting, growth, and development of the breasts. During this time, the mammary glands grow in size and volume and begin resting on the chest. These development stages of secondary sex characteristics (breasts, pubic hair, etc.) are illustrated in the five-stage Tanner scale. During thelarche, the developing breasts are sometimes of unequal size, and usually the left breast is slightly larger. This condition of asymmetry is transitory and statistically normal in female physical and sexual development. Medical conditions can cause overdevelopment (e.g., juvenile breast hypertrophy, macromastia) or underdevelopment (e.g., tuberous breast deformity, micromastia) in girls and women. Approximately two years after the onset of puberty (a girl's first menstrual cycle), estrogen and growth hormone stimulate the development and growth of the glandular fat and suspensory tissues that compose the breast. This continues for approximately four years until the final shape of the breast (size, volume, density) is established at about the age of 21. Mammoplasia (breast enlargement) in girls begins at puberty, unlike all other primates, in which breasts enlarge only during lactation.
Supercritical CO2 can be used as a working fluid for geothermal electricity generation in both enhanced geothermal systems and sedimentary geothermal systems (so-called CO2 Plume Geothermal). EGS systems utilize an artificially fractured reservoir in basement rock while CPG systems utilize shallower naturally-permeable sedimentary reservoirs. Possible advantages of using CO2 in a geologic reservoir, compared to water, include higher energy yield resulting from its lower viscosity, better chemical interaction, and permanent CO2 storage as the reservoir must be filled with large masses of CO2. As of 2011, the concept had not been tested in the field.
Sources: en.wikipedia.org
It targets the growth hormone-releasing hormone receptor on pituitary somatotroph cells. Binding stimulates cyclic AMP signaling and growth hormone secretion. This is the same receptor used by endogenous GHRH.
It does not act directly on adipose tissue as a primary mechanism. Instead, it increases endogenous growth hormone, which then influences lipolysis and fat distribution. The reduction in visceral fat is an indirect pharmacodynamic effect.
Tesamorelin acts upstream at the pituitary to amplify natural pulsatile growth hormone release. Growth hormone injections provide exogenous hormone and bypass pituitary regulation. The two approaches therefore differ in feedback control and hormonal dynamics.
It is a synthetic peptide analog of human growth hormone-releasing hormone. It is used clinically to reduce excess visceral abdominal fat in adults with HIV-associated lipodystrophy. It works by stimulating pituitary growth hormone release.