G protein-coupled receptors driven intestinal glucagon-like peptide-1 reprogramming for obesity: Hope or hype? - 29/02/24
Abstract |
‘Globesity’ is a foremost challenge to the healthcare system. The limited efficacy and adverse effects of available oral pharmacotherapies pose a significant obstacle in the fight against obesity. The biology of the leading incretin hormone glucagon-like-peptide-1 (GLP-1) has been highly captivated during the last decade owing to its multisystemic pleiotropic clinical outcomes beyond inherent glucoregulatory action. That fostered a pharmaceutical interest in synthetic GLP-1 analogues to tackle type-2 diabetes (T2D), obesity and related complications. Besides, mechanistic insights on metabolic surgeries allude to an incretin-based hormonal combination strategy for weight loss that emerged as a forerunner for the discovery of injectable ‘unimolecular poly-incretin-agonist’ therapies. Physiologically, intestinal enteroendocrine L-cells (EECs) are the prominent endogenous source of GLP-1 peptide. Despite comprehending the potential of various G protein-coupled receptors (GPCRs) to stimulate endogenous GLP-1 secretion, decades of translational GPCR research have failed to yield regulatory-approved endogenous GLP-1 secretagogue oral therapy. Lately, a dual/poly-GPCR agonism strategy has emerged as an alternative approach to the traditional mono-GPCR concept. This review aims to gain a comprehensive understanding by revisiting the pharmacology of a few potential GPCR-based complementary avenues that have drawn attention to the design of orally active poly-GPCR agonist therapy. The merits, challenges and recent developments that may aid future poly-GPCR drug discovery are critically discussed. Subsequently, we project the mechanism-based therapeutic potential and limitations of oral poly-GPCR agonism strategy to augment intestinal GLP-1 for weight loss. We further extend our discussion to compare the poly-GPCR agonism approach over invasive surgical and injectable GLP-1-based regimens currently in clinical practice for obesity.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | The role of G protein-coupled receptors (GPCRs) is implicated in incretin secretion. |
• | A single oral pill may reprogram incretin secretion to lead to weight loss. |
• | Endogenous incretin secretion may offer a safer alternative to current therapies. |
• | GPCR mechanisms is needed to prolong efficacy and minimise side effects. |
Abbreviations : ABCD, Abn-CBD, AC, AgoPAMs, BAs, BID, CA, CA7S, cAMP, CCK, CDCA, cryo-EM, DCA, EEC, FFAR, GIP, GLP-1, GLP-1 RA, GPCRs, GSIS, HFD, IP3, LCA, LCFAs, LPC, LPI, NTS, OEA, O-LPI, OXM, PEA, PLC, PO, POMC/CART, PYY, QD, QW, RA, RY, SC, SCFAs, T2D, TAB1, TAK1, VAN
Keywords : Intestinal GLP-1, G-protein coupled receptors (GPCRs), Weight-loss, Oral poly-GPCR agonist, GLP-1-based injectable dual/poly peptide analogues, Metabolic surgery
Plan
Vol 172
Article 116245- mars 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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