A practical reference on dual agonist: what it is, how it behaves, what the literature reports, and where the honest uncertainties sit.
Reviewed 2026-05-31. Anything still debated is marked as such rather than presented as settled.
The peptide activates two G protein-coupled receptors, GIPR and GLP-1R. Binding triggers adenylyl cyclase activity and raises intracellular cyclic AMP in pancreatic beta cells, which potentiates insulin release when glucose is elevated. Signaling in the central nervous system is associated with reduced appetite and lower energy intake, while effects on gastric emptying and glucagon secretion are also reported. Because activity at both receptors is retained, the pharmacological profile is often described as incretin-based rather than selective for a single receptor.
After subcutaneous injection, absorption is gradual, and peak plasma levels are generally reached within one to three days. Albumin binding extends the apparent half-life to roughly five days, which supports a weekly administration schedule. Metabolism proceeds mainly through proteolytic cleavage of the peptide backbone and beta-oxidation of the fatty acid chain, rather than through cytochrome P450 pathways. Eliminated fragments are largely recycled through general protein turnover, and excretion of intact drug in urine is minimal. These properties distinguish the molecule from short-acting incretin mimetics.
溶解操作一般使用注射用水或适宜的水性缓冲液，必要时加入少量助溶剂以改善溶解速度，但应避免剧烈涡旋振荡，因为剪切力可能促进聚集。配制后的溶液在冷藏条件下的稳定时间通常短于固体形态，具体时限取决于浓度、缓冲体系与容器材质。是否加入防腐成分，则取决于用途是否为多次取样。
定量分析的主流方法是反相高效液相色谱联用紫外或质谱检测，利用肽在疏水固定相上的保留行为确定纯度与含量。对于生物基质中的浓度测定，常采用液相色谱串联质谱，并配合固相萃取或蛋白沉淀进行样品前处理。免疫分析法也可使用，但可能受到结构相关肽的交叉反应干扰。
纯度评估通常综合反相色谱、体积排阻色谱与质谱三方面信息：前者反映疏水性杂质，后者反映聚集体，质谱则确认分子量与主要降解产物。有关降解途径的完整图谱——例如脱酰胺、氧化与水解各占多大比例——在不同储存条件下仍有差异，属于需要逐案验证的问题。
| Property | Value | Notes |
|---|---|---|
| Molecular formula | C225H348N48O68 | Approximate composition of the free peptide |
| Molecular weight | Approximately 4813 Da | Calculated for the free base |
| Structural class | Synthetic linear peptide | 39 residues with modified backbone |
| Solubility | Soluble in water and polar solvents | Behavior of the lyophilized solid |
| Typical storage temperature | -20 degrees Celsius or below | Solid form, protected from light |
Tirzepatide activates both the glucose-dependent insulinotropic polypeptide receptor and the glucagon-like peptide-1 receptor, making it a dual agonist rather than a selective agent. Engagement of the GLP-1 receptor is linked to glucose-dependent insulin release, slower gastric emptying, and reduced appetite signalling. The relative contribution of the GIP arm remains an active research question; proposed roles include improved insulin sensitivity and altered adipose tissue handling. Receptor occupancy studies suggest the molecule interacts with both targets at circulating concentrations achieved during therapy.
Development began in the 2010s, when researchers modified a GIP-based scaffold to add GLP-1 activity and then attached the fatty diacid to lengthen its half-life. Clinical evaluation proceeded through large phase 3 programmes in type 2 diabetes and in obesity, and regulators in the United States cleared the compound for type 2 diabetes in 2022 and for chronic weight management in 2023. Several cardiovascular and metabolic outcome studies are still reporting, so the picture of long-term benefit and risk is incomplete. Approvals in other regions followed on different timelines.
Tirzepatide is a synthetic peptide built from 39 amino acid residues. Its backbone derives from the native glucose-dependent insulinotropic polypeptide sequence, altered at several positions to resist enzymatic cleavage. A fatty diacid group attached through a linker extends plasma residence time by promoting reversible binding to serum albumin. The molecule carries a net negative charge near physiological pH and has a reported molecular weight close to 4813 daltons. These features separate it from shorter incretin analogs and account for its prolonged dosing interval.
Pharmacologically, tirzepatide activates two distinct G protein-coupled receptors: the glucose-dependent insulinotropic polypeptide receptor and the glucagon-like peptide-1 receptor. Binding at each target triggers cyclic AMP accumulation and downstream signaling in pancreatic beta cells, adipose tissue and the central nervous system. Because the two pathways overlap only partially, the combined effect on insulin secretion, glucagon suppression and appetite signaling differs from that of selective single-receptor compounds. Affinity is not equal across the two targets, and the clinical meaning of that imbalance remains an area of active study.
Methylxanthines (e.g. caffeine found in coffee, theophylline found in tea, or theobromine found in chocolate) have a purine structure and bind to some of the same receptors as adenosine. Methylxanthines act as competitive antagonists of adenosine and can blunt its pharmacological effects. Individuals taking large quantities of methylxanthines may require increased doses of adenosine. Caffeine acts by blocking binding of adenosine to the adenosine A1 receptor, which enhances release of the neurotransmitter acetylcholine. Caffeine also increases cyclic AMP levels through nonselective inhibition of phosphodiesterase. "Caffeine has a three-dimensional structure similar to that of adenosine," which allows it to bind and block its receptors. Alcohol can increase extracellular adenosine levels.
==== Antistasin binding to factor Xa ==== Antistasin contains an N- and a C-terminal domain which are similar in their amino acid sequences with ~40% identity and ~56% homology. Each of them contains a short β-sheet structure and 5 disulfide bonds. Only the N-terminal domain is necessary to inhibit Xa while the C-terminal domain does not contribute to the inhibitory properties due to differences in the 3 dimensional structure, even though the C-terminal domain has a strongly analogue pattern to the actual active site. The interaction of antistasin with FXa involves both the active site and the inactive surface of FXa. The reactive site of antistasin formed by Arg-34 and Val-35 in the N-terminal domain suits the binding site of FXa, most likely the S1 pocket. At the same time, Glu-15 located outside the reactive site of antistasin fits to positively charged residues on the surface of FXa. The multiple binding is thermodynamically advantageous and leads to sub-nanomolar inhibition (Ki = 0.3–0.6 nM).
== Peptides and proteins == A number of algorithms for estimating isoelectric points of peptides and proteins have been developed. Most of them use Henderson–Hasselbalch equation with different pK values. For instance, within the model proposed by Bjellqvist and co-workers, the pKs were determined between closely related immobilines by focusing the same sample in overlapping pH gradients. Some improvements in the methodology (especially in the determination of the pK values for modified amino acids) have been also proposed. More advanced methods take into account the effect of adjacent amino acids ±3 residues away from a charged aspartic or glutamic acid, the effects on free C terminus, as well as they apply a correction term to the corresponding pK values using genetic algorithm. Other recent approaches are based on a support vector machine algorithm and pKa optimization against experimentally known protein/peptide isoelectric points. Moreover, experimentally measured isoelectric point of proteins were aggregated into the databases. Recently, a database of isoelectric points for all proteins predicted using most of the available methods had been also developed. In practice, a protein with an excess of basic aminoacids (arginine, lysine and/or histidine) will bear an isoelectric point roughly greater than 7 (basic), while a protein with an excess of acidic aminoacids (aspartic acid and/or glutamic acid) will often have an isoelectric point lower than 7 (acidic).
In August 2023, Pritzker vetoed legislation to lift a moratorium on nuclear power plant construction in Illinois, citing concerns over nuclear waste. But later that year, he signed into law bipartisan legislation that suspends the moratorium with relation to the deployment of new nuclear capacity through small modular reactors, defined at a maximum capacity of 300 megawatts, and establishes a regulatory structure of the construction of SMRs. In January 2026, Pritzker signed the Clean and Reliable Grid Affordability Act (CRGA), an energy reform package that lifts the moratorium on nuclear power plant construction, creates incentives for battery storage systems, and introduces "virtual power plants" aimed at harvesting wind and solar energy from homes and businesses to boost the reliability of Illinois's grids. He also signed an executive order directing state agencies to develop a plan, in coordination with local governments, research institutions, developers, and labor organizations, to deploy at least two gigawatts of new nuclear energy capacity, with construction to begin by 2033. On September 15, 2021, Pritzker signed into law the Climate and Equitable Jobs Act, which directed the Illinois Environmental Protection Agency to establish rebate and grant programs for electric vehicles and charging stations and oversee the phase-out of coal-fired power plants by 2035 and natural gas plants by 2045. It also doubled the state's annual funding for the transition to clean energy sources like solar and wind, with the aim to source 50% of its energy from renewables by 2040.
==== Musculoskeletal ==== Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to treat musculoskeletal symptoms. For individuals with severe complications, corticosteroids or immunosuppressive drugs may be prescribed, and sometimes intravenous immunoglobulins. Also, disease-modifying antirheumatic drugs, such as methotrexate, may be helpful. Hydroxychloroquine (Plaquenil) is another option and is generally considered safer than methotrexate. However, these prescribed drugs have a range of side effects such as nausea, loss of appetite, dizziness, hair loss, stomach aches/cramps, headache, liver toxicity and increased risk of infections.
Sources: en.wikipedia.org
=== Transmasculine individuals === Numerous studies have recorded the proliferation of prostate tissue in transmasculine individuals undergoing testosterone therapy. A 2022 study concluded that "one hundred percent of vaginal specimens obtained from transmasculine individuals on testosterone therapy (21/21 cases) demonstrated prostatic metaplasia" and notes, congruously with similar studies, that further research in this area is warranted so as to contribute to higher standards of care for transgender patients, and so that the presence of this tissue does not register to healthcare providers as an abnormality.
==== Stems ==== Young lotus stems are used as a salad ingredient in Vietnamese cuisine and as a vegetable ingredient for some soup and curry in Thailand, such as keang som sai bua (Thai: แกงส้มสายบัว, lotus stem sour soup) and keang kati sai bua (แกงกะทิสายบัว, lotus stem in coconut milk curry). In northern and eastern regions of India, the stalk of the flower is used to prepare a soup, kamala gaṭṭē kī sabzī (Hindi: कमल गट्टे की सब्ज़ी) and an appetizer, kamala kakaṛī pakauṛē (Hindi: कमल ककड़ी पकौड़े). In South Indian states, the lotus stem is sliced, marinated with salt to dry, and the dried slices are fried and used as a side dish. In Kerala (Malayalam: താമര) and Tamil Nadu, this end product is called thamara vathal. In the Philippines, an indigenous variety called tukal is used as the main ingredient in dishes with coconut milk. The stems and petals can be bought in markets when in season.
Soot aerosols are thought to have spread around the world over the ensuing months and years; they would have cooled the surface of the Earth by reflecting thermal radiation, and greatly slowed photosynthesis by blocking out sunlight, thus creating an impact winter. (This role was ascribed to sulfate aerosols until experiments demonstrated otherwise.) The cessation of photosynthesis would have led to the collapse of food webs depending on leafy plants, which included all dinosaurs save for grain-eating birds.
=== Charge detection mass spectrometry === Most mass spectrometers measure the mass-to-charge ratio; the actual mass can be found only if the charge is known. For smaller molecules the charge can be determined from the spacing of isotope peaks, but for very large biomolecules and particles (in the megadalton range) resolution may not be adequate to separate isotope peaks, and thus the mass cannot be determined. In charge detection mass spectrometry (CDMS), the charge of an individual ion/particle is measured directly (alongside its mass-to-charge ratio) and therefore the true mass is known. It is a single-particle technique, but to produce more precise and accurate results, the data from many individually-measured ions can be combined.
Sources: en.wikipedia.org
It is a synthetic linear peptide that acts as a dual agonist at the GIP and GLP-1 receptors. It combines a modified incretin backbone with a fatty diacid side chain that extends its circulation time. It is not a small-molecule drug and is not orally absorbed in its native form.
Single-receptor agents act predominantly at GLP-1R. Tirzepatide retains activity at GIPR, which is expressed in pancreatic islets, adipose tissue, and the central nervous system. The contribution of each receptor to the overall response is still an area of active study, and the relative weight of GIPR signaling in humans is not fully settled.
The fatty diacid moiety binds serum albumin, which reduces renal filtration of the active peptide. Additional resistance to enzymatic breakdown comes from non-natural residues in the backbone. Together these features produce an apparent half-life of about five days and permit weekly dosing intervals.
建议在低温、避光、干燥环境中密封保存，常见条件为 2 至 8 摄氏度，长期存放可置于更低温度。应避免反复冻融，并尽量减少容器开启次数。