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Last reviewed on 2025-10-02. Where a claim depends on a specific study, the study is described rather than over-claimed.
Large randomised trials in adults with type 2 diabetes and in adults with obesity have reported reductions in body weight and improvements in several cardiovascular risk markers. One outcome trial found a lower incidence of major adverse cardiovascular events in participants with diabetes and established cardiovascular disease. Gastrointestinal effects such as nausea and vomiting are the most frequently reported adverse events and often diminish over time. Changes in lean body mass during weight loss are an area of ongoing investigation. Effects in adolescents and in pregnancy are less well characterised, and current labelling advises against use during pregnancy.
Semaglutide is a synthetic peptide analogue of glucagon-like peptide-1, a gut hormone released after nutrient intake. The molecule contains 31 amino acid residues and differs from the native sequence at several positions. A non-natural residue at position eight resists the enzyme that normally truncates the hormone, while a lysine-linked fatty diacid side chain promotes binding to serum albumin. These two modifications extend the circulating half-life from minutes to roughly one week. The peptide is produced by solid-phase synthesis followed by selective acylation, and its identity and purity are confirmed by spectrometric and chromatographic techniques.
The primary target is the GLP-1 receptor, a class B G protein-coupled receptor expressed on pancreatic beta cells, in the gut, and in several brain regions. Receptor activation raises intracellular cyclic AMP, which potentiates glucose-dependent insulin secretion and lowers glucagon release when blood glucose is elevated. Signalling in the hypothalamus and brainstem is associated with reduced appetite and slower gastric emptying. Because the insulinotropic effect depends on prevailing glucose levels, the hypoglycaemic risk of the peptide alone is described as low in most study settings. The relative contribution of peripheral and central actions remains an active research question.
Receptor activation follows the canonical Gs pathway: binding increases intracellular cyclic AMP, which promotes protein kinase A activity. In pancreatic beta cells this amplifies glucose-dependent insulin release, so secretion rises when blood glucose is high and changes little when it is low. The same signalling suppresses glucagon release from alpha cells and slows gastric emptying. Receptors in the hypothalamus and brainstem are thought to contribute to reduced appetite and lower energy intake. Which of these effects dominates clinical outcomes remains an area of active study.
Semaglutide is a synthetic peptide analogue of glucagon-like peptide-1, a gut hormone released by intestinal L cells after food intake. The natural hormone acts on pancreatic and central receptors but is degraded within minutes by dipeptidyl peptidase-4 and other peptidases. Semaglutide belongs to the class of long-acting GLP-1 receptor agonists, a group distinguished by structural changes that slow breakdown and extend circulation time. Its development followed earlier short-acting analogues and reflects a general strategy in peptide drug design: preserve receptor activity while blocking proteolytic clearance.
| Property | Value | Notes |
|---|---|---|
| Molecular class | Acylated GLP-1 receptor agonist | 31-residue synthetic peptide |
| Molecular formula | C187H291N45O59 | established for the free peptide |
| Appearance | White to off-white powder | as supplied before formulation |
| Solubility | Freely soluble in water | aqueous buffers near neutral pH |
| Typical storage | 2 to 8 degrees Celsius, protected from light | powder and solution forms differ in shelf life |
The semaglutide sequence is a 31-residue analogue of human GLP-1, altered at three positions relative to the parent hormone. Aminoisobutyric acid replaces alanine at position 8, arginine replaces lysine at position 34, and a lipophilic diacid is attached to lysine 26 through a short linker. These features are reported consistently in the structural literature. The position 8 substitution blocks recognition by dipeptidyl peptidase-4, while the attached chain drives strong, reversible association with a carrier protein in blood.
Receptor activation raises intracellular cyclic AMP through Gs coupling, which promotes glucose-dependent insulin release and suppresses glucagon secretion when blood glucose is elevated. Effects outside the pancreas include slower gastric emptying and altered appetite signalling in the hypothalamus and hindbrain. The relative contribution of each tissue to overall metabolic outcomes remains an area of active investigation. Central mechanisms in particular are inferred mainly from animal models and indirect human measures rather than direct observation.
Serum protein binding dominates the pharmacokinetic profile. The attached chain associates strongly with albumin, shielding the peptide from enzymatic attack and slowing filtration by the kidney. This interaction extends the circulation half-life to roughly one week in humans, which supports weekly administration intervals. An oral version pairs the peptide with an absorption enhancer that transiently alters gastric epithelium, permitting limited uptake; bioavailability by that route is substantially lower than by injection.
Semaglutide 是一种经结构修饰的胰高血糖素样肽-1 类似物，其主链与内源性 GLP-1(7-36) 约有百分之九十四的序列一致性。第 8 位丙氨酸被 α-氨基异丁酸取代，使二肽基肽酶-4 无法识别原有切割位点。第 34 位赖氨酸换为精氨酸，进一步降低酶解速率。第 26 位赖氨酸经间隔基连接一条含十八个碳的二酸脂肪链，该侧链赋予分子与血浆白蛋白结合的能力。
该分子作为 GLP-1 受体的选择性激动剂发挥作用，受体属于 B 类 G 蛋白偶联受体家族，激活后经 Gs 通路提升细胞内环腺苷酸水平。在胰腺 β 细胞，信号促进葡萄糖依赖性的胰岛素释放，血糖偏低时该作用明显减弱。在胰岛 α 细胞，胰高血糖素分泌受到抑制。中枢神经系统与胃肠道同样存在受体表达，相应信号参与食欲调节以及胃排空速率的降低。
皮下注射后吸收相对缓慢，绝对生物利用度约为百分之八十九，血药浓度峰值通常出现在给药后一到三天。与白蛋白结合使清除减慢，终末半衰期约为一百六十五小时，接近一周。连续给药约四到五周后达到稳态暴露水平。表观分布容积约为每千克零点二五升，血浆蛋白结合率超过百分之九十九。代谢以蛋白水解切割和脂肪二酸侧链的 β-氧化为主，相关产物主要经尿液与粪便排出。
Functional gastrointestinal disorders the most common of which is irritable bowel syndrome. Functional constipation and chronic functional abdominal pain are other functional disorders of the intestine that have physiological causes but do not have identifiable structural, chemical, or infectious pathologies.
== Biological function == Lipoic acid is a cofactor for five enzymes or classes of enzymes: pyruvate dehydrogenase, α-ketoglutarate dehydrogenase, the glycine cleavage system, branched-chain alpha-keto acid dehydrogenase, and the α-oxo(keto)adipate dehydrogenase. The first two are critical to the citric acid cycle. The GCS regulates glycine concentrations. HDAC1, HDAC2, HDAC3, HDAC6, HDAC8, and HDAC10 are targets of the reduced form (open dithiol) of (R)-lipoic acid.
== Erythrose 4-phosphate and phosphoenolpyruvate: phenylalanine, tyrosine, and tryptophan == Phenylalanine, tyrosine, and tryptophan, the aromatic amino acids, arise from chorismate. The first step, condensation of 3-deoxy-D-arabino-heptulosonic acid 7-phosphate (DAHP) from PEP/E4P, uses three isoenzymes AroF, AroG, and AroH. Each one of these has its synthesis regulated from tyrosine, phenylalanine, and tryptophan, respectively. The rest of the enzymes in the common pathway (conversion of DAHP to chorismate) appear to be synthesized constitutively, except for shikimate kinase, which can be inhibited by shikimate through linear mixed-type inhibition.
He helped to revive the Ginsberg crèche, a daycare for children of working mothers, and establish a Ginsberg education fund to raise bursaries for promising local students. He helped establish Njwaxa Home Industries, a leather goods company providing jobs for local women. In 1975, he co-founded the Zimele Trust, a fund for the families of political prisoners. Biko endorsed the unification of South Africa's black liberationist groups – among them the BCM, PAC, and African National Congress (ANC) – in order to concentrate their anti-apartheid efforts. To this end, he reached out to leading members of the ANC, PAC, and Unity Movement. His communications with the ANC were largely via Griffiths Mxenge, and plans were being made to smuggle him out of the country to meet Oliver Tambo, a leading ANC figure. Biko's negotiations with the PAC were primarily through intermediaries who exchanged messages between him and Sobukwe; those with the Unity Movement were largely via Fikile Bam.
=== Urinary tract infections === Methenamine is used in the treatment and prevention of recurrent urinary tract infections (UTIs) requiring long-term therapy. It is approved and used in both adults and children at least 6 years of age. The drug can also be used in special populations including older adults, people undergoing genitourinary surgical procedures, people with long-term catheterization, and kidney transplant recipients. It has not been studied in neonates or infants. Methenamine is employed as an alternative to antibiotics. The drug is not used in the curative treatment of UTIs and should be started only after bacterial eradication by appropriate antimicrobial agents. As it is an antiseptic and not an antibiotic, methenamine has no risk of promoting bacterial resistance. Studies have administered continuous methenamine therapy usually for 12 months or less, but in some studies for as long as 2 to 10 years. A 2012 Cochrane review found that methenamine was effective in the prevention of UTIs. The relative risk of symptomatic UTI was 0.24 and of bacteriuria was 0.56. In the case of short-term treatment (≤1 week), the relative risk of symptomatic UTI was 0.14. On the other hand, methenamine was not effective in reducing the risk of symptomatic UTI or bacteriuria in people with known renal tract abnormalities or neurogenic bladder. The quality of evidence was mixed and often poor.
Sources: en.wikipedia.org
=== Weaning === Weaning is the process of replacing breast milk with other foods; the infant is fully weaned after the replacement is complete. Psychological factors affect the weaning process for both mother and infant, as issues of closeness and separation are very prominent. Unless a medical emergency necessitates abruptly stopping breastfeeding, it is best to gradually increase the period between feedings or eliminate feedings to allow the breasts to adjust to the decreased demands without becoming engorged. Studies show that a large number of women discontinue breastfeeding early due to lack of working place support for breastfeeding mothers. La Leche League advises parents to shift their children's focus at bedtime away from breastfeeding, as it is often the most difficult feeding for them to let go. If weaning starts at 12 months or later, it is not necessary to switch to infant formula or "toddler formula" as is sold commercially. At 12 months, it is recommended that the baby be switched to whole cow's milk. Reduced-fat or skim milk generally is not appropriate before age 2 because it lacks sufficient fat or calories to promote early brain development. If the mother was experiencing lactational amenorrhea, periods will begin to return with weaning, along with restored fertility.
Topiramate is used to treat epilepsy in children and adults, and it was originally used as an anticonvulsant. In children, it is indicated for the treatment of Lennox-Gastaut syndrome, a disorder that causes seizures and developmental delay. It is most frequently prescribed for the prevention of migraines, as it decreases the frequency of attacks. Topiramate is used to treat medication overuse headache and is recommended by the European Federation of Neurological Societies as one of the few medications showing effectiveness for this indication.
Tranexamic acid is a medication used to treat or prevent excessive blood loss from major trauma, postpartum bleeding, surgery, tooth removal, nosebleeds, and heavy menstruation. It is also used for hereditary angioedema. It is taken either by mouth, injection into a vein, or by intramuscular injection. Tranexamic acid is a synthetic analog of the amino acid lysine. It serves as an antifibrinolytic by reversibly binding four to five lysine receptor sites on plasminogen. This decreases the conversion of plasminogen to plasmin, preventing fibrin degradation and preserving the framework of fibrin's matrix structure. Tranexamic acid has roughly eight times the antifibrinolytic activity of an older analogue, ε-aminocaproic acid. Tranexamic acid also directly inhibits the activity of plasmin with weak potency (IC50 = 87 mM), and it can block the active-site of urokinase plasminogen activator (uPA) with high specificity (Ki = 2 mM), one of the highest among all the serine proteases. Side effects are rare; they include changes in color vision, seizures, blood clots, and allergic reactions. Tranexamic acid appears to be safe for use during pregnancy and breastfeeding. Tranexamic acid was first made in 1962 by Japanese researchers Shosuke and Utako Okamoto. It is on the World Health Organization's List of Essential Medicines. Tranexamic acid is available as a generic drug.
During the uncontrolled burning phase from February to April, various sources estimated that the ignited wellheads burnt through between four and six million barrels of crude oil, and between seventy and one hundred million cubic meters of natural gas per day. Seven months later, 441 facilities had been brought under control, while 308 remained uncontrolled. The last well was capped on November 6, 1991. The total amount of oil burned is generally estimated at one billion barrels or just below one percent of Kuwait's entire supply of 104 billion barrels. Daily global oil consumption in 2022 is about 99.4 million barrels; the oil lost to combustion would last 10 days at modern usage rates.
It was not until he [Trask] had exercised for some time that he could perform any labor ... [H]is neck and back have continued to curve drawing his head downward on his breast. The account of Trask became the first documented case of AS in the United States, owing to its indisputable description of inflammatory disease characteristics of AS and the hallmark of deforming injury in AS. In the late nineteenth century, the neurophysiologist Vladimir Bekhterev of Russia in 1893, Adolf Strümpell of Germany in 1897, and Pierre Marie of France in 1898 were the first to give adequate descriptions which permitted an accurate diagnosis of AS prior to severe spinal deformity. For this reason, AS is also known as Bekhterev disease, Bechterew's disease or Marie–Strümpell disease. The word is from Greek ankylos meaning crooked, curved or rounded, spondylos meaning vertebra, and -itis meaning inflammation.
Sources: en.wikipedia.org
== External links == Weird Fruit Explorer (20 September 2017). "Cupuacu Review - Ep. 210". Archived from the original on 2021-12-22 – via YouTube. Scalabrini, Osvaldo (28 April 2013). "Cupuaçu, Theobroma grandiflorum, cupuaçueiro, Flora amazônica, Endêmica do amazonas". Archived from the original on 2021-12-22 – via YouTube.
Premier League: 1997–98, 2001–02, 2003–04 FA Cup: 1997–98, 2001–02, 2002–03, 2004–05, 2013–14, 2014–15, 2016–17; runner-up: 2000–01 FA Charity/Community Shield: 1998, 1999, 2002, 2004, 2014, 2015 2017 Football League/EFL Cup runner-up: 2006–07, 2010–11, 2017–18 UEFA Champions League runner-up: 2005–06 UEFA Cup runner-up: 1999–2000 Individual
==== Energy and the environment ==== Larson has introduced various pieces of legislation in attempts to nationalize the US's energy and to reduce greenhouse gas emissions in order to protect the environment. He cosponsored the Energy Independence and Security Act of 2007 "to move the United States toward greater energy independence and security, to increase the production of clean renewable fuels, to protect consumers, to increase the efficiency of products, buildings, and vehicles, to promote research on and deploy greenhouse gas capture and storage options, and to improve the energy performance of the Federal Government, and for other purposes." According to Larson, "I have become convinced of the need for comprehensive legislation to reduce the amount of greenhouse gases we are emitting into the environment." His stances on environmental protection have earned him a rating of 100% with the League of Conservation Voters.
The authors suggested that PDE3 inhibitors might be repurposed for short-stature disorders such as achondroplasia, while cautioning that the findings are preclinical and that self-administration of cilostazol for growth purposes is unsupported and carries cardiovascular and bleeding risks.
Trump has said repeatedly that he wanted to end "ridiculous" wars and prevent the start of new ones. Ahmed Fouad Alkhatib, a Gazan analyst and Atlantic Council fellow, said that Trump's vision could not believably be considered an option and that it was transparently impossible. He wrote that Trump may be trying to pressure Arab nations into action through threatening to take over the Strip and communicating that he would become involved if there was not Arab initiative, including finance from Gulf nations. Alkhatib added that regardless of Trump's intentions, his statements have been damaging and have further contributed to the perception of the unhelpfulness of the United States.
Sources: en.wikipedia.org
Native GLP-1 is degraded within minutes by dipeptidyl peptidase-4 and neutral endopeptidases. Semaglutide carries a non-natural amino acid at position eight that blocks that cleavage, and a fatty diacid side chain that binds albumin. The result is a much longer duration of action than the native hormone.
The fatty diacid chain associates strongly with serum albumin, which keeps the peptide in circulation and shields it from rapid renal clearance. Bound peptide is released gradually, producing a sustained receptor signal. This mechanism also reduces the peak-to-trough variation seen with shorter-acting analogues.
The balance between peripheral receptor activation and signalling in the central nervous system is not fully resolved. The extent to which slowed gastric emptying accounts for reduced energy intake, compared with direct effects on appetite circuits, is debated. Long-term effects on lean mass and on tissues outside the gut and brain are still under study.
Native GLP-1 is a short-lived peptide cleared within one to two minutes by dipeptidyl peptidase-4 and related enzymes. Semaglutide keeps the receptor-binding backbone but adds substitutions and a lipid chain. These changes block the main cleavage site and allow reversible albumin binding, extending the half-life to roughly 165 hours.