the therapeutic potential of a venomous lizard the use of glucagon-like peptide-1 analogues in the critically ill毒蜥蜴的治疗潜力的使用glucagon-like peptide-1病危的类似物.pdfVIP

Deane et al. Critical Care 2010, 14:1004 /content/14/5/1004 CO M M E N TA R Y The therapeutic potential of a venomous lizard: the use of glucagon-like peptide-1 analogues in the critically ill 1,2,3 1,2,3 3,4 Adam M Deane* , Marianne J Chapman and Michael Horowitz See related research by Mecott et al., /content/14/4/R153 exogenous GLP-1 are glucose dependent, such that even Abstract pharma co logical doses of GLP-1 are most unlikely to Glucagon-like peptide-1 (GLP-1), a principal mediator cause hypo glycaemia. of the postprandial insulinotropic response in health, Native GLP-1 is not used as a glucose-lowering agent in has a half-life of minutes. The saliva of the Gila monster ambulant type 2 diabetic patients because of the necessity contains exendin-4, a structural analogue of human for continuous administration [4]. Endogenous GLP-1 is GLP-1, but with a much longer half-life. A synthetic metabolised rapidly to its so-called inactive metabolite by preparation of exendin-4, exenatide, is suitable for the ubiquitous enzyme dipeptyl-peptidase-4 (DPP-4), the human use and eff ectively lowers glucose in ambulant half-life of native GLP-1 being ~1 to 2 minutes [5]. While type 2 diabetic patients. When compared with insulin, this factor essentially precludes the use of exogenous exenatide therapy is associated with a reduction in GLP-1 in ambulant patients, rapid metabolism of an hypoglycaemic episodes and postprandial glycaemic