Everything below concerns incretin. We keep the language plain, cite what the science says, and separate well-supported claims from open questions.
Last reviewed on 2025-08-28. Where a claim depends on a specific study, the study is described rather than over-claimed.
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.
Three structural changes define the molecule. At position 8 an alpha-aminoisobutyric acid residue replaces alanine, which blocks dipeptidyl peptidase-4 cleavage. At position 34 arginine replaces lysine, and at position 26 a lysine carries a C18 fatty diacid attached through a short linker. The fatty chain binds serum albumin, and this albumin association reduces renal filtration and enzymatic attack. The unchanged backbone retains the receptor contacts that produce signalling. The free base has the formula C187H291N45O59 and a molecular weight near 4114 daltons.
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 analog of human glucagon-like peptide-1, developed by Novo Nordisk and first approved in 2017 for type 2 diabetes. It belongs to the incretin mimetic class, a group of agents that reproduce the glucose-dependent actions of endogenous GLP-1. The molecule was engineered to resist degradation by dipeptidyl peptidase-4 and to bind serum albumin, extending its half-life from minutes to roughly one week. Approval for chronic weight management followed in 2021, based on large cardiovascular and obesity outcome trials.
GLP-1 receptors are expressed on pancreatic beta cells, in the gut, and in several brain regions. Receptor activation raises cyclic AMP, enhances glucose-dependent insulin secretion, and suppresses glucagon release when blood glucose is high. Effects on gastric emptying and on hypothalamic appetite circuits reduce energy intake. Because insulin release remains glucose-dependent, the risk of hypoglycemia is low when the drug is used alone. The precise contribution of each pathway to body weight change in humans remains an area of active investigation.
| Property | Value | Notes |
|---|---|---|
| Molecular formula | C187H291N45O59 | free base, without counter-ion |
| Molecular weight | About 4114 Da | peptide backbone plus attached lipid chain |
| Plasma half-life | About 165 hours | supports once-weekly dosing in humans |
| Plasma protein binding | Greater than 99 percent | attributed mainly to serum albumin |
| Receptor target | GLP-1 receptor | Gs-coupled, raises intracellular cyclic AMP |
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.
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.
Quality control for peptide material focuses on identity, purity, content and the profile of impurities. Common degradants include deamidated and oxidised forms, plus aggregates formed during storage or handling. Forced degradation studies under heat, light, acid and peroxide help define which conditions accelerate change and which analytical methods detect it. Limits for individual impurities are set by pharmacopoeial monographs or manufacturer specifications. How much a given impurity affects biological activity is often uncertain, and conclusions may depend on the assay used.
Solid peptide material is generally kept at reduced temperature to limit degradation. Short-term storage at 2 to 8 degrees Celsius is common, while longer archival storage at minus 20 degrees Celsius or below is typical for lyophilised powder. Vials should remain sealed and protected from light, because ultraviolet exposure can oxidise susceptible residues. Repeated freeze-thaw cycles are avoided, as they promote aggregation and loss of soluble material. Solutions are less stable than solids and are usually prepared close to the time of use.
Reversed-phase high-performance liquid chromatography is widely used to assess purity and to separate the parent peptide from related substances. Mass spectrometry confirms identity and can resolve modifications that differ by a few daltons. Size-exclusion chromatography detects dimers and higher aggregates, which are relevant to both stability and immunogenicity questions. Peptide mapping with enzymatic digestion locates specific modifications along the sequence. Circular dichroism provides a secondary-structure profile, although it gives limited information about local conformational changes.
Storage at minus 20 degrees Celsius or lower in a desiccated container preserves the peptide for extended periods, while working solutions are commonly held at two to eight degrees Celsius for short intervals. Light exposure and repeated freeze-thaw cycles accelerate degradation, so dividing material into single-use aliquots is generally recommended. Adsorption to glass and plastic surfaces can lower the measured concentration of dilute solutions, particularly below one milligram per millilitre. The degradation routes most often reported for GLP-1 analogues are deamidation, methionine oxidation, and backbone hydrolysis. Relative rates under specific conditions are frequently described only for individual formulations.
Reverse-phase high-performance liquid chromatography with ultraviolet detection near 214 or 280 nanometres is widely used to assess purity and to resolve related impurities. Liquid chromatography coupled to mass spectrometry confirms identity through the protonated molecular ion and fragment ions formed in tandem experiments. Capillary electrophoresis and peptide mapping after enzymatic digestion supply complementary information on charge variants and modification sites. Circular dichroism and nuclear magnetic resonance can report on secondary structure in solution. Absolute quantification usually depends on an external standard, and reported purity depends on the detection wavelength and integration parameters chosen.
Yeolmu radishes and cucumbers are summer vegetables made into kimchi, yeolmu-kimchi (열무김치) which is eaten in several bites. Brined fish or shellfish can be added, and freshly ground dried chili peppers are often used.
=== Complications === Complications of smallpox arise most commonly in the respiratory system and range from simple bronchitis to fatal pneumonia. Respiratory complications tend to develop on about the eighth day of the illness and can be either viral or bacterial in origin. Secondary bacterial infection of the skin is a relatively uncommon complication of smallpox. When this occurs, the fever usually remains elevated. Other complications include encephalitis (1 in 500 patients), which is more common in adults and may cause temporary disability; permanent pitted scars, most notably on the face; and complications involving the eyes (2% of all cases). Pustules can form on the eyelid, conjunctiva, and cornea, leading to complications such as conjunctivitis, keratitis, corneal ulcer, iritis, iridocyclitis, and atrophy of the optic nerve. Blindness results in approximately 35–40% of eyes affected with keratitis and corneal ulcer. Hemorrhagic smallpox can cause subconjunctival and retinal hemorrhages. In 2–5% of young children with smallpox, virions reach the joints and bone, causing osteomyelitis variolosa. Bony lesions are symmetrical, most common in the elbows, legs, and characteristically cause separation of the epiphysis and marked periosteal reactions. Swollen joints limit movement, and arthritis may lead to limb deformities, ankylosis, malformed bones, flail joints, and stubby fingers. Between 65 and 80% of survivors conserve indelible white scars.
Chipotle expanded to Europe with the first European restaurant opening in May 2010 in London. A second location opened in London in September 2011. The following year, three additional locations quickly opened in the London area. After this growth spurt, the rate of further expansion in London slowed greatly with the sixth location appearing in 2013 and the seventh in June 2015. Although Chipotle blames the slow growth in the United Kingdom on the British unfamiliarity with Mexican foods, several locally owned burrito chains had opened locations across the United Kingdom during the same interval. As of February 2024, there were 19 UK locations, of which 17 were in London.
Sources: en.wikipedia.org
Acute toxicity has been reportedly associated with hyperhidrosis, panic attacks, severe anxiety, mydriasis, paranoia, aggressive behavior, psychosis, rhabdomyolysis, and punding. The violent and aggressive behavior associated with acute stimulant toxicity may partially be driven by paranoia. Most drugs classified as stimulants are sympathomimetic, meaning that they stimulate the sympathetic branch of the autonomic nervous system. This stimulation leads to effects such as mydriasis (dilation of the pupils), increased heart rate, blood pressure, respiratory rate and body temperature. When these changes become pathological, they are called arrhythmia, hypertension, and hyperthermia, and may lead to rhabdomyolysis, stroke, cardiac arrest, or seizures. However, given the complexity of the mechanisms that underlie these potentially fatal outcomes of acute stimulant toxicity, it is impossible to determine what dose may be lethal.
Raffi Berg is the Middle East editor of the BBC News website; graduated in modern and medieval history from the London School of Economics; was student of Jewish and Israel studies at the Hebrew University of Jerusalem; author of Red Sea Spies: The True Story of Mossad's Fake Diving Resort (Icon Books, 2020) Lionel Blue, rabbi and journalist Amber de Botton, head of UK news at ITV News; was previously head of politics at ITV and deputy head of politics at Sky News, after starting career as a parliamentary reporter; currently Prime Minister Rishi Sunak's director of communications. Julian Borger; journalist and non-fiction writer; world affairs editor at The Guardian. He was a correspondent in the United States, Eastern Europe, the Middle East and the Balkans and covered the Bosnian War for the BBC. Borger is a contributor to the Center on International Cooperation, a foreign policy think tank based at New York University that works to enhance multilateral responses to global problems, including conflict, humanitarian crises, and recovery; international security challenges, including weapons proliferation and the changing balance of power; resource scarcity and climate change.
== Further reading == Laurence, J (2015). "Centennial celebration of Translational Research: The Journal of Laboratory and Clinical Medicine". Translational Research. 165 (1): 1–6. doi:10.1016/j.trsl.2014.08.004. PMID 25301250. Hammerschmidt, DE (2004). "A new look and a heightened focus: Translational medicine and the Journal of Laboratory and Clinical Medicine". Journal of Laboratory and Clinical Medicine. 144 (1): 5–6. doi:10.1016/j.lab.2004.05.006. Vaughan, WT (1940). "We celebrate our silver anniversary". Journal of Laboratory and Clinical Medicine. 26 (1): 1–3.
==== Never marketed ==== 4′-Fluorococaine (also a Dopamine reuptake inhibitor) Delucemine (also an NMDA antagonist) Mesembrenone (also a weak PDE4 inhibitor (found in Sceletium tortuosum (kanna)) Mesembrine (also a weak PDE4 inhibitor (found in Sceletium tortuosum (kanna)) Roxindole (EMD-49,980) (also a 5-HT1A and D2-like receptor agonist)
Sources: en.wikipedia.org
War within the Culture is mostly fought by the Culture's sentient warships, the most powerful of these being war-converted GSVs, which are described as powerful enough to oppose whole enemy fleets. The Culture has little use for conventional ground forces (as it rarely occupies enemy territory); combat drones equipped with knife missiles do appear in Descendant and "terror weapons" (basically intelligent, nano-form assassins) are mentioned in Look to Windward, while infantry combat suits of great power (also usable as capable combat drones when without living occupants) are used in Matter.
=== Carbon-Carbon Composite for Hip Joint Implant === The main properties required from an artificial joint implant are long term strength and stability under cyclic load (up to seven times body weight), bio-chemical inertness, wear resistance and biological bio-compatibility. Years of clinical experience with a variety of metals and polymers fell short of achieving all the requirements. Carbon is the basic component of organic material and in certain configurations is extremely stable mechanically and chemically. In this pioneer collaboration between Rafael industry and scientists from the Technion, a carbon composite hip implant was constructed. The implant was created using carbon fibers and carbon matrix. The result achieved three dimensions stability in compression and tension. The composite hip was implanted in animal experiments at the Technion laboratory by a team of the Center for Implant Surgery. These experiments did, however, uncover the one disadvantage of carbon composite: weakness in resistance to wear in friction and cyclic motion.
== As lipid-modifying medication == Prescription nicotinic acid, commonly labeled as niacin in the United States, is available in immediate-release and slow-release formulations. It is used to treat primary hyperlipidemia and hypertriglyceridemia. It is used either as a monotherapy or in combination with other lipid-modifying drugs. Dosages start at 500 mg/day and are often gradually increased to as high as 3000 mg/day for immediate release or 2000 mg/day for slow release (also referred to as sustained release) to achieve the targeted lipid changes (lower LDL-C and triglycerides, and higher HDL-C). Prescriptions in the US peaked in 2009, at 9.4 million and had declined to 800 thousand by 2020. In 2023, it was the 288th most commonly prescribed medication in the United States, with more than 500,000 prescriptions. Systematic reviews found no effect of prescription nicotinic acid on all-cause mortality, cardiovascular mortality, myocardial infarctions, nor fatal or non-fatal strokes despite raising HDL cholesterol in patients already taking statins. Reported side effects include an increased risk of new-onset type 2 diabetes.
A British force, including troops from several African countries, launched the campaign in January 1941 from Kenya to liberate British Somaliland and Italian-occupied Ethiopia and conquer Italian Somaliland. By February most of Italian Somaliland was captured and, in March, British Somaliland was retaken from the sea. The forces of the British Empire operating in Somaliland comprised the three divisions of South African, West African, and East African troops. They were assisted by Somali forces led by Abdulahi Hassan with Somalis of the Isaaq, Dhulbahante, and Warsangali clans prominently participating. The number of Italian Somalis began to decline after World War II, with fewer than 10,000 remaining in 1960.
States choose to balance for two reasons. First, they place their survival at risk if they fail to curb a potential hegemon before it becomes too strong; to ally with the dominant power means placing one's trust in its continued benevolence. Secondly, joining the weaker side increases the likelihood that the new member will be influential within the alliance. States choose to bandwagon because it may be a form of appeasement as the bandwagoner may hope to avoid an attack by diverting it elsewhere—a defensive reason—or because it may align with the dominant side in wartime to share the spoils of victory—an offensive reason. Realists claim that balancing is when states ally against the prevailing threat and results in a more secure world whereas in a bandwagoning world security is scarce as rising hegemons are not kept in check. With bandwagoning, the threatened state abandons hope of preventing the aggressor from gaining power at its expense and instead joins forces with its dangerous foe to get at least some small portion of the spoils of war. The weaker the state the more likely it is to bandwagon than to balance as they do little to affect the outcome and thus must choose the winning side. Strong states may change a losing side into a winning side and thus are more likely to balance. States will be tempted to bandwagon when allies are unavailable, however excessive confidence in allied support encourages weak states to free ride relying on the efforts of others to provide security.
Sources: en.wikipedia.org
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.
Albumin is the most abundant protein in plasma and carries molecules that bear fatty-acid chains. Binding shields the peptide from renal filtration and from peptidases, keeping a circulating reservoir. Slow release from this reservoir produces sustained receptor occupancy and supports infrequent dosing.
The insulinotropic effect is glucose-dependent, meaning secretion increases mainly when glucose is elevated. This property is often described as lowering the chance of hypoglycaemia when the compound is used alone. Other glucose-lowering agents used at the same time can still cause low blood glucose.
It is given either as a once-weekly subcutaneous injection or as an oral tablet taken once daily. The two forms use different absorption strategies, so they are not interchangeable on a milligram-for-milligram basis.