GIP receptor agonism attenuates GLP-1 receptor agonist–induced nausea and emesis in preclinical models

T Borner, CE Geisler, SM Fortin, R Cosgrove… - Diabetes, 2021 - Am Diabetes Assoc
T Borner, CE Geisler, SM Fortin, R Cosgrove, J Alsina-Fernandez, M Dogra, S Doebley…
Diabetes, 2021Am Diabetes Assoc
Glucagon-like peptide 1 receptor (GLP-1R) agonists decrease body weight and improve
glycemic control in obesity and diabetes. Patient compliance and maximal efficacy of GLP-1
therapeutics are limited by adverse side effects, including nausea and emesis. In three
different species (ie, mice, rats, and musk shrews), we show that glucose-dependent
insulinotropic polypeptide receptor (GIPR) signaling blocks emesis and attenuates illness
behaviors elicited by GLP-1R activation, while maintaining reduced food intake, body weight …
Glucagon-like peptide 1 receptor (GLP-1R) agonists decrease body weight and improve glycemic control in obesity and diabetes. Patient compliance and maximal efficacy of GLP-1 therapeutics are limited by adverse side effects, including nausea and emesis. In three different species (i.e., mice, rats, and musk shrews), we show that glucose-dependent insulinotropic polypeptide receptor (GIPR) signaling blocks emesis and attenuates illness behaviors elicited by GLP-1R activation, while maintaining reduced food intake, body weight loss, and improved glucose tolerance. The area postrema and nucleus tractus solitarius (AP/NTS) of the hindbrain are required for food intake and body weight suppression by GLP-1R ligands and processing of emetic stimuli. Using single-nuclei RNA sequencing, we identified the cellular phenotypes of AP/NTS cells expressing GIPR and GLP-1R on distinct populations of inhibitory and excitatory neurons, with the greatest expression of GIPR in γ-aminobutyric acid-ergic neurons. This work suggests that combinatorial pharmaceutical targeting of GLP-1R and GIPR will increase efficacy in treating obesity and diabetes by reducing nausea and vomiting.
Am Diabetes Assoc
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