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    庄亚平, 杨孝伟, 俞麟, 丁建东. 治疗Ⅱ型糖尿病的GLP-1受体激动剂及其高分子递送系统的研究进展[J]. 功能高分子学报, 2019, 32(2): 126-139. doi: 10.14133/j.cnki.1008-9357.20180810001
    引用本文: 庄亚平, 杨孝伟, 俞麟, 丁建东. 治疗Ⅱ型糖尿病的GLP-1受体激动剂及其高分子递送系统的研究进展[J]. 功能高分子学报, 2019, 32(2): 126-139. doi: 10.14133/j.cnki.1008-9357.20180810001
    ZHUANG Yaping, YANG Xiaowei, YU Lin, DING Jiandong. Progress of GLP-1 Receptor Agonists and Their Delivery Systems for the Treatment of Type Ⅱ Diabetes[J]. Journal of Functional Polymers, 2019, 32(2): 126-139. doi: 10.14133/j.cnki.1008-9357.20180810001
    Citation: ZHUANG Yaping, YANG Xiaowei, YU Lin, DING Jiandong. Progress of GLP-1 Receptor Agonists and Their Delivery Systems for the Treatment of Type Ⅱ Diabetes[J]. Journal of Functional Polymers, 2019, 32(2): 126-139. doi: 10.14133/j.cnki.1008-9357.20180810001

    治疗Ⅱ型糖尿病的GLP-1受体激动剂及其高分子递送系统的研究进展

    Progress of GLP-1 Receptor Agonists and Their Delivery Systems for the Treatment of Type Ⅱ Diabetes

    • 摘要: 糖尿病是一种以慢性高血糖为特征的代谢性疾病。糖尿病患者又以Ⅱ型患者为主,Ⅱ型糖尿病患者占比超过90%。胰高血糖素样肽-1(GLP-1)是由肠道L细胞分泌的一种肽类激素,能够以葡萄糖浓度依赖方式作用于胰岛β细胞,促进胰岛素基因的转录,增加胰岛素的生物合成和分泌;然而,GLP-1极易被体内的二肽基肽酶Ⅳ(DPP-4)降解,其血浆半衰期不足2 min,缺乏临床应用价值。为了延期体内作用,许多GLP-1受体激动剂被研究和开发。根据其体内半衰期的长短,这些GLP-1受体激动剂可以分为短效型和长效型。同时,研究者还以各类功能高分子材料为载体,发展了不同GLP-1受体激动剂的递送体系来延长药物体内作用时间,减少给药频率,提高患者的顺应性。本综述介绍了已获得临床批准的GLP-1受体激动剂以及基于它们的热致水凝胶等药物递送系统在治疗Ⅱ型糖尿病中的应用。

       

      Abstract: Diabetes is a kind of metabolic disorders disease of aberrant glucose homeostasis that is characterized by elevated blood glucose levels. Type Ⅱ diabetes accounts for over 90% of cases globally. There are many different classes of antidiabetes therapies used in clinic, and recently incretin-based therapy has drawn increasing attention. Glucagon-like peptide 1 (GLP-1), a incretin hormone produced in the L cells of the intestines, can act on pancreatic islet cells, promote transcription of insulin gene, and augment biosynthesis and secretion of insulin in a glucose-dependent manner without significant risks for hypoglycemia. Additional effects of GLP-1 include inhibiting β-cell apoptosis, delaying gastric emptying and increasing appetite. However, GLP-1 is easily degraded by dipeptidyl peptidase Ⅳ (DPP-4) within 2-3 min in the circulation, which significantly limits its therapeutic application. Therefore, a series of strategies including exchanging amino acids to restrain the degradation of DPP-Ⅳ, attachment of fatty acid side chains or covalent association with large molecules such as albumin or IgG to extend the duration of action of GLP-1 have been utilized to develop various GLP-1 receptor agonists. These GLP-1 receptor agonists can be classified as either short-acting compounds or as long-acting ones. The short-acting GLP-1 receptors agonists, such as exenatide and lixisenatide, can activate the GLP-1 receptor short-termly, while the long-acting ones, such as liraglutide, albiglutide, dulaglutide and semaglutide, can provide long-lived receptor activation. Meanwhile, multifarious delivery systems of GLP-1 receptor agonists using microspheres, hydrogels, implanted devices or nanoparticles as carriers have also been exploited to provide prolonged in vivo actions, reduce administration frequency and increase patient compliance. This review focuses on the progress of GLP-1 receptor agonists approved by U.S. Food and Drug Administration and their delivery systems, such as injectable thermogel systems containing GLP-1 receptor agonists, for the treatment of type Ⅱ diabetes.

       

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