Targeted estrogen delivery reverses the metabolic syndrome.

Targeted estrogen delivery reverses the metabolic syndrome.
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DOI:
10.1038/nm.3009
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发表时间:
2012-12
期刊:
影响因子:
82.9
通讯作者:
--
中科院分区:
医学1区
文献类型:
--
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我们报告了一种新的组合方法的发展,允许肽介导的选择性组织靶向的核激素药理学,同时消除在其他组织中的不良反应。具体而言,我们报告了胰高血糖素样肽-1(GLP-1)-雌激素偶联物的开发,该偶联物在纠正小鼠肥胖、高血糖症和血脂异常方面具有优于单独使用任何一种激素的上级非性别依赖性功效。如功能丧失模型和遗传作用谱所示,治疗益处是由多效性双重激素作用驱动的,以改善能量、葡萄糖和脂质代谢。值得注意的是,基于肽的靶向策略还防止雌激素在雄性和雌性小鼠中的标志性副作用,例如生殖内分泌毒性和致癌性。总之,GLP-1靶向组织中雌激素受体的选择性激活产生了前所未有的功效,可增强GLP-1激动剂的代谢益处。这个靶向代谢综合征的例子代表了一类新的治疗剂的发现,其通过基于肽的小分子的选择性递送实现协同共激动作用。尽管我们对GLP-1-雌激素缀合物的观察证明了糖尿病和肥胖症的转化研究,但肽和小分子的许多其他可能的组合可能为其他疾病提供同样的希望。
We report the development of a new combinatorial approach that allows for peptide-mediated selective tissue targeting of nuclear hormone pharmacology while eliminating adverse effects in other tissues. Specifically, we report the development of a glucagon-like peptide-1 (GLP-1)-estrogen conjugate that has superior sex-independent efficacy over either of the individual hormones alone to correct obesity, hyperglycemia and dyslipidemia in mice. The therapeutic benefits are driven by pleiotropic dual hormone action to improve energy, glucose and lipid metabolism, as shown by loss-of-function models and genetic action profiling. Notably, the peptide-based targeting strategy also prevents hallmark side effects of estrogen in male and female mice, such as reproductive endocrine toxicity and oncogenicity. Collectively, selective activation of estrogen receptors in GLP-1–targeted tissues produces unprecedented efficacy to enhance the metabolic benefits of GLP-1 agonism. This example of targeting the metabolic syndrome represents the discovery of a new class of therapeutics that enables synergistic co-agonism through peptide-based selective delivery of small molecules. Although our observations with the GLP-1–estrogen conjugate justify translational studies for diabetes and obesity, the multitude of other possible combinations of peptides and small molecules may offer equal promise for other diseases.
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