GHRH 类似物 comes up often in conversation and rarely with the context attached. Here we lay out the basics in order, then work through the practical considerations.
Updated 2025-11-26. Numbers and descriptions here follow the published literature rather than marketing material.
Tesamorelin is a synthetic peptide that belongs to the growth hormone-releasing hormone family and contains the same forty-four amino acid sequence as endogenous GHRH, extended at the amino terminus by a trans-3-hexenoyl group. That small fatty acid modification protects the peptide from rapid cleavage by dipeptidyl peptidase-4, the enzyme that shortens the half-life of native GHRH to only a few minutes. Chemically the compound is produced by solid-phase peptide synthesis, purified by chromatography, and supplied as a sterile lyophilized powder for reconstitution.
Regulatory approval in the United States came in 2010, when the Food and Drug Administration cleared the peptide for the reduction of excess abdominal fat in adults with HIV infection and associated lipodystrophy. The decision rested mainly on two randomized phase 3 trials that enrolled roughly eight hundred patients and ran for twenty-six weeks. Participants receiving active drug showed substantially greater declines in visceral adipose tissue than those receiving placebo, while total body weight changed comparatively little. A reformulated presentation was later approved, and the product has remained a niche therapy rather than a general weight-loss agent.
Clinical interest in tesamorelin arose from the need to address visceral adiposity in people living with HIV. Antiretroviral therapy improved survival but was associated in some patients with central fat accumulation, altered lipid profiles, and metabolic complications. This condition, often called HIV-associated lipodystrophy, involves excess visceral adipose tissue that is difficult to manage through diet and exercise alone. Investigators evaluated tesamorelin because GHRH analogs can stimulate growth hormone secretion and influence fat distribution without direct liposuction or invasive procedures.
A Phase 3 program led to regulatory approval in the United States in 2010 for reduction of excess visceral abdominal fat in adults with HIV and lipodystrophy. Subsequent studies examined effects on liver fat, muscle area, and metabolic markers, with mixed findings for some endpoints. Long-term cardiovascular outcomes and effects on mortality remain uncertain because most trials were relatively short and focused on imaging-based fat measurements. Use in populations without HIV has been studied experimentally but is not part of the approved indication.
Tesamorelin is a synthetic analog of growth hormone-releasing hormone, a peptide hormone produced by the hypothalamus. The molecule retains the 44-amino-acid sequence of human GHRH and carries a trans-3-hexenoyl modification at its N-terminus. This modification increases resistance to enzymatic degradation and extends the peptide's functional stability relative to native GHRH. The compound is supplied as a lyophilized powder for reconstitution and subcutaneous administration in clinical settings. Its development code was TH9507, and it belongs to the GHRH analog class. It is not a growth hormone product; instead, it acts upstream to stimulate endogenous growth hormone release.
| Property | Value | Notes |
|---|---|---|
| Peptide class | Synthetic GHRH analogue | 44 residues; N-terminal trans-3-hexenoyl group |
| First approval year | 2010 | United States; HIV-associated abdominal fat accumulation |
| Administration route | Subcutaneous injection | Abdominal site; clinician-administered or self-injected |
| Common synonyms | TH9507; tesamorelin acetate | Development code and acetate salt form |
| Originator | Canadian biotechnology firm | Original developer and regulatory sponsor |
在临床研究之外，特沙莫瑞林常被讨论为生长激素分泌促进剂，但这一说法需要限定。它并不等同于生长激素本身，也不属于普通减重药物。部分研究关注其减少腹部脂肪和改善脂质谱的潜力，另一些研究则关注胰岛素抵抗和 IGF-1 升高等信号。这些效应的临床意义仍在评估中，尚未形成统一结论。
特沙莫瑞林是一种合成肽，其序列与人生长激素释放激素的 44 个氨基酸形式相关。它在 N 端带有反式-3-己烯酰基修饰，这一改动可减缓二肽基肽酶 IV 的降解。该化合物属于生长激素释放激素受体激动剂，可刺激垂体释放生长激素。研究文献通常将其归入合成肽类药物，而非小分子化合物。
监管记录显示，特沙莫瑞林于 2010 年在美国首次获得批准，用于人类免疫缺陷病毒感染相关的脂肪营养不良患者。批准依据来自降低内脏脂肪的临床试验，而非体重或瘦体重的普遍改善。后续出现了不同制剂版本，但其核心适应症保持一致。关于长期心血管结局和死亡率影响，现有证据仍不充分。
Binding of tesamorelin to GHRH receptors on pituitary somatotroph cells triggers cyclic AMP signaling and the release of growth hormone into circulation. Because the peptide acts upstream of the growth hormone axis, its effects are partly mediated by hepatic insulin-like growth factor 1 (IGF-1) production. The pulsatile character of endogenous growth hormone secretion is preserved rather than replaced. Whether amplified signaling produces effects beyond those of native GHRH remains an area of ongoing investigation.
A documented effect of tesamorelin is a reduction in visceral adipose tissue in some study populations. Researchers have reported decreases in trunk fat measured by computed tomography alongside changes in lipid markers. The mechanism is thought to involve growth hormone-mediated lipolysis, though the precise contribution of direct versus indirect pathways is not fully resolved. Studies have generally examined defined groups over finite periods, so long-term outcomes are less well characterized. Findings have not been uniform across all trials.
The peptide is synthesized chemically rather than extracted from biological sources. Solid-phase synthesis builds the chain from the C-terminus toward the N-terminus, after which the hexenoyl group is attached. Purity is typically assessed by high-performance liquid chromatography, and identity is confirmed by mass spectrometry. Regulatory review of the finished product focuses on these analytical controls, since small deviations in sequence or modification can change biological activity. Questions about long-term effects on the pituitary axis remain areas of continued investigation.
Tesamorelin is a synthetic peptide that belongs to the growth hormone-releasing hormone (GHRH) family. Its sequence corresponds to the fully active 44-amino-acid form of human GHRH, with a single structural modification: the addition of a trans-3-hexenoyl group at the N-terminus. That modification is not found in the naturally occurring hormone and was introduced deliberately during development to improve stability against enzymatic degradation. The compound is therefore best described as a stabilized analogue rather than a naturally occurring peptide.
研究背景集中在特定人群的体成分改变，尤其是与脂肪分布异常相关的内脏脂肪堆积。不同地区对它的监管状态与获批适应症并不一致，部分市场仅限特定诊断人群使用。在一般人群中的长期效应、与其他激素的相互作用以及停药后的维持情况仍属开放问题，现有数据不足以给出普遍结论。
tesamorelin 是一种人工合成的四十四肽，序列与内源性生长激素释放激素（GHRH）的 1-44 片段一致，区别在于 N 端加接了一个反式-3-己烯酰基。该修饰抑制二肽基肽酶 IV 的快速切割，从而延长分子在循环中的存留时间。作为肽类分子，它难以经胃肠道吸收，文献中讨论的均是注射途径。分类上通常把它归为 GHRH 类似物，以区别于生长激素本身。
==== Enzymatic methods ==== Bilirubin can be detected based on oxidation of bilirubin to biliverdin by bilirubin oxidase. At pH near 8 in presence of sodium cholate and sodium dodecylsulfate, both conjugated and unconjugated fractions are oxidised to biliverdin, which is then oxidised to purple then colourless products. The unconjugated fraction can be measured alone at pH 3.7 to 4.5, where bilirubin oxidase only oxidises unconjigated bilirubin. At pH 10 bilirubin oxidase preferentially oxidises conjugated bilirubin. Assays can thereby be taylored to detection of the specific bilirubin fractions by fine-tuning pH. These methods show good agreement with the Jendrassik-Grof method.
=== Structural drawings === Organic molecules are described more commonly by drawings or structural formulas, combinations of drawings and chemical symbols. The line-angle formula is simple and unambiguous. In this system, the endpoints and intersections of each line represent one carbon, and hydrogen atoms can either be notated explicitly or assumed to be present as implied by tetravalent carbon.
== History == In the early 18th century, Jakob Le Mort (1650–1718), a professor of chemistry at Leiden University, prepared an elixir for asthma and called it "paregoric". The word "paregoric" comes from the Greek word "paregoricon" which was originally applied to oratory – to speak, but, more accurately, talk over, soothe, and finally came to have the same meaning as "anodyne". Le Mort's elixir, consisting of "honey, licorice, flowers of Benjamin, and opium, camphor, oil of aniseed, salt of tartar and spirit of wine", appears as "Elixir Asthmaticum" in the London Pharmacopoeia of 1721. Its ingredients were assembled according to the humoral theory of the time. Paregoric was used in various formulations for hundreds of years. Paregoric was a household remedy in the 18th and 19th centuries when it was widely used to control diarrhea in adults and children, as an expectorant and cough medicine, to calm fretful children, and to rub on the gums to counteract the pain from teething. In a memoir of life in Mississippi after the American Civil War, one woman recalled, "I wonder how any of us grew up, the drinking water of the village was so contaminated...All the family was subject to violent attacks of stomach and intestinal trouble. These were called cramp colic, cholera, morbus flux, etc., and no one ever dreamed of connecting them with the drinking supply. My father had a medicine chest filled with paregoric, Jamaica ginger and cholera mixture, which he dispersed freely." A formula for paregoric from Dr. Chase's Recipes (1865):
His name is also removed from the Roll of the Peerage, but he is still eighth in the line of succession and remains a Counsellor of State. Starmer announces that Chancellor Rachel Reeves will face no further action for failing to obtain the relevant licence before renting out her family home, but rebukes her for not providing him with all of the information when the story about her broke. Dartford Borough Council councillor James Buchan defects from Reform UK to the Conservatives after becoming "uncomfortable" with his former party.
Sources: en.wikipedia.org
=== Transdermal and topical === A topical gel formulation of progesterone, for direct application to the breasts as a local therapy for breast disorders such as breast pain, was introduced under the brand name Progestogel in Europe by 1972. No transdermal formulations of progesterone for systemic use have been successfully marketed, in spite of efforts of pharmaceutical companies towards this goal. The low potency of transdermal progesterone has thus far precluded it as a possibility. Although no formulations of transdermal progesterone are approved for systemic use, transdermal progesterone is available in the form of creams and gels from custom compounding pharmacies in some countries, and is also available over-the-counter without a prescription in the United States. However, these preparations are unregulated and have not been adequately characterized, with low and unsubstantiated effectiveness.
1st Special Air Service 2nd Special Air Service 3rd Special Air Service – 3e Régiment de Chasseurs Parachutistes 4th Special Air Service – 2e Régiment de Chasseurs Parachutistes 5th Special Air Service – lineage continued by Belgian Special Forces Group F Squadron – responsible for signals and communications It was tasked with parachute operations behind the German lines in France and carried out operations supporting the Allied advance through France (Operations Houndsworth, Bulbasket, Loyton, Kipling and Wallace-Hardy), Belgium, the Netherlands (Operation Pegasus), and eventually into Germany (Operation Archway and Operation Howard). As a result of Hitler's issuing of the Commando Order on 18 October 1942, the members of the unit faced the additional danger that they would be summarily executed if captured by the Germans. In July 1944, following Operation Bulbasket, 34 captured SAS commandos were indeed summarily executed by the Germans; in October 1944, in the aftermath of Operation Loyton, another 31 captured SAS commandos were summarily executed by the Germans. The last original member of the Special Air Service and the last survivor of the Long Range Desert Group, Mike Sadler, died on 4 January 2024, at the age of 103.
==== Alternative theories ==== The 5,000-year-old mummified body of Ötzi the Iceman was found with 15 groups of tattoos, many of which were located at points on the body where acupuncture needles are used for abdominal or lower back problems. Evidence from the body suggests Ötzi had these conditions. This has been cited as evidence that practices similar to acupuncture may have been practised elsewhere in Eurasia during the early Bronze Age; however, The Oxford Handbook of the History of Medicine calls this theory "speculative". It is considered unlikely that acupuncture was practised before 2000 BC. Acupuncture may have been practised during the Neolithic era, near the end of the Stone Age, using sharpened stones called Bian shi. Many Chinese texts from later eras refer to sharp stones called "plen", which means "stone probe", that may have been used for acupuncture purposes. The ancient Chinese medical text, Huangdi Neijing, indicates that sharp stones were believed at-the-time to cure illnesses at or near the body's surface, perhaps because of the short depth a stone could penetrate. However, it is more likely that stones were used for other medical purposes, such as puncturing a growth to drain its pus. The Mawangdui texts, which are believed to be from the 2nd century BC, mention the use of pointed stones to open abscesses, and moxibustion, but not for acupuncture. It is also speculated that these stones may have been used for bloodletting, due to the ancient Chinese belief that illnesses were caused by demons within the body that could be killed or released.
== Current research == New treatments and clinical trials for breast cancer patients, non-small cell lung cancer patients, and patients with high grade gliomas or other solid tumors with leptomeningeal disease are currently being explored. People with leptomeningeal metastasis are generally excluded from clinical trials, thereby limiting the systematic assessment of novel therapies in this subgroup of patients with poor prognosis. More patients with leptomeningeal metastasis should be enrolled into trials investigating novel agents with the potential to penetrate the blood–brain barrier. Novel approaches are being studied as currently available therapies are toxic and provide limited benefits.
Signs and symptoms which (a) are suggestive of a connective tissue disease, but (b) do not meet the criteria of any defined connective tissue diseases, and (c) have lasted for at least three years. (Note, if less than three years, may be regarded as early UCTD). Positive ANA test on two different occasions.
Sources: en.wikipedia.org
=== Pharmacology === Cannabinoids are administered via smoking, vaporizing, oral ingestion, transdermal patch, intravenous injection, sublingual absorption, or rectal suppository. Most are metabolized in the liver by cytochrome P450 enzymes, mainly CYP 2C9. Inhibiting CYP 2C9 can extend intoxication. Δ9-THC is metabolized to 11-hydroxy-Δ9-THC and then 9-carboxy-THC, detectable in the body for weeks due to their lipophilic nature and storage in fat. The entourage effect suggests that terpenes modulate cannabinoid effects.
== Enzyme function == Cyanophycinase is a carboxy terminal specific exopeptidase, meaning it catalyzes the cleavage of the carboxy terminal peptide bond of cyanophycin. It was hypothesized that cyanophycinase was a serine protease due to extreme inhibition of the enzyme when used with known serine protease inhibitors, such as DMSO. Site directed mutagenesis experiments confirmed that the enzyme is a serine protease and suggested that Ser 132 is the primary catalytic residue. Other key residues for specificity include Gln101, Asp172, Gln173, Arg178, Arg180 and Arg183 which form a conserved pocket adjacent to Ser 132. Kinetic characterization of the enzyme demonstrates that the enzyme displays Michaelis–Menten kinetics with a kcat of 16.5 s−1 and a kcat/KM of 7.5 × 106 M−1 s−1.
A nerve is an enclosed, cable-like bundle of nerve fibers (called axons). Nerves have historically been considered the basic units of the peripheral nervous system. A nerve provides a common pathway for the electrochemical nerve impulses called action potentials that are transmitted along each of the axons to peripheral organs or, in the case of sensory nerves, from the periphery back to the central nervous system. Each axon is an extension of an individual neuron, along with other supportive cells such as some Schwann cells that coat the axons in myelin. Each axon is surrounded by a layer of connective tissue called the endoneurium. The axons are bundled together into groups called fascicles, and each fascicle is wrapped in a layer of connective tissue called the perineurium. The entire nerve is wrapped in a layer of connective tissue called the epineurium. Nerve cells (often called neurons) are further classified as either sensory or motor. In the central nervous system, the analogous structures are known as nerve tracts.
The FDA also said that coincidental natural mood variation is the most likely explanation for the apparent worsening of depression after the switch from Wellbutrin XL to Budeprion XL. After several years of denying patient reports, in 2012 the FDA reversed this opinion, announcing that "Budeprion XL 300 mg fails to demonstrate therapeutic equivalence to Wellbutrin XL 300 mg." The FDA did not test the bioequivalence of any of the other generic versions of Wellbutrin XL 300 mg, but requested that the four manufacturers submit data on this question to the FDA by March 2013. As of October 2013, the FDA has made determinations on the formulations from some manufacturers not being bioequivalent. In 2004, Ranbaxy was revealed to have been falsifying data regarding the generic drugs they were manufacturing. As a result, 30 products were removed from US markets and Ranbaxy paid $500 million in fines. The FDA investigated many Indian drug manufacturers after this was discovered, and as a result at least 12 companies have been banned from shipping drugs to the US. In 2017, The European Medicines Agency recommended suspension of a number of nationally approved medicines for which bioequivalence studies were conducted by Micro Therapeutic Research Labs in India, due to inspections identifying misrepresentation of study data and deficiencies in documentation and data handling.
Sources: en.wikipedia.org
It is a laboratory-made peptide of forty-four amino acids whose sequence matches human growth hormone-releasing hormone, with a modified amino terminus. The modification is a short unsaturated fatty acid chain attached to the first residue. This change slows enzymatic breakdown and lengthens the time the peptide stays active in circulation.
The clinical program was designed around HIV-associated lipodystrophy, a condition in which fat accumulates abnormally around the internal organs. Trials enrolled that specific population, so the evidence base covers it rather than the general population. Regulators approved the drug for the studied indication only, and promotion outside it is not permitted.
Growth hormone therapy supplies the finished hormone directly, while this peptide acts upstream and asks the pituitary to secrete its own. That difference means the response depends on a functioning pituitary and on the body's normal feedback loops. It also means the circulating hormone profile is pulsatile rather than a flat, injected level.
It is a synthetic peptide analog of human growth hormone-releasing hormone. It is used clinically to reduce excess visceral abdominal fat in adults with HIV-associated lipodystrophy. It works by stimulating pituitary growth hormone release.