The short version of Tesamorelin fits in a sentence. The long version — which is the one that helps — is below.
Reviewed 2026-06-15. Anything still debated is marked as such rather than presented as settled.
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.
| 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.
Larry Friedman (Mulligan) performed in the musical Rasputin with Ted Neeley and John Hurt. Mion Hahm (Micki) is a realtor in Florida. Steve Einbender (Mike) is Senior Manager of Customer Analytics for The Home Depot, in Atlanta, Georgia. He still plays drums. Benjamin Sands (Manny) is a music teacher in the Washington, D.C. area. Sherry Wright (Maggie) pursued an acting and singing career while living in Alexandria, Virginia; she died in July 2009. Barry Michlin (Wilbur) had a number of minor roles throughout the 1970s and 1980s, and also made recurring appearances in several TV commercials including for Arm & Hammer Baking Soda with actress Beverly Sanders. He is a photographer based in Los Angeles.
The Metabolic Score for Insulin Resistance (METS-IR) is a metabolic index designed to quantify peripheral insulin sensitivity in humans. It was first described by Bello-Chavolla et al. in 2018 and developed by the Metabolic Research Disease Unit at the Instituto Nacional de Ciencias Médicas Salvador Zubirán. METS-IR was validated in the Mexican population against the euglycemic hyperinsulinemic clamp and the frequently-sampled intravenous glucose tolerance test. It offers a non-insulin-based alternative to traditional methods such as SPINA Carb, HOMA-IR, and QUICKI. METS-IR is currently validated for assessing cardiometabolic risk in Latino population.
=== Pain and pain management === Most patients report mild to moderate pain during insertion, and a minority report severe pain. Clinicians tend to underestimate this pain. In a study of 200 insertions, patients rated their peak pain at a mean of 65 on a 100-point scale, while providers rated it at 35. Guidelines historically did not recommend routine pain relief, and patients sharing their experiences on social media in the 2020s increased scrutiny of the practice. In 2025 the American College of Obstetricians and Gynecologists (ACOG) acknowledged that many patients feel clinicians have dismissed their pain. Options include NSAIDs, topical lidocaine, a paracervical block, nitrous oxide, inhaled methoxyflurane (the "green whistle"), and intravenous sedation or general anaesthesia where available. Sedation and general anaesthesia usually require a referral or separate appointment. Some clinics also offer virtual reality headsets for distraction. Evidence for individual methods is mixed. A Cochrane review found that lidocaine gel and most NSAIDs did not reduce pain, while some lidocaine formulations, tramadol and naproxen helped in some groups. A 2026 meta-analysis found no significant effect of virtual reality on pain. Paracervical block is underused in the United States. The US CDC and ACOG recommend that clinicians discuss expected pain and pain relief options with every patient before insertion.
==== Financial inclusion ==== Digital agriculture technologies can expand farmers' access to credit, insurance, and bank accounts for a number of reasons. First, digital technology helps alleviate the information asymmetry that exists between farmers and financial institutions. When lenders decide a farmer's credit ceiling or insurance premium, they are usually uncertain about what risks the farmer presents. Digital technology reduces the costs of verifying farmers' expected riskiness. The Kenyan company M-Shwari uses customers' phone and mobile money records to assess creditworthiness. Organizations like FarmDrive and Apollo Agriculture incorporate satellite imagery, weather forecasts, and remote sensor data when calculating farmers' loan eligibility. Drone imagery can confirm a farmer's physical assets or land use and Asset tracking using RFID technology allows stakeholders to monitor livestock, making it easier for insurers to understand farmers' riskiness. In all instances, low-cost digital verification reduces lenders' uncertainty: the questions "will this farmer repay the loan?" and "what risks does this farmer face?" become clearer. Second, digital technology facilitates trust between farmers and financial institutions. A range of tools create trust, including real-time digital communication platforms and blockchain/distributed ledger technology/smart contracts. In Senegal, a digitalized, supply-chain-tracking system allows farmers to collateralize their rice to obtain the credit necessary for planting.
Sources: en.wikipedia.org
Potential sources of therapeutic agents Phytochemical and pharmacological researches suggest that freshwater macrophytes, such as Centella asiatica, Nelumbo nucifera, Nasturtium officinale, Ipomoea aquatica and Ludwigia adscendens, are promising sources of anticancer and antioxidative natural products. Hot water extracts of the stem and root of Ludwigia adscendens, as well as those of the fruit, leaf and stem of Monochoria hastata were found to have lipoxygenase inhibitory activity. Hot water extract prepared from the leaf of Ludwigia adscendens exhibits alpha-glucosidase inhibitory activity more potent than that of acarbose.
== Diagnosis == Diagnosis can be suspected by symptoms and abnormalities in test, such as: atrophy of cerebellum on MRI, elevated levels of alpha-fetoprotein and cholesterol, neuropathic pattern on electromyography (procedure when a needle is inserted into a muscle in order to measure muscle activity caused by neurons). Consequently, diagnosis can be confirmed via genetic testing.
Some residents warned that, if the situation continued for another week or two, it could lead to a humanitarian crisis, and also expressed concern that the districts might fall to Pakistani forces. Since the closure of roads, Taliban have been airlifting essential supplies to effected areas. Locals in Nuristan also said that the road between Kunar and Nuristan had been closed, and that Pakistani soldiers targeted anyone travelling along the route. Residents of Kunar and Nuristan state that while artillery attacks had occurred in the area for years, road closures and airstrikes had been relatively rare in the past. Meanwhile, an Afghan media outlet, citing a Pakistani official, reported that Pakistani security forces had taken control of several strategic border posts. The official said the positions had been secured because of their tactical importance and elevation, and stated that Pakistan's aim was not to seize Afghan territory but to prevent cross-border infiltration and protect vulnerable areas inside Pakistan. Enayatullah Toofan, a member of Taliban's High Council for Armed Forces Coordination, states that Pakistani forces have occupied parts of Paktika province and issued Pakistani identity cards to the residents there. According to him, Pakistan wants to open girls schools in those areas. However, Enayatullah Khwarizmi, a spokesperson for the Afghan Ministry of Defense, said that all areas on the Afghan side of the border remained under Afghan control and that the Afghan armed forces were committed to defending every inch of the country's territory.
== Neuron-intrinsic changes == Immediately following injury, neurons undergo a large number of transcriptional and proteomic changes which switch the cell from a mature, synaptically active neuron to a synaptically silent, growth state. This process is dependent on new transcription, as blocking the ability of cells to transcribe new mRNA severely impairs regeneration. A number of signaling pathways have been shown to be turned on by axon injury and help to enable long distance regeneration including BMP, TGFβ, and MAPKs. Similarly, a growing number of transcription factors also boost the regenerative capacity of peripheral neurons including ASCL1, ATF3, CREB1, HIF1α, JUN, KLF6, KLF7, MYC, SMAD1, SMAD2, SMAD3, SOX11, SRF, STAT3, TP53, and XBP1. Several of these can also boost the regenerative capacity of CNS neurons, making them potential therapeutic targets for treating spinal cord injury and stroke.
=== "Central pillar" cave structure === In the typical "central pillar" design, pilgrims can circumambulate around a central column incorporating a niche for a statue of the Buddha, which is a representation of the stupa. The so-called "central pillar" which appears on a plan is actually not a pillar at all but only the rock at the back of the cave, into which was bored a circular corridor allowing for circumambulation. A large vaulted chamber is located in front of the "central pillar" column and a smaller rear chamber behind with two tunnel-like corridors on the sides linking these spaces. In the front chamber, a three-dimensional image of Buddha would have been housed in a large niche serving as the focus of the interior, however, none of these sculptures have survived at Kizil. The rear chamber may feature the parinirvana scene in the form of a mural or large sculpture, and in some cases, a combination of both. The "central pillar" layout is possibly related to the structural design of Kara Tepe in northern Bactria. The program of the paintings in the "central pillar" caves generally follows a fixed arrangement: the walls of the main cella show sermons of the Buddha, the ceiling has rhomboid vignettes alluding to Jatakas, the central niche has the scene of the Indrasala Cave. The back room or corridor has scenes related to the Parinirvana, and finally the painting over the exit is related to the Tusita Heaven and the future Buddha Maitreya.
Sources: en.wikipedia.org
However, official IUPAC stoichiometric nomenclature is based on an idealized convention of determining the relative electronegativities of the elements by the mere virtue of their position within the periodic table. According to this convention, astatine is handled as though it is more electronegative than hydrogen, irrespective of its true electronegativity. The electron affinity of astatine, at 233 kJ mol−1, is 21% less than that of iodine. In comparison, the value of Cl (349) is 6.4% higher than F (328); Br (325) is 6.9% less than Cl; and I (295) is 9.2% less than Br. The marked reduction for at was predicted as being due to spin–orbit interactions. The first ionization energy of astatine is about 899 kJ mol−1, which continues the trend of decreasing first ionization energies down the halogen group (fluorine, 1681; chlorine, 1251; bromine, 1140; iodine, 1008).
However, because CPE is not a rate-limiting enzyme for the production of most neuropeptides and peptide hormones, it is not clear how relatively modest decreases in CPE activity can cause physiological effects.
=== Energy expenditure === The Na+/K+-ATPase is an active enzyme. It uses energy from ATP to move ions against their concentration gradient. In fact, all cells expend a large fraction of the ATP they produce (typically 30% and up to 70% in nerve cells) to maintain their required cytosolic Na and K concentrations. For neurons, the Na+/K+-ATPase can be responsible for up to three-fourths of the cell's energy expenditure. In many types of tissue, ATP consumption by the Na+/K+-ATPases have been related to glycolysis. This was first discovered in red blood cells (Schrier, 1966), but has later been evidenced in renal cells, smooth muscles surrounding the blood vessels, and cardiac cells which compose Purkinje fibers. Recently, glycolysis has also been shown to be of particular importance for Na+/K+-ATPase in skeletal muscles, where inhibition of glycogen breakdown (a substrate for glycolysis) leads to reduced Na+/K+-ATPase activity and lower force production.
== History == In 1980 Ferguson-Miller et al. at Michigan State developed n-dodecyl-β-D-maltopyranoside (DDM) as part of a successful effort to purify an active, stable, monodisperse form of cytochrome c oxidase. Maltosides have been used extensively to stabilize membrane proteins for biophysical and structural studies.
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.