This is a working overview of visceral adiposity, written for readers who want more than a one-paragraph summary but less than a textbook.
This page was last updated on 2025-08-15 and is reviewed periodically as new material appears.
Tesamorelin occupies a narrow position among agents that act on the growth hormone axis. Unlike growth hormone itself, which is given as replacement, it stimulates the pituitary to release the hormone in pulses, so the downstream increase in insulin-like growth factor 1 depends on intact somatotroph function. Other peptides in the same family include shorter GHRH fragments and synthetic secretagogues with different stability profiles. Several points remain unresolved, including whether the reduction in visceral fat translates into fewer cardiovascular events, what happens to metabolic markers after long-term use, and how the drug compares with lifestyle or surgical approaches.
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.
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。
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.
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.
The native hormone is produced in the hypothalamus and acts on the anterior pituitary. Binding of GHRH to its receptor stimulates synthesis and release of growth hormone into circulation. Because the analogue retains the receptor-binding region of the parent sequence, it engages the same receptor and triggers the same downstream signaling. The result is increased growth hormone secretion from pituitary cells, which in turn influences hepatic production of insulin-like growth factor 1. This axis is the basis for the compound's measured biological effects.
作用位置在垂体前叶。tesamorelin 与 GHRH 受体结合后激活腺苷酸环化酶，升高细胞内 cAMP，再经蛋白激酶 A 通路促进生长激素的合成与释放。由于它作用于内源调控节点，生长激素仍以脉冲方式分泌，而不是被持续抬升到固定水平。生长激素随后在肝脏等组织诱导胰岛素样生长因子 1 产生，构成完整的生长激素轴响应。
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。
Epithelium or epithelial tissue is a thin, continuous, protective layer of cells with little extracellular matrix. An example is the epidermis, the outermost layer of the skin. Epithelial (mesothelial) tissues line the outer surfaces of many internal organs, the corresponding inner surfaces of body cavities, and the inner surfaces of blood vessels. Epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. Epithelial tissues lack blood or lymph supply, but are supplied by nerves. There are three principal shapes of epithelial cell: squamous (scaly), columnar, and cuboidal. These can be arranged in a singular layer of cells as simple epithelium, either simple squamous, simple columnar, or simple cuboidal, or in layers of two or more cells deep as stratified (layered), or compound, either squamous, columnar or cuboidal. In some tissues, a layer of columnar cells may appear to be stratified due to the placement of the nuclei. This sort of tissue is called pseudostratified. All glands are made up of epithelial cells. Functions of epithelial cells include diffusion, filtration, secretion, selective absorption, germination, and transcellular transport. Compound epithelium has protective functions. Epithelial layers contain no blood vessels (avascular), so they must receive nourishment via diffusion of substances from the underlying connective tissue, through the basement membrane. Cell junctions are especially abundant in epithelial tissues.
Lipidomics is the large-scale study of pathways and networks of cellular lipids in biological systems. The word "lipidome" is used to describe the complete lipid profile within a cell, tissue, organism, or ecosystem and is a subset of the "metabolome" which also includes other major classes of biological molecules (such as amino acids, sugars, glycolysis & TCA intermediates, and nucleic acids). Lipidomics is a relatively recent research field that has been driven by rapid advances in technologies such as mass spectrometry (MS), nuclear magnetic resonance (NMR) spectroscopy, fluorescence spectroscopy, dual polarisation interferometry and computational methods, coupled with the recognition of the role of lipids in many metabolic diseases such as obesity, atherosclerosis, stroke, hypertension and diabetes. This rapidly expanding field complements the huge progress made in genomics and proteomics, all of which constitute the family of systems biology. Lipidomics research involves the identification and quantification of the thousands of cellular lipid molecular species and their interactions with other lipids, proteins, and other metabolites. Investigators in lipidomics examine the structures, functions, interactions, and dynamics of cellular lipids and the changes that occur during perturbation of the system. Han and Gross first defined the field of lipidomics through integrating the specific chemical properties inherent in lipid molecular species with a comprehensive mass spectrometric approach.
== Function == Elastin, a protein in the extracellular matrix, provides elasticity and its soluble precursor is tropoelastin. When elastin cross links it produces desmosine and isodesmosine. When desmosine is mentioned, it is usually grouped with isodesmosine, the other tetrafunctional amino acid that is specific to elastin.
Forensic chemists' analysis can provide leads for investigators, and they can confirm or refute their suspicions. The identification of the various substances found at the scene can tell investigators what to look for during their search. During fire investigations, forensic chemists can determine if an accelerant such as gasoline or kerosene was used; if so, this suggests that the fire was intentionally set. Forensic chemists can also narrow down the suspect list to people who would have access to the substance used in a crime. For example, in explosive investigations, the identification of RDX or C-4 would indicate a military connection as those substances are military grade explosives. On the other hand, the identification of TNT would create a wider suspect list, since it is used by demolition companies as well as in the military. During poisoning investigations, the detection of specific poisons can give detectives an idea of what to look for when they are interviewing potential suspects. For example, an investigation that involves ricin would tell investigators to look for ricin's precursors, the seeds of the castor oil plant. Forensic chemists also help to confirm or refute investigators' suspicions in drug or alcohol cases. The instruments used by forensic chemists can detect minute quantities, and accurate measurement can be important in crimes such as driving under the influence as there are specific blood alcohol content cutoffs where penalties begin or increase.
Sources: en.wikipedia.org
Buried bumper syndrome (BBS) is a condition that affects feeding tubes placed into the stomach (gastrostomy tubes) through the abdominal wall. Gastrostomy tubes include an internal bumper, which secures the inner portion of the tube inside the stomach, and external bumper, which secures the outer portion of the tube and opposes the abdomen. Buried bumper syndrome occurs when the internal bumper of a gastrostomy tube erodes into the wall of the stomach. The internal bumper may become entirely buried within the fistulous tract. The main causative factor is excessive tightening of the external bumper, leading to increased pressure of the internal bumper on the wall of the stomach. Additional risk factors include: obesity, weight gain, malnutrition, corticosteroid therapy, and poor wound healing. Buried bumper syndrome may be entirely asymptomatic, though tube dysfunction is common. The gastrostomy tube may leak around the entry site, or it may become difficult to infuse feeds, fluids or medications. Less often, bleeding, infection, abscess or peritonitis may occur. Diagnosis is achieved most often with upper endoscopy. Computed tomography imaging may also confirm the diagnosis. Treatment consists of removal of the gastrostomy tube, either via simple external traction or endoscopic removal. Surgery is rarely necessary.
Austin no-showed the Raw after WrestleMania and took a week-long break without the company's consent, citing exhaustion. Austin returned on the April 1 episode of Raw, the first of the new "brand extension" era. The show was centered around which show he would sign with, and he ultimately chose Raw. Austin entered a feud with The Undertaker that resulted in a number-one contender's match for the Undisputed WWF Championship at Backlash on April 21, which Austin lost. In a May interview on WWE's internet program, Byte This!, Austin stunned the company and fans by launching a verbal attack on the direction the company was heading in and slated the creative team for not using him the way he felt they previously did. The WWE rehired Eddie Guerrero for Austin to feud with, while also prepping Austin for a feud with Brock Lesnar. However, Austin balked at the proposition that he lose a King of the Ring qualifying match on Raw to Lesnar, and ultimately walked out of the company. Austin later explained that he thought hot-shotting a rookie made Austin look weak, and airing the match on free television with no build-up did not give Lesnar a proper stage for such a big win over a star of Austin's magnitude. Further fanning the flames among Austin's growing number of detractors was a well-publicized domestic dispute incident between Austin and his wife Debra (see below). After Austin again no-showed the June 10 episode of Raw, his storylines were immediately dropped.
=== Pharmacokinetics === DET demonstrates significant resistance to metabolism by monoamine oxidase A (MAO-A) compared to DMT. This may be due to the increased steric bulk of the N-ethyl substituents relative to the respective methyl groups of DMT which results in metabolic stability sufficient for oral activity. This is also true for many other tryptamines with larger nitrogen substituents. The drug similarly to DMT is rapidly absorbed from the intraperitoneal cavity and quickly distributed through plasma, liver and brain. Most of the substance had disappeared from the aforementioned tissues 30 minutes from administration, except in the brain, where it could still be detected at 60 minutes. Likewise to DMT the substance is metabolized through 6-hydroxylation and N-dealkylation to form the corresponding intermediates. These metabolites were found to be excreted in urine of about 20% of the administered dose as the glucoronide conjugate, of which the parent compound can be detected by chromatographic analysis at low concentrations (3–5%). Hepatic 6-hydroxylation of the indole ring, yields a minor, psychoactively inactive metabolite 6-hydroxy-DET (6-HO-DET) in similar concentration, with additional hydroxylation possible at alternative positions. Repeated administration of DET, or second exposure one to two weeks after the first, resulted in significant metabolic changes. The unchanged drug excreted after a later exposure was significantly lower, while the excretion of the metabolites which were measured in this case were higher than at the first exposure to DET.
Karen M. Frank is an American clinical pathologist and microbiologist researching the pathogenesis of Staphylococcus aureus pneumonia and resistant gram-negative bacteria. She is a senior clinician, principal investigator, and chief of laboratory medicine at the National Institutes of Health Clinical Center.
== Role in microbial cooperation == Once pyoverdine is secreted, it diffuses freely in the environment. Iron-bound pyoverdine (also known as ferripyoverdine) can be taken up by any bacterial cell with the appropriate receptor, although this varies between strains. Importantly, this creates a common good which can be exploited by 'cheaters' which retain the ability to use pyoverdine but have stopped making it. Since pyoverdine production is energetically costly, this can create a fitness advantage in cells that are not synthesizing it. Consequently, pyoverdine has become a model trait to study microbial cooperation and exploitation. In P. aeruginosa, pyoverdine non-producing "cheat" bacteria have been shown to i) evolve readily from a producing ancestor; and ii) outcompete cooperating strains in mixed culture in a density- and frequency-dependent manner. Since pyoverdine usage relies on passive diffusion and pyoverdine production is metabolically costly, environmental conditions are known to influence the likelihood of successful exploitation. The competitive advantage of pyoverdine non-producers over producers in mixed culture was shown to be maximized when environments are well-mixed and molecules diffuse readily (low spatial structure) and when the costs and benefits of pyoverdine production are high, i.e. when iron is strongly limited. Most studies on pyoverdine cooperation and cheating have been conducted using clinical isolates, but siderophore exploitation was recently also demonstrated in natural Pseudomonas isolates from non-clinical samples.
Sources: en.wikipedia.org
== External links == CD49a+antigen at the U.S. National Library of Medicine Medical Subject Headings (MeSH) Human ITGA1 genome location and ITGA1 gene details page in the UCSC Genome Browser. ITGA1[link removed] Info with links in the Cell Migration Gateway Archived 2014-12-11 at the Wayback Machine PDBe-KB provides an overview of all the structure information available in the PDB for Human Integrin alpha-1
=== Detection === Quantification of alprazolam in blood and plasma samples may be necessary to confirm a diagnosis of intoxication in hospitalized patients, or to provide evidence in the case of crimes e.g., impaired driving arrest, or to assist in a thorough forensic investigation, e.g., in a medicolegal death investigation. Blood or plasma alprazolam concentrations are usually in a range of 10–100 μg/L in persons receiving the drug therapeutically, 100–300 μg/L in those arrested for impaired driving, and 300–2,000 μg/L in victims of acute overdosage. Most of the commercial immunoassays used for the benzodiazepine class of drugs cross-react with alprazolam, but confirmation and quantitative determination are usually done by chromatographic techniques.
== January 22, 1982 (Friday) == In the U.S. state of Washington, the board of directors of the state's Public Power Supply System voted to halt further construction of two nuclear power plants, bringing the number of construction permit revocations to 30 in the U.S. since the beginning of 1979. The first convictions in the U.S., on criminal charges of slavery resulting in death, were issued by a federal jury in North Carolina for Dennis Warren, a migrant labor crew leader, and along with his brother Richard Warren, and his assistant John Lester Harris. Died: Eduardo Frei, 71, President of Chile from 1964 to 1970 and a critic of the regime of President Augusto Pinochet, died after having surgery at a hospital in Santiago for a hiatal hernia, reported initially as death from sepsis. More than 35 years later, allegations would be made that Frei had been poisoned by members of Pinochet's secret police organization, the CNI and although six defendants would be found guilty of homicide in 2019, the convictions would be overturned on appeal and a Chilean court would conclude that Frei was not a victim of homicide. Hans Fidesser, 90, Austrian opera tenor Ragini Devi (stage name for Esther Sherman), 88, American performer of Indian classical dance Edward Farber, 67, American photographer and inventor of the portable strobe light.
=== Decompensated cirrhosis === Manifestations of decompensation in cirrhosis include gastrointestinal bleeding, hepatic encephalopathy, jaundice or ascites. In patients with previously stable cirrhosis, decompensation may occur due to various causes, such as constipation, infection (of any source), increased alcohol intake, medication, bleeding from esophageal varices or dehydration. It may take the form of any of the complications of cirrhosis listed below. People with decompensated cirrhosis generally require admission to a hospital, with close monitoring of the fluid balance, mental status, and emphasis on adequate nutrition and medical treatment – often with diuretics, antibiotics, laxatives or enemas, thiamine and occasionally steroids, acetylcysteine and pentoxifylline. Administration of saline is avoided, as it would add to the already high total body sodium content that typically occurs in cirrhosis. Life expectancy without a liver transplant is low, at most three years.
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.