Терапія на основі інкретину для лікування кардіометаболічних захворювань: минуле, сьогодення та майбутнє

James P. Psaltis

Медичний факультет, Університет Аделаїди, Аделаїда, Австралія

Jessica A. Marathe

Медичний факультет, Університет Аделаїди, Аделаїда, Австралія; Програма здоров’я серця і судин, Програма здоров’я впродовж життя, Південноавстралійський інститут охорони здоров’я та медичних досліджень, Аделаїда, Австралія; Відділення кардіології, Центральна місцева лікарня, Аделаїда, Австралія

Mau T. Nguyen

Медичний факультет, Університет Аделаїди, Аделаїда, Австралія; Програма здоров’я серця і судин, Програма здоров’я впродовж життя, Південноавстралійський інститут охорони здоров’я та медичних досліджень, Аделаїда, Австралія; Відділення кардіології, Центральна місцева лікарня, Аделаїда, Австралія

Richard Le

Програма здоров’я серця і судин, Програма здоров’я впродовж життя, Південноавстралійський інститут охорони здоров’я та медичних досліджень, Аделаїда, Австралія; Коледж медицини та громадського здоров’я; Університет Фліндерса, Аделаїда, Австралія

Christina A. Bursill

Медичний факультет, Університет Аделаїди, Аделаїда, Австралія; Програма здоров’я серця і судин, Програма здоров’я впродовж життя, Південноавстралійський інститут охорони здоров’я та медичних досліджень, Аделаїда, Австралія

Chinmay S. Marathe

Медичний факультет, Університет Аделаїди, Аделаїда, Австралія; Кафедра ендокринології, Місцева мережа охорони здоров’я Аделаїди, Аделаїда, Австралія

Adam J. Nelson

Медичний факультет, Університет Аделаїди, Аделаїда, Австралія; Програма здоров’я серця
і судин, Програма здоров’я впродовж життя, Південноавстралійський інститут охорони здоров’я та медичних досліджень, Аделаїда, Австралія; Відділення кардіології, Центральна місцева лікарня, Аделаїда, Австралія

Peter J. Psaltis

Медичний факультет, Університет Аделаїди, Аделаїда, Австралія; Програма здоров’я серця
і судин, Програма здоров’я впродовж життя, Південноавстралійський інститут охорони здоров’я та медичних досліджень, Аделаїда, Австралія; Відділення кардіології, Центральна місцева лікарня, Аделаїда, Австралія

DOI :

Резюме

Серед нових класів препаратів для лікування цукрового діабету (ЦД) 2-го типу агоністи рецепторів глюка-гоноподібного пептиду 1 (арГПП-1) — це засоби на основі інкретину, які знижують рівень глюкози в крові та сприяють зниженню маси тіла. Вони активують рецептори ГПП-1 (рГПП-1) в підшлунковій залозі, сприяючи глюкозозалежному вивільненню інсуліну та пригнічуючи секрецію глюкагону. Вони також впливають на рецептори в головному мозку та шлунково-кишковому тракті, пригнічуючи апетит, сповільнюючи спорожнення шлунка та затримуючи всмоктування глюкози. 3 фаза клінічних досліджень показала, що препарати ГПП-1 покращують серцево-судинні результати при ЦД 2-го типу або надлишковій масі тіла/ожирінні у людей, які мають серцево-судинні захворювання або високий ризик розвитку атеросклеротичного серцево-судинного захворювання. Це значною мірою зумовлено зменшенням кількості ішемічних подій, хоча нові дані також підтверджують переваги при інших серцево-судинних захворюваннях, таких як серцева недостатність зі збереженою фракцією викиду. Успіх арГПП-1 також спричинив еволюцію інших методів лікування інкретином. Тирзепатид з’явився як подвійний глюкозозалежний інсулінотропний поліпептид (ГІП)/арГПП-1, що має більш вражаючі ефекти на контроль глікемії та зниження ваги, ніж ті, що досягаються ізольованим агонізмом лише рГПП-1. Це полягає у зниженні рівня глікованого гемоглобіну більш ніж на 2 % та втратою маси тіла понад 15 % від початкового рівня. У цьому огляді ми розглянемо фармакологічні властивості арГПП-1 і тирзепатиду та обговоримо їх клінічну ефективність при ЦД 2-го типу і надмірній масі тіла/ожирінні, включаючи їх здатність знижувати несприятливі серцево-судинні наслідки. Ми також заглиблюємося в механічну основу цих кардіопротекторних ефектів і розглядаємо наступні кроки у впровадженні існуючої і майбутньої терапії на основі інкретинів для більш широкого лікування кардіометаболічних захворювань.

Ключові слова:  атеросклероз, цукровий діабет, інкретини, ожиріння, тирзепатид.

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Опубліковано: 2024

Як цитувати:

James P. Psaltis, Jessica A. Marathe, Mau T. Nguyen, Richard Le, Christina A. Bursill, Chinmay S. Marathe, Adam J. Nelson, Peter J. Psaltis (2024) Терапія на основі інкретину для лікування кардіометаболічних захворювань: минуле, сьогодення та майбутнє 13(5), (8-38)