visceral adiposity is one of those subjects where the details matter more than the headlines. This page pulls together the background, the mechanisms, and the practical points readers ask about most.
Last reviewed on 2025-12-24. Where a claim depends on a specific study, the study is described rather than over-claimed.
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.
Interest in this peptide developed because native GHRH has a short circulating lifetime. The N-terminal modification slows cleavage by dipeptidyl peptidase IV, an enzyme that removes the first two residues of many peptides and terminates their activity. Slower degradation means a longer window of receptor stimulation per administration. This design logic parallels other modified peptide hormones, where a small chemical change at a vulnerable site yields a more durable molecule without altering the core mechanism of action.
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.
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。
=== Former all-vegetarian locations === Alcott House in Surrey, United Kingdom Ephrata Cloister in Pennsylvania, United States Fruitlands in Massachusetts, United States Octagon City, Kansas, United States The Sanctuary (community) in West Sussex, United Kingdom
=== Expansion === In 1994, Dane and Travis Boersma struck a deal with a customer, Marty McKenna, which allowed him to open his own Dutch Bros in Medford, about 30 miles away from Grants Pass. McKenna's first stand performed so well that he soon opened up a second one across town. In 1997, the Boersmas brought McKenna on as a partner, hoping he would continue to expand the Medford operations. Two years later, they bought out McKenna's stake in the company. In 1999, Dutch Bros started formally franchising. The company opened its 50th franchised drive-thru location in 2004. That same year, shortly after moving into a new headquarters in Grants Pass, a nearby dumpster fire spread to the building, destroying Dutch Bros roasting equipment, five vehicles, and thousands of pounds of coffee beans. Following this incident, the company continued to expand, and by the end of 2004, operated 61 coffee shops spanning from Northern California to Oregon's Willamette Valley. By 2009, Dutch Bros was running about 135 coffee stands in seven states and generating $50 million in gross annual revenue. Dane Boersma died in 2009 from amyotrophic lateral sclerosis. In 2013, Travis Boersma was featured on the American version of the television show Undercover Boss. Revenues continued to grow into the mid-2010s. The company earned $238 million in systemwide sales in 2015, $350 million in 2016, and $415.3 million in 2017, when over 283 Dutch Bros locations were operating.
These resynthesis experiments provided strong evidence: lichens are a product of symbiosis. The dual hypothesis gained influential supporters; in 1878, Royal Society president Joseph Hooker publicly endorsed Schwendener's theory in his annual address, and by 1880 leading British and American textbooks presented lichens as dual organisms. By 1900 the consensus had shifted. Most botanists now viewed lichens as fungi partnered with algae or cyanobacteria and reclassified them accordingly. Dissent lingered. In a 1909 poll of 42 botanists, Bruce Fink found 18 calling lichens dual organisms, 14 insisting they were fungi, and the rest undecided. Yet even holdouts were beginning to adopt the dual view. The Finnish lichenologist Edvard Vainio (1890) folded lichens into a fungal scheme—labelling them fungi that happen to form symbioses—a move said to have cost him a professorship. The next puzzle was how to classify lichens now that their dual nature was clear. Taxonomists questioned whether to base classification on fungal traits, algal traits, or both. In practice, they chose the fungus. Since the fungus governs reproduction and form, its fruiting bodies and spores carried the most taxonomic weight. By the late 1800s, taxonomists grouped lichens by fungal traits—spore colour, septation, fruiting-body type—rather than thallus shape or algal partner. The shift broke with thallus-based schemes and aligned lichen study with modern fungal taxonomy.
Arrestins block GPCR coupling to G proteins in two ways. First, arrestin binding to the cytoplasmic face of the receptor occludes the binding site for heterotrimeric G-protein, preventing its activation (desensitization). Second, arrestin links the receptor to elements of the internalization machinery, clathrin and clathrin adaptor AP2, which promotes receptor internalization via coated pits and subsequent transport to internal compartments, called endosomes. Subsequently, the receptor could be either directed to degradation compartments (lysosomes) or recycled back to the plasma membrane where it can again signal. The strength of arrestin-receptor interaction plays a role in this choice: tighter complexes tend to increase the probability of receptor degradation (Class B), whereas more transient complexes favor recycling (Class A), although this rule is far from absolute. More recently direct interactions between Gi/o family G proteins and Arrestin were discovered downstream of multiple receptors, regardless of canonical G protein coupling. These recent findings introduce a GPCR signaling mechanism distinct from canonical G protein activation and β-arrestin desensitization in which GPCRs cause the formation of Gαi:β-arrestin signaling complexes.
Sources: en.wikipedia.org
== Further information == Thorium, from which 233U is bred, is roughly three to four times more abundant in the Earth's crust than uranium. The decay chain of 233U itself is part of the neptunium series, the decay chain of its grandparent 237Np. Uses for uranium-233 include the production of the medical isotopes actinium-225 and bismuth-213 which are among its daughters, low-mass nuclear reactors for space travel applications, use as an isotopic tracer, nuclear weapons research, and reactor fuel research including the thorium fuel cycle. Bismuth-213 has been investigated for use in cancer treatment. However, producing the medical isotopes from 233U practically requires separating the long-lived intermediate thorium-229. At Oak Ridge, thorium-229 is recovered from stored uranium-233 and supplied to TerraPower Isotopes for the production of actinium-225 used in cancer-treatment research.
γ-Butyrolactone (GBL) or gamma-butyrolactone is an organic compound with the formula O=CO(CH2)3. It is a hygroscopic, colorless, water-miscible liquid with a pleasant odor. It is the simplest 4-carbon lactone. It is mainly used as an intermediate in the production of other chemicals, such as N-methyl-2-pyrrolidone. In humans, GBL acts as a prodrug for gamma-hydroxybutyric acid (GHB) and is often used as a recreational drug. GHB acts as a central nervous system (CNS) depressant with effects similar to those of barbiturates.
== Powers and abilities == In addition to the standard powers of a Green Lantern power ring, Mogo can also alter his weather and surface conditions such as plant growth and gravity, and travel through space at faster-than-light speeds. Mogo has a form of sensory or extrasensory awareness of what is happening around and on it. However, his well-being is largely sustained by the constant supply of energy from a Green Lantern power battery. Without it, he eventually loses his strength and even falls into a seemingly comatose state. Mogo also telepathically guided the Green Lantern power rings to their bearers.
== External links == Media related to Alpha-synuclein at Wikimedia Commons alpha-Synuclein at the U.S. National Library of Medicine Medical Subject Headings (MeSH) Human SNCA genome location and SNCA gene details page in the UCSC Genome Browser.
Towards the end of this period the pro-independence forces made two important advances. In the Southern Cone, a veteran of the Spanish army with experience in the Peninsular War, José de San Martín, became the governor of the Province of Cuyo. He used this position to begin organizing an army as early as 1814 in preparation for an invasion of Chile. This was an important change in strategy after three United Provinces campaigns had been defeated in Upper Peru. San Martín's army became the nucleus of the Army of the Andes, which received crucial political and material support in 1816 when Juan Martín de Pueyrredón became Supreme Director of the United Provinces. In January 1817, San Martín was finally ready to advance against the royalists in Chile. Ignoring an injunction from the congress of the Río de la Plata not to move against Chile, San Martín together with General Bernardo O'Higgins Riquelme, later Supreme Director of Chile, led the Army over the Andes in a move that turned the tables on the royalists. By 10 February, San Martín had control of northern and central Chile, and a year later, after a war with no quarter, the south. With the aid of a fleet under the command of former British naval officer Thomas Cochrane, Chile was secured from royalist control and independence was declared that year. San Martín and his allies spent the next two years planning an invasion of Peru, which began in 1820.
Sources: en.wikipedia.org
=== Production quantities === World production was approximately 1,100 kt in 2017, with the bulk being produced in China (930 kt) and Russia (60 kt). The United States was in the 20th century the major world supplier of this metal, supplying 45% of world production even as recently as 1995. Since the Chinese mastery of the Pidgeon process the US market share is at 7%, with a single US producer left as of 2013: US Magnesium, a Renco Group company located on the shores of the Great Salt Lake. In September 2021, China took steps to reduce production of magnesium as a result of a government initiative to reduce energy availability for manufacturing industries, leading to a significant price increase.
Immune reconstitution inflammatory syndrome (IRIS) is a condition seen in some cases of HIV/AIDS or immunosuppression, in which the immune system begins to recover, but then responds to a previously acquired opportunistic infection with an overwhelming inflammatory response that paradoxically makes the symptoms of infection worse. IRIS may also be referred to as immune reconstitution syndrome, immune reconstitution disease, immune recovery disease, and immune restoration disease. Systemic or local inflammatory responses may occur with improvement in immune function. While this inflammatory reaction is usually self-limited, there is risk of long-term symptoms and death, particularly when the central nervous system is involved. Management generally involves symptom control and treatment of the underlying infection. In severe cases of IRIS, corticosteroids are commonly used. Important exceptions to using corticosteroids include cryptococcal meningitis and Kaposi's sarcoma, as they have been associated with poorer outcomes.
=== Detailed expression of Thy-1 === In mice, Thy-1 is also found on thymocytes, peripheral T cells, myoblasts, epidermal cells, and keratinocytes. It is one of the "pan T cell markers"(of mice) like CD2, CD5 and CD28. In humans, Thy-1 is also expressed by endothelial cells, smooth muscle cells, a subset of CD34+ bone marrow cells, and umbilical cord blood-, cardiac fibroblasts, and fetal liver-derived hemopoietic cells. Thy-1 is present on a fraction of brain cells and a fraction of fibroblasts of most vertebrate species studied. Nervous tissue: Thy-1 expression in the nervous system is predominantly neuronal, but some glial cells also express Thy-1 especially at later stages of their differentiation. One study compared Thy-1 expression in four human neuronal cell lines, two neuroglial cell lines, and fresh tumor cells of neuronal origin and found three of the four neuronal cell lines, all of the neuroglial cell lines, and 80% of the tumors to be strongly positive for Thy-1. Brain part specific ELISA reports are available which show highest concentrations of Thy-1 protein in the striatum and hippocampus, followed by the neocortex, cerebellum, spinal cord, and the retina and optic nerve. Thy-1 promoter has often been assumed to be "brain specific". "Neuron specific" mouse Thy-1 promoter has been used to drive "brain specific" forced expression of proteins e.g. mutated Amyloid precursor protein(APP) as transgenic animal models of Alzheimer's disease. Thy-1 expression in the brain is developmentally regulated.
USAF Pararescue combat medics in Afghanistan used fentanyl lozenges in the form of lollipops on combat casualties from IED blasts and other trauma. The stick is taped to a finger and the lozenge put in the cheek of the person. When enough fentanyl has been absorbed, the (sedated) person generally lets the lollipop fall from the mouth, indicating sufficient analgesia and somewhat reducing the likelihood of overdose and associated risks.
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.