The short version of insulin-like growth factor 1 fits in a sentence. The long version — which is the one that helps — is below.
Reviewed 2026-05-20. Anything still debated is marked as such rather than presented as settled.
Clinical study of tesamorelin has centered on adults with HIV-associated lipodystrophy, a condition in which abdominal fat accumulates while peripheral fat is lost. In controlled trials, treated participants showed reductions in visceral adipose tissue measured by imaging, alongside modest shifts in some lipid values. Effects on subcutaneous fat were smaller and less consistent across studies. Whether these changes translate into fewer cardiovascular events remains an open question, because the trials were not designed or powered to answer it.
Tesamorelin is a synthetic peptide that acts as an analog of growth hormone-releasing hormone, a natural hypothalamic signal. Its sequence corresponds to the forty-four amino acid form of the human hormone, with a small acyl group attached near the amino terminus. That modification slows enzymatic breakdown and extends the time the peptide remains active in circulation. The compound was developed as a pharmacological way to raise endogenous growth hormone output rather than supplying the hormone directly.
After injection, the peptide binds receptors on somatotroph cells in the anterior pituitary. Receptor activation raises intracellular cyclic AMP and triggers release of stored growth hormone into the bloodstream. Because the compound works through the body's own regulatory system, growth hormone pulses retain much of their normal feedback control. Repeated administration also raises insulin-like growth factor 1, a hormone produced mainly in the liver. Investigators treat that rise as a marker that the pituitary axis has been engaged.
Growth hormone released from the pituitary stimulates the liver and other tissues to produce insulin-like growth factor 1, a stable circulating protein that serves as a practical marker of activity. Clinical studies therefore track IGF-1 concentrations alongside the hormone itself, and they commonly measure body composition with imaging rather than relying on body weight alone. Visceral adipose tissue, the fat surrounding abdominal organs, is quantified by computed tomography in the studies that supported approval. Adverse effects reported in trials include injection-site reactions, joint pain, and increases in blood glucose, which is why monitoring accompanies use.
Questions remain about how much of the observed fat reduction reflects direct GHRH-receptor signaling versus the downstream growth hormone and IGF-1 surge. It is also unclear whether the compound produces meaningful benefit in populations without lipodystrophy, since trials in cognitive impairment did not reach their stated goals. Long-term effects on glucose metabolism and on cardiovascular outcomes are not fully characterized. Published work generally describes effects on surrogate markers rather than on hard clinical endpoints, and independent replication of some findings is limited.
| Property | Value | Notes |
|---|---|---|
| Drug class | Peptide hormone analog | Acts at the growth hormone-releasing hormone receptor |
| Receptor | Growth hormone-releasing hormone receptor | G protein-coupled; raises cyclic AMP in somatotrophs |
| Key mediator | Insulin-like growth factor 1 | Increases with repeated administration |
| Main studied population | Adults with HIV-associated lipodystrophy | Trials measured visceral adipose tissue by imaging |
| Route | Subcutaneous injection | Given once daily in clinical use |
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。
Measuring the effect of a growth hormone-releasing hormone analogue requires markers that reflect pituitary output rather than the peptide itself. The two most frequently used are growth hormone and insulin-like growth factor 1. Growth hormone fluctuates sharply across the day and responds to sleep, stress, and meals, so isolated readings can be difficult to interpret. Insulin-like growth factor 1 changes more slowly and is often treated as the more stable integrated marker of axis activity.
Because growth hormone is released in pulses, single measurements can misrepresent overall secretion. Investigators sometimes use repeated sampling or overnight profiles to capture the pattern rather than a single value. Provocative testing, in which a stimulus is given and the response is tracked over time, offers another way to characterize the axis. Each approach carries trade-offs between sensitivity, burden on the participant, and the influence of non-target variables.
=== Pharmacodynamics === Ripasudil's mechanism of action affects intraocular pressure, or IOP, "by directly acting on the trabecular meshwork, thereby increasing conventional outflow through the Schlemm’s canal." More simply, it is an "out-flow" drug that reduces IOP by stimulating the movement of aqueous humour from the ciliary body away from the eye. It is a selective rho-associated coiled-coil-containing protein kinase 1 (ROCK1) inhibitor, where ROCK1 is "an important downstream effector of Rho guanosine trisphosphates (GTP)," proteins that are significant in the contractile control of smooth muscle tissue. The S configuration at the 2-position on the 1,4-diazepane ring of Ripasudil is what gives the drug its characteristic effect. Ripasudil was originally developed from fasudil, as both compounds share the same core structure of 5-(1,4-diazepan-1-ylsulfonyl)isoquinoline. Fasudil was already recognized as a potent Rho-kinase inhibitor, but after exploring the chemical derivatives of fasudil, developers observed that the incorporation of a fluorine atom at the C4 position of isoquinoline moiety and the chiral attachment of a methyl group to the C2’ position of 1,4-diazepane moiety dramatically improved the pharmacological action. In short, "ripasudil showed much more potent and selective Rho-kinase inhibitory activity than fasudil".
=== Blood pressure control === Blood pressure control may be indicated after a TIA to reduce the risk of ischemic stroke. About 70% of patients with recent ischemic stroke are found to have hypertension, defined as systolic blood pressure (SBP) > 140 mmHg or diastolic blood pressure (DBP) > 90 mmHg. Until the first half of the 2010s, blood pressure goals have generally been SBP < 140 mmHg and DBP < 90 mmHg. However, newer studies suggest that a goal of SBP <130 mmHg may confer even greater benefit. Blood pressure control is often achieved using diuretics or a combination of diuretics and angiotensin converter enzyme inhibitors, although the optimal treatment regimen depends on the individual. Studies that evaluated the application of blood pressure‐lowering drugs in people who had a TIA or stroke concluded that this type of medication helps to reduce the possibility of a recurrent stroke, a major vascular event, and dementia. The effects achieved in stroke recurrence were mainly obtained through the ingestion of angiotensin-converting enzyme (ACE) inhibitor or a diuretic.
=== Toxicity === Iron is also potentially toxic. Its ability to donate and accept electrons means that it can catalyze the conversion of hydrogen peroxide into free radicals. Free radicals can cause damage to a wide variety of cellular structures, and ultimately kill the cell. Iron bound to proteins or cofactors such as heme is safe. Also, there are virtually no truly free iron ions in the cell, since they readily form complexes with organic molecules. However, some of the intracellular iron is bound to low-affinity complexes, and is termed labile iron or "free" iron. Iron in such complexes can cause damage as described above. To prevent that kind of damage, all life forms that use iron bind the iron atoms to proteins. This binding allows cells to benefit from iron while also limiting its ability to do harm. Typical intracellular labile iron concentrations in bacteria are 10–20 micromolar, though they can be 10-fold higher in anaerobic environment, where free radicals and reactive oxygen species are scarcer. In mammalian cells, intracellular labile iron concentrations are typically smaller than 1 micromolar, less than 5 percent of total cellular iron.
==== Mars ==== In 1964, NASA's Mariner 4 became the first successful Mars flyby, transmitting 21 pictures of the planets surface. This was followed by Mariner 6 and 7 in 1969 which completed the first dual mission to Mars in 1969.
Sources: en.wikipedia.org
The scenario of a large unification of civilizations over an extent of 1 to 10 billion light-years with concentration in a certain region has a probability of 60%. These civilizations are to be searched for in the most powerful quasars and in the galactic bulge, at a radiation level higher than 1038 W, in the wavelengths from 10 μm to 10 cm, as well as in the other regions of the spectrum. This is to detect megastructures or signals with a wavelength of 1.5 mm and omnidirectional emission up to 21 cm. In the event of contact, humanity would see progress in all areas of society in order to join this supercivilization; it is also expected that an ethnographic conservatory would be created on Earth. The scenario of a unification on the scale of the galactic cluster has only a 20% probability of realization. Kardashev advises to observe the Virgo cluster (especially M87) and other clusters in a similar way as in the first scenario. The consequences for humanity are the same as in the first scenario. The scenario of a unification on the scale of galaxies has only a 10% probability. To confirm it, we must study the galactic centers, both of the Milky Way and of neighboring galaxies (such as M31, M33), according to a procedure similar to that of the first scenario. The consequences for humanity are the same as in the first scenario. The scenario of a complete colonization of space has no probability of being realized according to Kardashev because if it were realizable then "they" would already be on Earth; yet this is not the case.
Mahathir also strengthened political and economic cooperation with China, whilst maintaining diplomatic ambivalence on security issues to avoid escalating territorial disputes in the South China Sea. He openly criticised China's involvement in Malaysia's communist insurgency, but downplayed any military threat from China after the Cold War ended. In 1985, Mahathir visited China for the first time as prime minister, where he met Chinese leader Deng Xiaoping, establishing a new level of trust that laid the foundation for Malaysia-China relations and set the stage for decades of economic and diplomatic growth. Later, he visited China again in 1993, 1994, 1996, 1999, and twice in 2001. In the early 1990s, Mahathir played a key role in engaging China with ASEAN despite South China Sea disputes, particularly in the post-Tiananmen and post-Cold War contexts, paving the way for then Chinese Foreign Minister Qian Qichen to attend the ASEAN meeting's opening ceremony in July 1991 as a guest of the Malaysian government, and eventually leading to China's upgrade to ASEAN's dialogue partner in 1996. Amidst the Asian financial crisis, Mahathir also led several large delegations to China and Russia to seek regional economic cooperation. Besides that, Mahathir also had significant interactions with Taiwan, especially during the 1980s and 1990s, when economic ties between the two sides were at their strongest despite the lack of formal diplomatic relations.
==== Charlotte's Web ==== Charlotte's Web is a high-cannabidiol (CBD), low-tetrahydrocannabinol (THC) cannabis variety and extract marketed as a dietary supplement under federal law of the United States. It is produced by the Stanley brothers in Colorado. It does not induce the psychoactive "high" typically associated with recreational marijuana strains that are high in THC. In September 2014, the Stanleys announced that they would ensure that the product consistently contained less than 0.3% THC. Charlotte's Web gained national attention when it was used to treat Charlotte Figi's epileptic seizures. Her story has led to her being described as "the girl who is changing medical marijuana laws across America," as well as the "most famous example of medicinal hemp use".
"We are deeply distressed by this verdict and the harmful ramifications of criminalizing the honest reporting of mistakes. Health care delivery is highly complex. It is inevitable that mistakes will happen, and systems will fail. It is completely unrealistic to think otherwise. The criminalization of medical errors is unnerving, and this verdict sets into motion a dangerous precedent. There are more effective and just mechanisms to examine errors, establish system improvements and take corrective action. The non-intentional acts of Individual nurses like RaDonda Vaught should not be criminalized to ensure patient safety.
=== Early history === Some of the earliest records of human occupation of Billericay are the burial mounds in Norsey Wood, showing evidence of occupation in the Bronze and Iron Ages. Evidence of a Roman town, subsequently abandoned, were found on the high ground at Billericay School, just south of the High Street during excavations in 1970–71. There may also have been a small cavalry fort at Blunts Wall Farm.
Sources: en.wikipedia.org
In atmospheric chemistry, the most common scavenger is the hydroxyl radical, a short-lived radical produced photolytically in the atmosphere. It is the most important oxidant for carbon monoxide, methane and other hydrocarbons, sulfur dioxide, hydrogen sulfide, and most of other contaminants, removing them from the atmosphere. In molecular laser isotope separation, methane is used as a scavenger gas for fluorine atoms. Hydrazine and ascorbic acid are used as oxygen scavenger corrosion inhibitors. Tocopherol and naringenin are bioactive free radical scavengers that act as antioxidants; synthetic catalytic scavengers are their synthetic counterparts Organotin compounds are used in polymer manufacture as hydrochloric acid scavengers. Oxygen scavengers or oxygen absorbers are small sachets or self adhesive labels that are placed inside modified atmosphere packs to help extend product life (notably cooked meats) and help improve product appearance. They work by absorbing any oxygen left in the pack by oxidation of the iron powder contained in the sachet/label. Glutathione in the body scavenges oxidizing free radicals and peroxides and as a thiol nucleophile, attacks dangerous alkylating electrophiles, which may be exogenous toxins or produced in the course of metabolism (e.g. NAPQI from paracetamol).
=== Longer-term popularity === Nylon’s popularity soared in the 1940s and 1950s due to its durability and sheerness. In the 1970s, it became more popular due to its flexibility and price. In spite of oil shortages in the 1970s, consumption of nylon textiles continued to grow by 7.5% per year between the 1960s and 1980s. Overall production of synthetic fibers, however, dropped from 63% of the worlds textile production in 1965, to 45% of the world's textile production in early 1970s. The appeal of "new" technologies wore off, and nylon fabric "was going out of style in the 1970s". Also, consumers became concerned about environmental costs throughout the production cycle: obtaining the raw materials (oil), energy use during production, waste produced during creation of the fiber, and eventual waste disposal of materials that were not biodegradable. Synthetic fibers have not dominated the market since the 1950s and 1960s. As of 2020, the worldwide production of nylon is estimated at 8.9 million tons. Although pure nylon has many flaws and is now rarely used, its derivatives have greatly influenced and contributed to society. From scientific discoveries relating to the production of plastics and polymerization, to economic impact during the depression and the changing of women's fashion, nylon was a revolutionary product. The Lunar Flag Assembly, the first flag planted on the moon in a symbolic gesture of celebration, was made of nylon. The flag itself cost $5.50 but had to have a specially designed flagpole with a horizontal bar so that it would appear to "fly".
His stated goal for the company was to add 1,000 new locations outside of the Northeastern United States by the end of 2020 and to have a revenue increase of 3 percent for stores open a year or longer. In late 2018, Dunkin' installed espresso machines at all possible locations and launched espresso products using a new recipe. In June 2019, Dunkin' partnered with Grubhub to begin the rollout of its new Dunkin' Delivers service. Later in July 2019, Dunkin' partnered with Beyond Meat to introduce a meatless breakfast sandwich in Manhattan, becoming the first U.S. restaurant brand to serve Beyond Sausage. The sandwich launched nationally later in 2019. In September 2019, the New York attorney general's office alleged in a lawsuit that Dunkin' mishandled a series of cyberattacks that were directed at customers using the Dunkin' mobile app. These attacks took place in early 2015 and thousands of usernames and passwords were stolen. The state lawsuit alleges that Dunkin' employees knew about these attacks, but failed to take appropriate action. In October 2020, Dunkin' Brands stated that the company was in conversation with Inspire Brands, a private equity-backed company, negotiating to sell the company. They agreed to a deal that was announced on Saturday, October 31, 2020. Inspire Brands bought Dunkin' Brands for $11.3 billion, which included Dunkin' Brands' debt that Inspire Brands would be paying off. Inspire paid $106.50 in cash for each of Dunkin' Brands' shares.
In 1917, before the revolution, health conditions were significantly behind those of developed countries. As Lenin later noted, "Either the lice will defeat socialism, or socialism will defeat the lice". The Soviet health care system was conceived by the People's Commissariat for Health in 1918. Under the Semashko model, health care was to be controlled by the state and would be provided to its citizens free of charge, a revolutionary concept at the time. Article 42 of the 1977 Soviet Constitution gave all citizens the right to health protection and free access to any health institutions in the USSR. Before Leonid Brezhnev became general secretary, the Soviet healthcare system was held in high esteem by many foreign specialists. This changed, however, from Brezhnev's accession and Mikhail Gorbachev's tenure as leader, during which the health care system was heavily criticized for many basic faults, such as the quality of service and the unevenness in its provision. Minister of Health Yevgeniy Chazov, during the 19th Congress of the Communist Party of the Soviet Union, while highlighting such successes as having the most doctors and hospitals in the world, recognized the system's areas for improvement and felt that billions of rubles were squandered. After the revolution, life expectancy for all age groups went up. These improvements continued into the 1960s when statistics indicated that the life expectancy briefly surpassed that of the United States; life expectancy started to decline in the 1970s, possibly because of alcohol abuse.
His 1922 estimate that total length of capillaries in a human body is as long as 100,000 km, had been widely adopted by textbooks and other secondary sources. This estimate was based on figures he gathered from "an extraordinarily large person". More recent estimates give a number between 9,000 and 19,000 km.
Sources: en.wikipedia.org
It is a laboratory-made peptide that mimics growth hormone-releasing hormone. It prompts the pituitary gland to release growth hormone and has been studied mainly in adults with HIV-associated lipodystrophy.
Administered growth hormone supplies the hormone directly, while this peptide acts upstream by prompting the pituitary to release it. The indirect route preserves pulsatile secretion and some endogenous feedback, which changes the hormone and IGF-1 profile observed after treatment.
Reductions in visceral adipose tissue appear consistently in randomized trials of the approved population. Effects on peripheral fat, cardiovascular outcomes, and use outside that population are less well established.
It acts upstream at the pituitary receptor and depends on functioning somatotroph cells to produce any effect. Growth hormone injections bypass that step and deliver the hormone directly. The pharmacokinetic profiles and the resulting feedback on the body's own secretion therefore differ.