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someone explain receptor to me like I have not read a paper in years

Question Clean Column ×2 Slow Clap ×1 Receipts ×3

someone explain receptor to me like I have not read a paper in years. If this has been answered properly somewhere, link me and I will delete.

GIP receptor biology is genuinely unsettled — there is a live argument about agonism versus antagonism at the receptor — and the clinical results are robust regardless, which is an uncomfortable and interesting position.

Long half-life in this class comes from structural modification that promotes albumin binding and resists enzymatic degradation. Weekly dosing is a consequence of the molecule, not a convenience decision.

Glucose-dependent insulin secretion is why hypoglycaemia risk is low as monotherapy: the effect scales with glycaemia rather than acting unconditionally.

Research-use-only material is not approved for human use and nothing here should be read as a recommendation to use it.

4,117 up / 85 down98% upvoted49 commentsid 1yk2rg28 Nov 2024

49 comments

30 in this archive, depth 4

best — the order this archive was captured in

u/greta_lokken507 points·1 year ago

Receptor expression in a tissue is necessary but not sufficient for an effect. You also need the agonist to reach it at relevant exposure, and that is where a lot of confident mechanism talk falls down.

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u/priya_guerrero401 points·1 year ago

Not convinced by the linearity assumption. Dose-response in this class is not linear and the trials show it.

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u/ismael_eriksen-36 points·1 year ago

Disagree. That is a preclinical finding in a rodent model and you are stating it as human pharmacology.

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u/incretin_ivyMOD210 points·1 year ago

Speculation is welcome here if it is labelled. This one has been relabelled rather than removed.

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u/aleksi_lehtinen105 points·1 year ago

Yes. The central component is the one that explains the reports on this site better than gastric emptying does.

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u/gradient_goblin163 points·1 year ago

Speculation is welcome here if it is labelled.

incretin_ivy is right that mechanism gives direction and not magnitude. Worth pinning.

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[deleted]186 points·1 year ago

[deleted]

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u/second_week_sceptic300 points·1 year ago

dose response is not linear and nobody should assume it is

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u/neha_krastev144 points·1 year ago

That conflates receptor affinity with clinical potency. They are related and they are not the same thing.

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u/camila_kowalski209 points·1 year ago

Tolerance to the gastric effect develops with continued exposure while the appetite effect largely persists. That single fact explains most of the "it settles but it still works" pattern the side-effect board reports.

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u/emeka_chowdhury54 points·1 year ago·edited

Tolerance to the gastric effect develops with continued exposure while the appetite effect largely persists.

Agreed — and it is why the central and peripheral stories are complementary rather than rival.

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u/kavya_kravchenko37 points·1 year ago·edited

That study was in a rodent model. Worth stating, since the thread has been reading it as human data.

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u/aleksi_eriksen22 points·1 year ago

Is there any human data on that mechanism yet?

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u/rafael_ostergaard139 points·1 year ago

Correction: that is glucose-dependent insulin secretion, which is why hypoglycaemia risk is low as monotherapy. Not the same claim as you made.

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u/rina_bergstrom117 points·1 year ago

Read the primary paper after arguing about the summary for a fortnight. The discussion section said almost the opposite of what the thread had concluded.

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u/plain_titration73 points·1 year ago

gastric emptying slows, it does not stop

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u/employer_carveout87 points·1 year ago

Agreed — the incretin effect is the load-bearing concept and everything downstream reads differently once you have it.

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u/plain_titration60 points·1 year ago

Agreed — the incretin effect is the load-bearing concept and everything downstream reads differently once you have it.

This is the concept everything else on this board is downstream of.

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u/split_dose_scepticOP25 points·1 year ago

What was the exposure in that experiment relative to therapeutic?

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u/rina_bergstrom127 points·1 year ago

The half-life explanation was the thing that made weekly dosing intuitive for me rather than arbitrary.

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u/devils_advocate_d57 points·1 year ago

Does the effect persist with continued dosing or does tolerance develop?

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u/aleksi_lehtinen34 points·1 year ago

Started reading limitations sections first. It has changed how much weight I give to almost everything posted here.

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u/hassan_ostergaard0 points·1 year ago

Small fix — it slows gastric emptying, it does not halt it, and the distinction matters for the mechanism you are proposing.

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u/nurse_ish_202542 points·1 year ago·edited

Yes. The discussion section is where the authors say what they actually think, and almost nobody here reads it.

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u/split_dose_scepticOP18 points·1 year ago

Spent an evening on the receptor distribution literature and the side-effect map suddenly stopped looking random.

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u/maintenance_mode_maxmaintenance29 points·1 year ago

receptor distribution is why the side effects are where they are

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u/tomas_broberg9 points·1 year ago

Same view. Tolerance developing to the gastric effect while the appetite effect persists explains most of what the side-effect board reports.

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u/rina_bergstrom5 points·1 year ago

Correcting my own comment: I attributed that to the GIP arm and the paper attributes it to the GLP-1 arm.

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u/camila_kowalski15 points·1 year ago·edited

What does the discussion section say about the limitation you are glossing?

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u/gradient_goblin4 points·1 year ago

Tried to build a mental model from mechanism alone and produced a confident prediction that the trial data flatly contradicted.

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The mechanism layer: incretin physiology, receptor distribution, gastric emptying, central appetite signalling, glucagon-receptor contribution, amylin co-agonism, and the pharmacokinetics that make weekly dosing possible. Papers get cited by journal and year or they get a [needs source] reply.

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