This is a working overview of IGF-1, written for readers who want more than a one-paragraph summary but less than a textbook.
Reviewed 2025-09-11. Anything still debated is marked as such rather than presented as settled.
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 peptide of forty-four amino acids whose sequence reproduces human growth hormone-releasing hormone. Its distinguishing feature sits at the amino terminus, where a trans-3-hexenoyl group replaces the free amine. That acylation slows cleavage by dipeptidyl peptidase IV, an enzyme that otherwise removes the first two residues and inactivates the natural hormone quickly. The modified peptide therefore persists longer in circulation while keeping the same receptor target. It is handled as a lyophilized solid and dissolved shortly before use.
Signaling begins at the GHRH receptor, a class B G protein-coupled receptor displayed on somatotroph cells of the anterior pituitary. Receptor occupancy activates Gs proteins, which raise adenylyl cyclase activity and intracellular cyclic AMP, in turn driving protein kinase A dependent pathways. The downstream output is synthesis and pulsatile secretion of growth hormone into the bloodstream. Hepatic tissue and peripheral sites respond by increasing insulin-like growth factor 1 production. Somatostatin and IGF-1 itself supply negative feedback that caps the size and duration of each secretory burst.
Metabolic interest in this compound centers on fat distribution rather than on hormone levels alone. Imaging trials in adults with excess abdominal fat report reductions in visceral adipose tissue, while subcutaneous depots change comparatively little. Growth hormone and IGF-1 are presumed to carry the effect, but the separate contribution of each is not firmly established. Whether these changes persist after treatment stops, and whether they alter longer-term health outcomes, remain open questions that published work does not answer consistently.
| Property | Value | Notes |
|---|---|---|
| Molecular weight | Approximately 5,136 Da | Based on the 44-amino-acid peptide backbone and N-terminal modification. |
| Appearance | White to off-white lyophilized powder | Usually supplied in single-use vials for reconstitution. |
| Solubility | Freely soluble in water; slightly soluble in some organic solvents | Peptide nature supports aqueous reconstitution. |
| Typical storage | 2–8 °C, protected from light | Refrigeration reduces degradation; avoid freezing unless specified. |
| Common analytical method | Reverse-phase high-performance liquid chromatography | Used for identity, purity, and quantification. |
| Synonyms | Tesamorelin, TH9507, GHRH(1-44) analog | Generic descriptors; avoid proprietary names. |
Tesamorelin is a synthetic peptide analog of growth hormone-releasing hormone (GHRH). Its sequence corresponds to the 44-amino-acid form of human GHRH with a trans-3-hexenoyl group attached to the N-terminal tyrosine. This modification slows enzymatic cleavage and extends the peptide's activity relative to the native hormone. The compound is produced by solid-phase peptide synthesis and supplied as a lyophilized powder. Researchers classify it as a GHRH receptor agonist. Its structure places it in the same family as other growth hormone secretagogues that act on the pituitary.
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 binds to growth hormone-releasing hormone receptors on the surface of pituitary somatotroph cells. This binding activates adenylate cyclase, raising intracellular cyclic AMP levels and triggering the release of growth hormone into circulation. The elevated growth hormone then stimulates hepatic production of insulin-like growth factor 1. Because the effect is mediated through the endogenous axis, secretion remains subject to feedback regulation. This distinguishes it from direct growth hormone administration, which bypasses pituitary control entirely.
Clinical investigation has focused on HIV-associated lipodystrophy, a condition in which antiretroviral therapy contributes to abnormal fat distribution. Excess visceral adipose tissue accumulates in the abdomen while peripheral fat may be lost. Tesamorelin was evaluated for reducing this visceral fat depot, with trials measuring changes in abdominal fat by imaging rather than by body weight alone. The rationale rests on the known lipolytic effects of growth hormone. Effects on visceral fat are documented, while long-term outcomes regarding cardiovascular risk remain less clearly established.
== Anticancer properties == Anticancer activities of cecropin B, cecropin P1, and Shiva-1 were first demonstrated with in vitro studies of mammalian leukemia and lymphoma cell lines, where cells were sensitive to peptide concentrations on the order of 10−6 M. Two multidrug-resistant breast and ovarian cancer cell lines also showed sensitivity to the peptides. Further, peptide anticancer activity is reported as being complete within one hour of treatment. In vivo studies of murine ascitic colon adenocarcinoma cells showed a similar trend, where mice treated with cecropin B exhibited increased survival time compared to untreated mice. Structural studies of cecropin B and its derivative cecropin B3 showed that anticancer activity arises from the ability of the antimicrobial peptides to form pores in stomach carcinoma cell membranes. Measuring electrical currents on cell surfaces showed that cecropin B, but not cecropin B3, induces outward currents indicative of pore formation. Further, cecropin B3 lacks an amphipathic group present in cecropin B, suggesting that this amphipathic group is necessary for cecropin B to insert into cell membranes and form pores. Cecropin B has strong activity on bacteria as well as cancer cells, while B3 has little effect on either. Notably, another derivative, cecropin B1, has two amphipathic regions and exhibits potent activity against human leukemia cell lines at concentrations that do not affect normal fibroblasts or red blood cells.
In plants, algae, cyanobacteria, and phototrophic and chemoautotrophic Pseudomonadota (formerly referred to as proteobacteria), the enzyme usually consists of two types of protein subunit, called the large chain (L, about 55,000 Da) and the small chain (S, about 13,000 Da). The large-chain gene (rbcL) is encoded by the chloroplast DNA in plants. There are typically several related small-chain genes in the nucleus of plant cells, and the small chains are imported to the stromal compartment of chloroplasts from the cytosol by crossing the outer chloroplast membrane. The enzymatically active substrate (ribulose 1,5-bisphosphate) binding sites are located in the large chains that form dimers in which amino acids from each large chain contribute to the binding sites. A total of eight large chains (= four dimers) and eight small chains assemble into a larger complex of about 540,000 Da. In some Pseudomonadota and dinoflagellates, enzymes consisting of only large subunits have been found. Magnesium ions (Mg2+) are needed for enzymatic activity. Correct positioning of Mg2+ in the active site of the enzyme involves addition of an "activating" carbon dioxide molecule (CO2) to a lysine in the active site (forming a carbamate). Mg2+ operates by driving deprotonation of the Lys210 residue, causing the Lys residue to rotate by 120 degrees to the trans conformer, decreasing the distance between the nitrogen of Lys and the carbon of CO2. The close proximity allows for the formation of a covalent bond, resulting in the carbamate.
=== 23 December === The Netherlands pledged up to 2.5 billion euros to help Ukraine in 2023. This aid was to pay for military equipment and rebuilding critical infrastructure. President Zelenskyy thanked them for this pledge.
Sources: en.wikipedia.org
=== Cardiac cycle === The cardiac cycle is the performance of the human heart from the beginning of one heartbeat to the beginning of the next. It consists of two periods: one during which the heart muscle relaxes and refills with blood, called diastole, following a period of robust contraction and pumping of blood, dubbed systole. After emptying, the heart immediately relaxes and expands to receive another influx of blood returning from the lungs and other systems of the body, before again contracting to pump blood to the lungs and those systems. A normally performing heart must be fully expanded before it can efficiently pump again. The rest phase is considered polarized. The resting potential during this phase of the beat separates the ions such as sodium, potassium, and calcium. Myocardial cells possess the property of automaticity or spontaneous depolarization. This is the direct result of a membrane which allows sodium ions to slowly enter the cell until the threshold is reached for depolarization. Calcium ions follow and extend the depolarization even further. Once calcium stops moving inward, potassium ions move out slowly to produce repolarization. The very slow repolarization of the CMC membrane is responsible for the long refractory period. However, the mechanism by which calcium concentrations within the cytosol rise differ between skeletal and cardiac muscle. In cardiac muscle, the action potential comprises an inward flow of both sodium and calcium ions.
Selenomethionine (SeMet) is a naturally occurring amino acid. The L-selenomethionine enantiomer is the main form of selenium found in Brazil nuts, cereal grains, soybeans, and grassland legumes, while Se-methylselenocysteine, or its γ-glutamyl derivative, is the major form of selenium found in Astragalus, Allium, and Brassica species. In vivo, selenomethionine is randomly incorporated instead of methionine. Selenomethionine is readily oxidized. Selenomethionine's antioxidant activity arises from its ability to deplete reactive oxygen species. Selenium and methionine also play separate roles in the formation and recycling of glutathione, a key endogenous antioxidant in many organisms, including humans.
=== Waldensian emigration === The settlement in Calabria of Waldensian peoples from the valleys bordering the Western Alps - predominantly the Germanasca, Chisone and Pellice valleys - might have taken place in the Swabian period, in the 13th century, although it spread mainly from the first half of the 14th century. Historian Pierre Gilles, author in 1644 of A History of the Reformed Churches, recounts how in 1315 some landowners in Calabria offered the Waldensians land to cultivate, in exchange for an annual fee. They were given power to establish communities there free of feudal obligations. This favored the founding, or repopulation, of numerous urban centers, such as San Sisto and La Guardia (now called Guardia Piemontese because of its Waldensian origins), inhabited mainly by Waldensians. They created a linguistic "island" in central Calabria, where the most common dialect is Occitan, a dialect typical of the Aosta Valley and northern Piedmont. The Waldensian community remained until the second half of the 16th century, when, during the European wars of religion between Catholics and Protestants, they adhered to the Lutheran faith, suffering persecution by the Spanish viceroyal authorities.
Sources: en.wikipedia.org
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.
Pivotal trials enrolled adults with HIV and excess visceral abdominal fat, often in the context of antiretroviral therapy. Participants were assessed mainly by computed tomography for visceral adipose tissue. The approved indication remains specific to that population.
Long-term effects on cardiovascular events, mortality, and sustained fat distribution are not well established. Most trials measured changes over months rather than years. Open questions also include whether benefits persist after treatment stops.
The amino acid sequence matches human growth hormone-releasing hormone, but the amino terminus carries a trans-3-hexenoyl group instead of a free amine. That single structural change chiefly affects enzymatic stability rather than receptor selectivity.