Peptide Research Database
Access 6,710 peer-reviewed studies, clinical trials, and research papers on peptides. Filter by key research, study type, compound, and category. Direct links to full PubMed entries for comprehensive, evidence-based exploration.
Phage anti-defense genes targeting NAD+ metabolism and DNA replication are associated with a broad host range against Klebsiella pneumoniae.
In a mouse study, our study identifies candidate genetic factors associated with the broad host range phenotype, specifically targeting host immunity, and provides a new strategy for engineering therapeutic phages.
Lei B, Xu Y, Zhu K, Gao K, Li Y, Li X, Xu X, Li H, Hu R, Wang Y, Dai J, Li Z, Lv Y, Ge W, Ni W, Hu S
Phage therapy for drug-resistant Klebsiella pneumoniae (K. pneumoniae) is limited by narrow host ranges. We isolated a broad-host-range phage, vB_KP_P4, that lyses 109 diverse K. pneumoniae strains, including multidrug-resistant (MDR) and carbapenem-resistant isolates. We suggest that its broad lytic spectrum is likely linked to its capacity to overcome host intracellular defenses. We provide genetic and comparative genomic insights indicating that three phage-encoded genes, deoxycytidylate deaminase (comEB), nicotinamide-nucleotide adenylyltransferase (nadM), and a DNA polymerase clamp loader (rfcS), are correlated with the ability of vB_KP_P4 to infect diverse K. pneumoniae. Deletion of these genes collapsed the host spectrum from 109 strains to fewer than 10, significantly compromising antibacterial efficacy. The wild-type phage substantially improves survival in a mouse bacteremia model. Our study identifies candidate genetic factors associated with the broad host range phenotype, specifically targeting host immunity, and provides a new strategy for engineering therapeutic phages.
Cost-effectiveness of tirzepatide versus semaglutide for patients with obesity or overweight in the US: evidence from the SURMOUNT-5 head-to-head phase-3 trial.
In a case report, this supports that tirzepatide (MTD) is a cost-effective treatment option for individuals with obesity or overweight compared to semaglutide (MTD). Evaluated the cost-effectiveness (from the United States [US] societal perspective) of tirzepatide at its maximum-tolerated-dose (MTD) compared to semaglutide (MTD), both administered adjunct to a reduced-calorie diet and increased physical activity.
Johansson E, Wilding JPH, Upadhyay N, van Hest N, Kirk M, Spaepen E, Zimner-Rapuch S, Annemans L, Bays H
This study evaluated the cost-effectiveness (from the United States [US] societal perspective) of tirzepatide at its maximum-tolerated-dose (MTD) compared to semaglutide (MTD), both administered adjunct to a reduced-calorie diet and increased physical activity. The analysis focused on individuals with obesity (body mass index [BMI] ≥ 30 kg/m2), or overweight (BMI ≥27 to <30 kg/m2 + ≥1 obesity-related complication), using data from the head-to-head Phase-3 SURMOUNT-5 trial (patients without type 2 diabetes [T2D]). This patient-level simulation modeling study assessed the cost and long-term clinical outcomes of tirzepatide (MTD) versus semaglutide (MTD), using data from the SURMOUNT-5 trial population. The modeled population were at risk of developing obesity-related complications including cardiovascular disease (CVD) and obstructive sleep apnea (OSA), amongst others. These outcomes were modeled using cardiometabolic parameters including weight, systolic blood pressure, high-density lipoprotein, glycated hemoglobin (HbA1c) and total cholesterol, by assessing their impact on healthcare and wider societal costs, quality of life, and mortality. Incremental cost-effectiveness ratios (ICERs; cost/quality-adjusted life year [QALY]) and incremental net health benefit (iNHBs) were calculated, and uncertainty was assessed through sensitivity and scenario analyses. Tirzepatide (MTD) was estimated to be less costly and more efficacious compared to semaglutide (MTD) with per patient cost savings of $41,688, 0.506 QALYs gained and positive iNHB of 0.784, indicating a net health benefit for tirzepatide. The model predicted that per 1,000 patients, 70 fewer patients will develop T2D, 10 fewer will develop CVD with tirzepatide (MTD) and patients spend 3.07 more years living with moderate/severe OSA when treated with semaglutide (MTD). Based on this simulation model, using head-to-head SURMOUNT-5 trial data, tirzepatide (MTD) had lower total costs and higher QALYs compared to semaglutide (MTD). This supports that tirzepatide (MTD) is a cost-effective treatment option for individuals with obesity or overweight compared to semaglutide (MTD).
Predicting Category II and III foetal heart rate patterns during epidural analgesia: a retrospective cohort study.
In a clinical study, clinical trial registration: (https://www.chictr.org.cn ChiCTR2300073493; registered 12th July 2023). Aimed to identify predictors and develop a multivariable prediction model for Category II and III foetal heart rate (FHR) patterns in parturients undergoing labour epidural analgesia (LEA).
Li B, Wang Q, Xie Y, Chen L, Jia J, Song X
This study aimed to identify predictors and develop a multivariable prediction model for Category II and III foetal heart rate (FHR) patterns in parturients undergoing labour epidural analgesia (LEA). A retrospective cohort study of 237 parturients receiving LEA was conducted. To address the multicollinearity of 18 intrapartum variables, least absolute shrinkage and selection operator (LASSO) regression and cross-validation were used for feature selection. A predictive nomogram was constructed and internally validated. Model performance was evaluated by the area under the receiver operating characteristic curve (AUC), calibration plots, and Decision Curve Analysis (DCA). Abnormal FHR patterns (Category II and III) occurred in 168 (70.9%) parturients. The LASSO algorithm identified 11 predictors. Multivariable logistic regression demonstrated that maternal intrapartum temperature (OR = 3.518), initial LEA bolus count (OR = 3.625), body mass index (BMI), and oxytocin dosage were independent predictors associated with abnormal FHR patterns. The constructed nomogram demonstrated good discrimination (AUC = 0.800) and good calibration. DCA demonstrated potential clinical net benefit across a wide range of threshold probabilities (0.02-0.99). We developed and internally validated an 11-variable nomogram (AUC = 0.800) to predict abnormal FHR patterns during LEA. By integrating routinely available clinical variables, the nomogram facilitate early risk stratification and support individualised intrapartum management. Clinical trial registration: (https://www.chictr.org.cn ChiCTR2300073493; registered 12th July 2023).
Glucagon-like peptide-1 receptor agonists as adjunctive therapy in refractory hypertriglyceridemia following recurrent pancreatitis.
In a clinical study, this case demonstrates that GLP-1 receptor agonists warrant consideration in treatment-resistant hypertriglyceridemia with prior pancreatitis when conventional therapy fails, challenging traditional contraindications in carefully selected patients under multidisciplinary care.
Miura D, Nicholls S, Joham AE, Braude M, Tay CT
A 39-year-old Chinese man was first evaluated at a multidisciplinary metabolic dysfunction-associated liver disease clinic following 6 episodes of hypertriglyceridemia-induced pancreatitis over 9 years despite maximal therapy with statins, fibrates, and omega-3 fatty acids. Peak triglycerides reached 2329 mg/dL (Système International [SI]: 26.3 mmol/L; reference range, <177 mg/dL [SI: <2 mmol/L]). Comorbidities included poorly controlled diabetes, recurrent hypoglycemia, and steatotic liver disease with moderate fibrosis. Despite historical safety concerns regarding glucagon-like peptide-1 receptor agonists in prior pancreatitis, semaglutide was cautiously initiated. This achieved sustained triglyceride normalization to 213 mg/dL (SI: 2.4 mmol/L), weight loss, glycemic improvement, hypoglycemia resolution, improved liver elastography parameters, and insulin cessation without pancreatitis recurrence. This case demonstrates that glucagon-like peptide-1 receptor agonists warrant consideration in treatment-resistant hypertriglyceridemia with prior pancreatitis when conventional therapy fails, challenging traditional contraindications in carefully selected patients under multidisciplinary care.
Simultaneous and recurrent hordeola and chalazia associated with tirzepatide therapy: a case series.
In a case report, clinicians should be aware of this potential adverse eyelid effect and pursue conservative ophthalmic management before considering medication changes.
Kolker A
Glucagon-like peptide-1 (GLP-1) and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists are increasingly prescribed for obesity and type 2 diabetes, but eyelid gland pathology has not previously been reported with these agents. We describe what we believe to be the first reported case series of 2 patients who developed multiple simultaneous internal hordeola after starting tirzepatide, a dual GLP-1/GIP receptor agonist. Patient 1, a 44-year-old woman, developed 6 simultaneous hordeola 4 weeks after dose escalation, 5 of which progressed to chalazia; lesions lessened after tirzepatide discontinuation and worsened upon rechallenge, a positive rechallenge providing strong evidence of causality. Patient 2, a 73-year-old woman with mild pre-existing blepharitis, developed 6 simultaneous hordeola 10 weeks after initiation of her 5 mg dose, 2 of which progressed to chalazia. Both patients lacked classic infectious blepharitis signs despite active lesions, supporting a sterile, obstructive meibomian gland process rather than infection, though both found the recurrences bothersome. These cases suggest a possible, previously undescribed association between tirzepatide and simultaneous or recurrent meibomian gland obstruction. Clinicians should be aware of this potential adverse eyelid effect and pursue conservative ophthalmic management before considering medication changes.
Inappropriate use of GLP-1-based antiobesity medications: beyond appropriate drug use toward appropriate weight reduction.
This study found propose that the discussion surrounding GLP-1-based therapies should move beyond appropriate drug use toward appropriate weight reduction, regardless of whether weight loss is pursued to improve obesity-related health conditions or for cosmetic purposes.
Ogawa W, Nishikage S, Nomura K, Hosooka T, Hirota Y
Glucagon-like peptide-1 (GLP-1) receptor agonists and glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor dual agonists have transformed obesity treatment, but their widespread use has been accompanied by increasing medically inappropriate use for weight loss. Current efforts to promote the appropriate use of GLP-1-based medications have largely focused on regulatory compliance related to off-label prescribing and illegal acquisition. However, recent reports of serious health consequences associated with inappropriate tirzepatide use suggest that these events may arise not only from the intrinsic toxicity of these medications but also from inappropriate dietary restriction and inadequate medical supervision during weight-loss attempts. We argue that inappropriate use should be understood from two complementary perspectives: regulatory appropriateness and medical appropriateness. Medical appropriateness encompasses not only drug-related risks but also the safety of weight reduction itself. Emerging concepts such as female underweight/undernutrition syndrome further emphasize that weight reduction should be evaluated not only by its magnitude but also by its nutritional and clinical consequences. We propose that the discussion surrounding GLP-1-based therapies should move beyond appropriate drug use toward appropriate weight reduction, regardless of whether weight loss is pursued to improve obesity-related health conditions or for cosmetic purposes.
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia with ectopic adrenocorticotropic hormone syndrome in Asia.
In lab experiments, consistent with previously reported cases, our findings highlight that even subtle lung nodules can secrete ACTH and must be evaluated in unexplained EAS.
Huang WL, Hsieh MS, Tsai YY, Lin MW, Lin CK, Lin CH
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare, preinvasive lung disorder characterized by multifocal neuroendocrine cell proliferation. Because it presents with chronic cough and wheezing, it is frequently misdiagnosed as asthma. Ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) arising from DIPNECH is exceptionally rare. We present a rare case of a 62-year-old woman with a long-standing history of presumed asthma who developed ACTH-dependent Cushing syndrome. Bilateral inferior petrosal sinus sampling confirmed ectopic ACTH secretion. Subsequently, comprehensive thoracic imaging revealed a potential ectopic source in a dominant right middle lobe nodule, accompanied by subtle micronodules and mosaic attenuation, which are characteristic of DIPNECH. Targeted lobectomy achieved complete remission, yielding a histopathological diagnosis of a neuroendocrine tumor within background DIPNECH that demonstrated marked immunohistochemical ACTH heterogeneity among hyperplastic cells and tumorlets. Consistent with previously reported cases, our findings highlight that even subtle pulmonary nodules can secrete ACTH and must be evaluated in unexplained EAS. Furthermore, because these subcentimeter nodules possess secretory potential and morphological progression risks, lifelong multidisciplinary surveillance is imperative.
Tirzepatide for treatment of postbariatric hypoglycemia after Roux-en-Y gastric bypass: a report of 3 cases.
In a case report, this report suggests that GLP-1 and GIP RA can be a promising adjunct in managing PBH; however, further studies to confirm their efficacy and establish optimal dosing strategies are needed.
Milosavljevic J, Meyer C, Levine JA, Sachdev S
Postbariatric hypoglycemia (PBH) represents a challenging complication of bariatric surgery. This case series describes 3 patients with PBH following Roux-en-Y gastric bypass who were treated with tirzepatide, a glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist (RA). All patients presented with symptomatic hypoglycemia characterized by episodes of diaphoresis, visual disturbances, confusion, and documented low blood glucose levels occurring postprandially. Conventional management strategies, including dietary modifications, acarbose, and other pharmacotherapies, were either partially effective or limited by side effects. Initiation of tirzepatide led to increased time in range, reduced number and severity of hypoglycemic episodes, and decreased glucose variability. This report suggests that GLP-1 and GIP RA can be a promising adjunct in managing PBH; however, further studies to confirm their efficacy and establish optimal dosing strategies are needed.
Sustained weight loss exceeding 100 kg with sequential incretin-based therapy in Prader-Willi syndrome.
In a case report, follow-up bioimpedance showed a skeletal muscle mass of 38.5 kg after a 58.8% reduction in total body weight.
Yovera-Aldana M, Manrique-Hurtado H, Umpierrez GE
Prader-Willi syndrome (PWS) is a neurogenetic disorder characterized by hyperphagia, severe obesity, and early-onset metabolic complications, in which durable weight loss is rarely achieved. We report a 29-year-old man with genetically confirmed maternal uniparental disomy PWS who presented with severe obesity (185 kg; body mass index [BMI] 59.7 kg/m2) and newly diagnosed type 2 diabetes (glycated hemoglobin [HbA1c], 8.3% [SI: 67 mmol/mol] [reference range, <5.7% (SI: <39 mmol/mol)]). He received sequential incretin-based therapy, initiated with retatrutide (1-12 mg weekly) within a clinical trial, followed by oral semaglutide and then dulaglutide after retatrutide became unavailable, together with a structured hypocaloric diet and supervised exercise. At 18 months, total weight loss reached 58.8% (-108.7 kg), with HbA1c of 4.9% (SI: 30 mmol/mol), consistent with diabetes remission after discontinuation of all glucose-lowering medications. Mild transient gastrointestinal symptoms occurred during dose escalation, with no serious adverse events. Follow-up bioimpedance showed a skeletal muscle mass of 38.5 kg after a 58.8% reduction in total body weight.
Postmenopausal bleeding associated with semaglutide: a diagnostic challenge.
In a case report, this case highlights postmenopausal bleeding as a rare but clinically important adverse effect of GLP-1 receptor agonist therapy warranting malignancy-first evaluation.
Prasad S, Parmar V, Sharma A, Kaur N, Kothia D, Bavaria D
Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, is widely used for obesity and type 2 diabetes management, but its gynecological adverse effects have not been systematically described. We report a 58-year-old postmenopausal woman with new-onset vaginal bleeding six weeks after starting semaglutide for weight reduction, with onset following dose escalation to 0.5 mg weekly. Hemoglobin fell from 12.9 g/dL (Système International [SI]: 129 g/L) to 10.8 g/dL (SI: 108 g/L) (reference range, 12.0-16.0 g/dL [SI: 120-160 g/L]). The serum follicle-stimulating hormone (FSH) concentration was elevated at 68.4 mIU/mL (SI: 68.4 IU/L; reference, >25 IU/L postmenopausal), and estradiol was suppressed at 3.5 pg/mL (SI: 13 pmol/L; reference, <5.4 pg/mL [SI: <20 pmol/L]), consistent with stable postmenopausal status throughout, without hormonal reactivation (no return toward a premenopausal pattern). Endometrial malignancy, structural pathology, and coagulopathy were excluded. The Naranjo Adverse Drug Reaction Probability Scale score was 6 ("probable"). Bleeding resolved completely within five weeks of discontinuation. We propose that rapid semaglutide-induced adipose loss may transiently alter peripheral estrogen metabolism, destabilizing the endometrium despite unchanged hormone levels. This case highlights postmenopausal bleeding as a rare but clinically important adverse effect of GLP-1 receptor agonist therapy warranting malignancy-first evaluation.