If you have been reading about IGF-1 and want a single page that covers the useful parts, this is it: definitions, context, how it is studied, and the questions that come up repeatedly.
Updated 2026-01-30. Numbers and descriptions here follow the published literature rather than marketing material.
Tesamorelin occupies a narrow position among agents that act on the growth hormone axis. Unlike growth hormone itself, which is given as replacement, it stimulates the pituitary to release the hormone in pulses, so the downstream increase in insulin-like growth factor 1 depends on intact somatotroph function. Other peptides in the same family include shorter GHRH fragments and synthetic secretagogues with different stability profiles. Several points remain unresolved, including whether the reduction in visceral fat translates into fewer cardiovascular events, what happens to metabolic markers after long-term use, and how the drug compares with lifestyle or surgical approaches.
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.
Studies of the compound rely on imaging and laboratory endpoints rather than on symptoms alone. Visceral adipose tissue is usually quantified by computed tomography or magnetic resonance imaging at the level of the abdomen, with waist circumference serving as a cheaper but less specific proxy. Blood work tracks insulin-like growth factor 1, fasting glucose, glycated hemoglobin, and lipid fractions. In the pivotal trials the imaging endpoint fell by roughly fifteen to twenty percent over six months, subcutaneous fat changed little, and the visceral fat returned toward baseline after treatment stopped, a pattern that shapes how clinicians discuss durability.
Whether the drug improves hard clinical outcomes is not settled. No completed trial has shown a reduction in heart attacks or strokes among treated patients, although a dedicated cardiovascular outcomes study has been discussed in the literature. Investigators have also examined hepatic fat in people with HIV and fatty liver disease, cognitive measures in small cohorts, and changes in bone density. Regulatory labeling emphasizes monitoring of insulin-like growth factor 1 because supraphysiologic levels raise questions about tissue growth, and the clinical significance of that signal remains an open question rather than a demonstrated harm.
| 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 |
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.
Stimulated growth hormone release leads to hepatic production of insulin-like growth factor 1, a key mediator of many growth hormone effects. In clinical studies, tesamorelin increased IGF-1 levels in a dose-dependent manner, although the response varies among individuals. The drug's effect on visceral fat is thought to involve growth hormone-mediated lipolysis and altered adipocyte metabolism. Muscle mass and lean body mass have also been assessed as secondary outcomes, but changes are generally smaller and less consistent than fat reductions.
Pharmacodynamic studies show that tesamorelin reduces visceral adipose tissue more than subcutaneous adipose tissue in the studied population. This selectivity may relate to differences in blood flow and hormone sensitivity between fat depots. Effects on glucose metabolism and insulin sensitivity have been investigated, with some trials reporting modest changes and others showing stability. The precise relationship between growth hormone exposure, IGF-1 levels, and visceral fat loss remains an active area of analysis.
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。
稳定性研究通常考察温度、光照、湿度和 pH 对肽链的影响。冻干粉在低温避光条件下较为稳定，复溶后则需控制保存时间并避免反复冻融。肽类可能发生氧化、脱酰胺、水解和聚集，这些变化会改变色谱纯度。强制降解实验用于识别主要降解途径并验证分析方法的专属性。
质量控制项目一般包括外观、身份、纯度、含量、有关物质、水分和微生物限度。身份确认可通过肽图谱、氨基酸分析和质谱完成，纯度则用面积归一化法计算。研究级材料与药品级材料的要求不同，前者常缺少完整药典验证。不同批次间杂质谱是否影响活性，仍是一个需要具体数据回答的问题。
Vegetable soup is prepared using vegetables, leafy greens, mushrooms, and roots as the main ingredients. Vegetable soup can be prepared as a stock- or cream-based soup. Basic ingredients in addition to vegetables can include beef, fish, beans and legumes, grains, tofu, noodles and pasta, vegetable broth or stock, milk, cream, water, olive or vegetable oil, seasonings, salt and pepper, among others. Some vegetable soups are pureed and run through a sieve, straining them to create a smooth texture. It is typically served hot, although some, such as gazpacho, are typically served cold. Vegetable soup is sometimes served as a starter or appetizer dish. Vegetable soup is mass-produced in canned, frozen, dried, powdered, and instant varieties.
=== Cardiac muscle mitochondrial metabolism and function === In addition to sarcomeres, PKCε also targets cardiac mitochondria. Proteomic analysis of PKCε signaling complexes in mice expressing a constitutively-active, overexpressed PKCε identified several interacting partners at mitochondria whose protein abundance and posttranslational modifications were altered in the transgenic mice. This study was the first to demonstrate PKCε at the inner mitochondrial membrane, and it was found that PKCε binds several mitochondrial proteins involved in glycolysis, TCA cycle, beta oxidation, and ion transport. However, it remained unclear how PKCε translocates from the outer to inner mitochondrial membrane until Budas et al. discovered that heat shock protein 90 (Hsp90) coordinates with the translocase of the outer mitochondrial membrane-20 (Tom20) to translocate PKCε following a preconditioning stimulus. Specifically, a seven amino acid peptide, termed TAT-εHSP90, homologous to the Hsp90 sequence within the PKCε C2 domain induced translocation of PKCε to the inner mitochondrial membrane and cardioprotection. PKCε has also been shown to play a role in modulating mitochondrial permeability transition (MPT); the addition of PKCε to cardiomyocytes inhibits MPT, though the mechanism is unclear.
=== Political views === Psychologists in the happiness community feel politics should promote population happiness. Politics should also consider level of human happiness among future generations, concern itself with life expectancy, and focus on the reduction of suffering. Based on political affiliation, some studies argue conservatives, on average, are happier than liberals. A potential explanation is greater acceptance of income inequalities in society leads to a less worried nature. Luke Galen, Associate Professor of Psychology at Grand Valley State University, mentioned political commitments as important because they are a sort of secular world view that, like religion, can be generally beneficial to coping with death anxiety (see also Terror management theory and religion and happiness).
Viola species can be annual or perennial, and can take the form of herbs, shrubs or very rarely treelets. In acaulescent taxa the foliage and flowers appear to rise from the ground. The remainder have short stems with foliage and flowers produced in the axils of the leaves (axillary). They typically have heart-shaped or reniform (kidney-shaped) scalloped leaves, though a number have linear or palmate leaves. The simple leaves of plants with either habit are arranged alternately; the acaulescent species produce basal rosettes. Plants always have leaves with stipules that are often leaf-like. The flowers of the vast majority of the species are strongly zygomorphic with bilateral symmetry and solitary, but occasionally form cymes. The flowers are formed from five petals; four are upswept or fan-shaped with two per side, and there is one, broad, lobed lower petal pointing downward. This petal may be slightly or much shorter than the others and is weakly differentiated. The shape of the petals and placement defines many species, for example, some species have a "spur" on the end of each petal while most have a spur on the lower petal. The spur may vary from scarcely exserted (projecting) to very long, such as in Viola rostrata. Solitary flowers end long stalks with a pair of bracteoles. The flowers have five sepals that persist after blooming, and in some species the sepals enlarge after blooming. The corolla ranges from white to yellow, orange or various shades of blue and violet or multicolored, often blue and yellow, with or without a yellow throat.
Sources: en.wikipedia.org
The Matrix Revolutions begins immediately after the events of the second movie; as a result of his struggle with the sentinels, Neo returns to consciousness finding himself caught in an isolated train station-like limbo only accessible by order of the Merovingian, from which his mind is unable to free itself. It is here that he meets Sati, a young program created without a purpose, who is being smuggled into the Matrix by her parents, also programs in the machine world. Neo remains trapped until he is freed by Trinity (assisted by Morpheus and Seraph), who threatens the Merovingian in a Mexican standoff. After a final visit to the Oracle, Neo learns that he has powers over the machines which extend beyond the Matrix and that Smith is spreading, threatening to destroy both the Matrix and the real world. Building on the Oracle's previous explanations about the nature of choice, Neo learns that the Architect's assertion that his choice to save Trinity would inherently lead to the extinction of humankind was incorrect, due to his nature as a purely mathematical being rendering him incapable of seeing past choices made by humans, as he considers them mere variables in equations. Having told Neo that he now has the power to choose to end the war and defeat Smith, the Oracle then states "everything that has a beginning has an end, Neo" and informs him that in order for true peace to happen, he must travel to the heavily guarded Machine City in the real world and make a truce with the machines in order to save both races from extinction because of Smith's activities.
== Operations == EFLM has an Executive Board and a range of committees for: science, education and training, quality and regulations, communication and professional representation. Each committee has working groups with a Chair and three full members, there is also a Young Scientist member and they may also have corresponding members, but only one member form each country is permitted. The Science Committee develops collaborative science in Laboratory Medicine between member organisations or individuals and guidelines to set standards of practice to assist member societies in providing quality patient care. The output of the scientific working groups is scientific papers and presentations which contribute to the science of laboratory medicine internationally; a list of publications can be found on the EFLM web-site (link below). Typically publications are peer-reviewed and published in the journal Clinical Chemistry and Laboratory Medicine. The Working Groups are overseen by the Chair of the Science Committee and their activities reviewed annually; scientific and clinically relevant output determine whether they continue. The Education and Training Committee runs educational activities particularly for trainees and those required to develop new skills as well as running scientific and clinical conferences, webinars, etc. The major Congress is Euromedlab held in conjunction with the IFCC, meetings are selected from bids by member societies at the annual General Meeting.
=== Biochemical studies === In the late 1980s, copper peptide GHK-Cu started attracting attention as a promising wound healing agent. At picomolar to nanomolar concentrations, GHK-Cu stimulated the synthesis of collagen in skin fibroblasts, increased accumulation of total proteins, glycosaminoglycans (in a biphasic curve) and DNA in the dermal wounds in rats. They also found out that the GHK sequence is present in collagen and suggested that the GHK peptide is released after tissue injury. They proposed a class of emergency response molecules which are released from the extracellular matrix at the site of an injury. GHK-Cu also increased synthesis of decorin – a small proteoglycan involved in the regulation of collagen synthesis, wound healing regulation and anti-tumor defense. GHK-Cu has been shown to produce anti-inflammatory effects and stimulate release of growth factors such as brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2). It was also established that GHK-Cu stimulates both the synthesis of metalloproteinases, the enzymes which break down dermal proteins, and their inhibitors (anti-proteases). The fact that GHK-Cu not only stimulates the production of dermal components, but also regulates their breakdown suggests that it should be used with caution.
The physiology of cardiac muscle shares many similarities with that of skeletal muscle. The primary function of both muscle types is to contract, and in both cases, a contraction begins with a characteristic flow of ions across the cell membrane known as an action potential. The cardiac action potential subsequently triggers muscle contraction by increasing the concentration of calcium within the cytosol.
Cone snails use a harpoon-like structure called a radula tooth for predation. Radula teeth are modified teeth, primarily made of chitin and formed inside the mouth of the snail, in a structure known as the toxoglossan radula. Each specialized cone snail tooth is stored in the radula sac, except for the tooth that is in current use. Cone snails employ two main hunting strategies: vermivores typically use a 'sting and retract' method, injecting venom directly into the worm. They patiently hunt, sting the worm, wait for it to be paralyzed, and then ingest it. This is a deliberate, slower process. In contrast, piscivores (fish-hunters) often employ a sophisticated 'venom net' strategy, releasing toxins into the surrounding water to instantly paralyze the prey before delivering the harpoon. The harpoon is then used to pull the paralyzed fish into the mouth. The snail engulfs it and may release further enzymes to liquefy the tissue, which is then consumed as fluid. The radula tooth is hollow and barbed, and is attached to the tip of the radula in the radular sac, inside the snail's throat. When the snail detects a prey animal nearby, it extends a long flexible tube called a proboscis towards the prey. The radula tooth is loaded with venom from the venom bulb and, still attached to the radula, is fired from the proboscis into the prey by a powerful muscular contraction. The venom can paralyze smaller fish almost instantly. The snail then retracts the radula, drawing the subdued prey into the mouth.
Sources: en.wikipedia.org
In June 2013, two biosimilar versions (Inflectra and Remsima) were submitted for approval in the European Union, by Hospira and Celltrion Healthcare respectively. Both had a positive opinion from European Medicines Agency's (EMA) Committee for Medicinal Products for Human Use (CHMP) for sale in the European Union (EU). Celltrion obtained marketing authorization approval (MAA) from 27 EU countries and 3 EEA (European Economic Area) countries by September 2013. Inflectra was approved for use in the European Union in September 2013, and Remsima was approved for use in the European Union in October 2013. In Japan, Celltrion received marketing authorization for Remsima from Japan's Ministry of Health, Labour and Welfare (MHLW) in July 2014. In India, Epirus Biopharmaceuticals obtained approval to produce biosimilar infliximab under the brand name "Infimab" (trail name BOW015). The US Food and Drug Administration (FDA) approved Celltrion/Hospira/Pfizer's Inflectra (infliximab-dyyb) in April 2016. The FDA approved Samsung Bioepis Co., Ltd.'s Renflexis (infliximab-abda) in April 2017. Biogen released another biosimilar, Flixabi, which was approved in Germany, the UK, and the Netherlands. Flixabi was approved for use in the European Union in May 2016. In December 2017, Ixifi (infliximab-qbtx) was approved in the United States. Zessly was approved for use in the European Union in May 2018. In December 2019, Avsola (infliximab-axxq) was approved in the United States. Avsola was approved for medical use in Canada in March 2020.
Most of the supporters also stated that the death sentence should be deployed for drug crimes due to its strong deterrent effect. Shen's death sentence was subsequently upheld after he lost his appeal on 1 March 2024. When CNN covered the topic of Singapore's death penalty and Changi Prison in October 2024, it was noted that the death penalty continued to thrive with huge public support, and there were about 40 inmates on death row as of the time when CNN covered the issue exclusively. An inmate, a former schoolteacher who introduced himself as Matthew, stated he believed in the deterrent effect of the death penalty for drug trafficking; Matthew was then serving a seven-year jail term for non-capital drug charges. However, his sentiments were not shared by the family members of death row inmates who spoke to CNN. Haslinda Ismail, whose son Muhammed Izwan bin Borhan was sentenced to death for diamorphine trafficking, stated that she was devastated over the outcome and felt resentful towards the government for not giving her son a second chance; Izwan remained on death row awaiting to be hanged as of the time of writing. Similarly, Nazeri Lajim's sister, Nazira Lajim, who was an anti-death penalty activist, stated that she was sad and angry that her brother was executed despite her push for a life sentence, and likely due to her brother's hanging in 2022, Nazira encouraged her adult children to permanently leave Singapore and emigrate to Australia.
== Other uses == lh (digraph), in many languages Bristol LH, a type of British bus manufactured between 1967 and 1982 Chrysler LH platform, a type of Chrysler car made from 1993 through 2004 Late Helladic, a period in the history of ancient Greece, during the Bronze Age Leasehold, or tenure, in property law Left-handed, or left hand Letterhead, a heading at the top of a sheet of letter paper Lewis Hamilton (born 1985), British racing driver
=== Eyes === A rare development is amyloid purpura, a susceptibility to bleeding with bruising around the eyes, termed "raccoon-eyes". Amyloid purpura is caused by amyloid deposition in the blood vessels and reduced activity of thrombin and factor X, two clotting proteins that lose their function after binding with amyloid.
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 mimics a natural hypothalamic signal that tells the pituitary to release growth hormone. The result is a rise in circulating growth hormone and, indirectly, in insulin-like growth factor 1. Over weeks of treatment this shift is associated with a selective decrease in fat stored inside the abdomen.