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He Z, Tabe AN, Rana S, King K. Tirzepatide-Induced Biphasic Anaphylactic Reaction: A Case Report. Cureus 2023; 15:e50112. [PMID: 38186543 PMCID: PMC10771104 DOI: 10.7759/cureus.50112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
Anaphylaxis is a rapid and severe reaction to a trigger that is characterized by skin, mucosal, and cardiorespiratory changes. A minority of patients exhibit a biphasic anaphylactic reaction (BAR). Tirzepatide is a dual incretin receptor analog approved for the treatment of type 2 diabetes mellitus (T2DM). Allergic reactions to tirzepatide were reported during clinical trials, but none were severe enough to be characterized as an anaphylactic reaction. We describe a case of a BAR to tirzepatide.
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Affiliation(s)
- Zhexiang He
- Internal Medicine, Conway Regional Medical Center, Conway, USA
| | - Agborya N Tabe
- Internal Medicine, Conway Regional Medical Center, Conway, USA
| | - Sohaib Rana
- Internal Medicine, Conway Regional Medical Center, Conway, USA
| | - Kristy King
- Internal Medicine, Conway Regional Medical Center, Conway, USA
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Fang Z, Chen S, Pickford P, Broichhagen J, Hodson DJ, Corrêa IR, Kumar S, Görlitz F, Dunsby C, French PMW, Rutter GA, Tan T, Bloom SR, Tomas A, Jones B. The Influence of Peptide Context on Signaling and Trafficking of Glucagon-like Peptide-1 Receptor Biased Agonists. ACS Pharmacol Transl Sci 2020; 3:345-360. [PMID: 32296773 PMCID: PMC7155199 DOI: 10.1021/acsptsci.0c00022] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Indexed: 01/14/2023]
Abstract
Signal bias and membrane trafficking have recently emerged as important considerations in the therapeutic targeting of the glucagon-like peptide-1 receptor (GLP-1R) in type 2 diabetes and obesity. In the present study, we have evaluated a peptide series with varying sequence homology between native GLP-1 and exendin-4, the archetypal ligands on which approved GLP-1R agonists are based. We find notable differences in agonist-mediated cyclic AMP signaling, recruitment of β-arrestins, endocytosis, and recycling, dependent both on the introduction of a His → Phe switch at position 1 and the specific midpeptide helical regions and C-termini of the two agonists. These observations were linked to insulin secretion in a beta cell model and provide insights into how ligand factors influence GLP-1R function at the cellular level.
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Affiliation(s)
- Zijian Fang
- Section
of Endocrinology and Investigative Medicine, Imperial College London, London, W12 0NN, United Kingdom
| | - Shiqian Chen
- Section
of Endocrinology and Investigative Medicine, Imperial College London, London, W12 0NN, United Kingdom
| | - Philip Pickford
- Section
of Endocrinology and Investigative Medicine, Imperial College London, London, W12 0NN, United Kingdom
| | - Johannes Broichhagen
- Department
Chemical Biology, Leibniz-Forschungsinstitut
für Molekulare Pharmakologie (FMP), Berlin, 13125, Germany
| | - David J. Hodson
- Institute
of Metabolism and Systems Research (IMSR), and Centre of Membrane
Proteins and Receptors (COMPARE), University
of Birmingham, Birmingham, B15 2TT, United Kingdom
- Centre
for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TT, United Kingdom
| | - Ivan R. Corrêa
- New
England
Biolabs, Ipswich, Massachusetts 01938, United States
| | - Sunil Kumar
- Department
of Physics, Imperial College London, London, SW7 2BX, United Kingdom
| | - Frederik Görlitz
- Department
of Physics, Imperial College London, London, SW7 2BX, United Kingdom
| | - Chris Dunsby
- Department
of Physics, Imperial College London, London, SW7 2BX, United Kingdom
| | - Paul M. W. French
- Department
of Physics, Imperial College London, London, SW7 2BX, United Kingdom
| | - Guy A. Rutter
- Section
of Cell Biology and Functional Genomics, Imperial College London, London, SW7 2AZ, United Kingdom
| | - Tricia Tan
- Section
of Endocrinology and Investigative Medicine, Imperial College London, London, W12 0NN, United Kingdom
| | - Stephen R. Bloom
- Section
of Endocrinology and Investigative Medicine, Imperial College London, London, W12 0NN, United Kingdom
| | - Alejandra Tomas
- Section
of Cell Biology and Functional Genomics, Imperial College London, London, SW7 2AZ, United Kingdom
| | - Ben Jones
- Section
of Endocrinology and Investigative Medicine, Imperial College London, London, W12 0NN, United Kingdom
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