Corrination of a GLP-1 Receptor Agonist for Glycemic Control without Emesis
Open accessAbstract
Glucagon-like peptide-1 receptor (GLP-1R) agonists used to treat type 2 diabetes mellitus often produce nausea, vomiting, and in some patients, undesired anorexia. Notably, these behavioral effects are caused by direct central GLP-1R activation. Herein, we describe the creation of a GLP-1R agonist conjugate with modified brain penetrance that enhances GLP-1R-mediated glycemic control without inducing vomiting. Covalent attachment of the GLP-1R agonist exendin-4 (Ex4) to dicyanocobinamide (Cbi), a corrin ring containing precursor of vitamin B12, produces a "corrinated" Ex4 construct (Cbi-Ex4). Data collected in the musk shrew (Suncus murinus), an emetic mammal, reveal beneficial effects of Cbi-Ex4 relative to Ex4, as evidenced by improvements in glycemic responses in glucose tolerance tests and a profound reduction of emetic events. Our findings highlight the potential for clinical use of Cbi-Ex4 for millions of patients seeking improved glycemic control without common side effects (e.g., emesis) characteristic of current GLP-1 therapeutics.
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An effect on the central nervous system has been suggested as a recent study with modified exenatide showed less vomiting in musk shrews, despite retaining effects on glucose control.
“An effect on the central nervous system has been suggested as a recent study with modified exenatide—with reduced brain penetrance—showed less vomiting in musk shrews, despite retaining effects on glucose control (46).”
From Safety of Semaglutide (2021) · cites this paper as [46]
The Results and Discussion report that Cbi-Ex4 caused significantly less emesis than native exendin-4 in musk shrews while retaining glucose-clearing potency. The Introduction and Results and Discussion propose reduced CNS penetrance as an explanation, but describe it as putative rather than an established property; the citing sentence presents reduced brain penetrance as fact. Page numbers are unavailable in our copy. (LLM, conf=0.85)
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Self-citationGhrelin and Glucagon-Like Peptide-1: A Gut-Brain Axis Battle for Food Reward
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Self-citationGLP-1R Signaling and Functional Molecules in Incretin Therapy
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GIP receptor agonism blocks chemotherapy-induced nausea and vomiting
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Peptide GLP-1 receptor agonists: From injection to oral delivery strategies
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The antiemetic actions of GIP receptor agonism
Borner, T., Jonghe, B. C. D., & Hayes, M. R. (2024) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00330.2023 · Cited by 23 · see citing works
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Approved and Emerging Hormone-Based Anti-Obesity Medications: A Review Article
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Poly-Agonist Pharmacotherapies for Metabolic Diseases: Hopes and New Challenges
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Corrination mitigates peptide aggregation as exemplified for Glucagon
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Self-citationGastrointestinal adverse events of semaglutide in patients with overweight or obesity
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A deep learning-based system for automatic detection of emesis with high accuracy in Suncus murinus
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Self-citation
- Authors
- Borner, T., Workinger, J. L., Tinsley, I. C., Fortin, S. M., Stein, L. M., Chepurny, O. G., Holz, G. G., Wierzba, A. J., Gryko, D., Nexø, E., Shaulson, E. D., Bamezai, A., Da Silva, V. A. R., De Jonghe, B. C., Hayes, M. R., & Doyle, R. P.
- Affiliations
- University of Pennsylvania (US)
- Syracuse University (US)
- SUNY Upstate Medical University (US)
- Institute of Organic Chemistry (PL)
- Aarhus University (DK)
- Corresponding author
- Doyle, Robert P.
- ORCID
- Venue
- Cell Reports
- Publisher
- Elsevier BV
- Published
- 2020-06
- Volume
- 31
- Issue
- 11
- Pages
- 107768
- ISSN
- 2211-1247 (ISSN-L)
- PMC
- PMC7376604
- OpenAlex
- W3035029907
- Cited by
- 39
- References
- 89
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 6 · 2023: 6 · 2022: 3 · 2021: 9 · 2020: 1
- FWCI
- 3.58
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cell Reports (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institutes of Health (DK115762, DK069575, DK112812, 097675, DK097675)
- Fundacja na rzecz Nauki Polskiej
- Syracuse University
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (186728, 178114, P2ZHP3?, SNF P2ZHP3\u2013178114, P400PB\u2013186728)
- Novo Nordisk
- Eli Lilly and Company
- University of Pittsburgh
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Chemical Synthesis and Analysis
- Keywords
- GLP-1 receptor agonists, exendin-4, brain penetration, vomiting, nausea and vomiting, type 2 diabetes, glycemic control, Suncus murinus, glucose tolerance, anorexia
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Glycemic Control, Glucagon-Like Peptide-1 Receptor Agonists, Animals, Anorexia, Blood Glucose, Humans, Hypoglycemic Agents, Peptides, Receptors, Glucagon, Glucagon-Like Peptide 1
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