GLP-1s Current and Future Benefits

Glucagon-like peptide-1 (GLP-1) receptor agonists are currently a prominent class of medications, initially approved for treating type 2 diabetes and subsequently for individuals with overweight or obesity. Despite their high cost and potential side effects, these medications, including well-known brands such as Ozempic, Wegovy, and Mounjaro, continue to generate significant interest. Researchers are delving into the specific ways these drugs function, as well as considering broader applications beyond diabetes and weight management. Early research suggests potential benefits for cardiovascular health and neurological conditions like Parkinson's and Alzheimer's diseases.

But what are the details on the mechanisms of action for these effects? For instance, GLP-1 receptor agonists can penetrate the blood-brain barrier, influencing the brain's satiety center to reduce food cravings. They may also decrease brain inflammation, which is being studied for its potential in treating neurodegenerative diseases.

In terms of cardiovascular health, the exact mechanisms by which GLP-1 receptor agonists confer benefits are not fully understood, but theories include enhanced vasorelaxation, protection from ischemic injury, and improved myocardial contractility. Weight loss, better blood pressure control, and a reduced risk of severe hypoglycemia likely contribute to these cardiovascular benefits.

GLP-1 receptor agonists slow down gastric emptying and peristalsis, which can lead to weight loss. Although this can cause adverse effects in some patients, many adjust to the medication within weeks. These agents also reduce glucagon release and help maintain glucose levels after meals, releasing insulin with a low risk of hypoglycemia, a common issue with traditional insulin therapy.

These medications have systemic effects as well, with receptors found in the pancreas, brain, heart, stomach, lungs, gastrointestinal tract, kidneys, and liver. They have been reported to have beneficial effects on the kidneys and liver.

For weight management, GLP-1 receptor agonists promote satiety and slow stomach emptying. Future research is exploring their potential in treating alcohol use disorder and reducing the risk of colorectal cancer.

Source: Where GLP-1s Work Now -- and What's Coming - Medscape - Mar 12, 2024