Exenatide and weight loss.
OBJECTIVE
Glucagon-like peptide-1 (GLP-1) is a gastrointestinal hormone mainly released from the distal ileum, jejunum, and colon in response to food ingestion. It is categorized as an incretin due to its activation of GLP-1 receptors in pancreatic beta-cells leading to insulin exocytosis in a glucose-dependent manner. Exenatide (synthetic exendin-4) is a subcutaneously injected GLP-1 receptor agonist that shares 50% homology with GLP-1. It is derived from lizard venom and stimulates the GLP-1 receptor for prolonged periods. The present review aims to enumerate exenatide-instigated weight loss, summarize the known mechanisms of exenatide-induced weight loss, and elaborate on its possible application in the pharmacotherapy of obesity.


METHODS
A search through PubMed was performed using exenatide and weight loss as search terms. A second search was performed using exenatide and mechanisms or actions as search terms.


RESULTS
In addition to exenatide's action to increase insulin secretion in individuals with elevated levels of plasma glucose, clinical trials have reported consistent weight loss associated with exenatide treatment. Studies have found evidence that exenatide decreases energy intake and increases energy expenditure, but findings on which predominates to cause weight loss are often inconsistent and controversial.


CONCLUSIONS
Further research on the effects of exenatide treatment on energy intake and expenditure are recommended to better understand the mechanisms through which exenatide causes weight loss.
Division of Endocrinology, University of Wisconsin, Madison, Wisconsin, USA.
David P
DP
Bradley
Roger
R
Kulstad
Dale A
DA
Schoeller
D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D002149:Energy Intake / Q000187:drug effects; D004734:Energy Metabolism / Q000187:drug effects; D000077270:Exenatide; D052216:Glucagon-Like Peptide 1 / Q000819:agonists; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D007328:Insulin / Q000378:metabolism*; D000078790:Insulin Secretion; D008116:Lizards; D009765:Obesity / Q000188:drug therapy* / Q000378:metabolism; D010455:Peptides / Q000494:pharmacology* / Q000627:therapeutic use; D018027:Receptors, Glucagon / Q000819:agonists*; D014688:Venoms / Q000494:pharmacology* / Q000627:therapeutic use; D015431:Weight Loss / Q000187:drug effects*
D007004:Hypoglycemic Agents; D007328:Insulin; D010455:Peptides; D018027:Receptors, Glucagon; D014688:Venoms; D052216:Glucagon-Like Peptide 1; D000077270:Exenatide