Visceral adipose tissue raises a handful of sensible questions. This page answers them in order, starting with the fundamentals and moving to applications.
Reviewed 2025-12-20. Anything still debated is marked as such rather than presented as settled.
Clinical interest in tesamorelin arose from the need to address visceral adiposity in people living with HIV. Antiretroviral therapy improved survival but was associated in some patients with central fat accumulation, altered lipid profiles, and metabolic complications. This condition, often called HIV-associated lipodystrophy, involves excess visceral adipose tissue that is difficult to manage through diet and exercise alone. Investigators evaluated tesamorelin because GHRH analogs can stimulate growth hormone secretion and influence fat distribution without direct liposuction or invasive procedures.
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.
tesamorelin 是一种人工合成的四十四肽，序列与内源性生长激素释放激素（GHRH）的 1-44 片段一致，区别在于 N 端加接了一个反式-3-己烯酰基。该修饰抑制二肽基肽酶 IV 的快速切割，从而延长分子在循环中的存留时间。作为肽类分子，它难以经胃肠道吸收，文献中讨论的均是注射途径。分类上通常把它归为 GHRH 类似物，以区别于生长激素本身。
作用位置在垂体前叶。tesamorelin 与 GHRH 受体结合后激活腺苷酸环化酶，升高细胞内 cAMP，再经蛋白激酶 A 通路促进生长激素的合成与释放。由于它作用于内源调控节点，生长激素仍以脉冲方式分泌，而不是被持续抬升到固定水平。生长激素随后在肝脏等组织诱导胰岛素样生长因子 1 产生，构成完整的生长激素轴响应。
研究背景集中在特定人群的体成分改变，尤其是与脂肪分布异常相关的内脏脂肪堆积。不同地区对它的监管状态与获批适应症并不一致，部分市场仅限特定诊断人群使用。在一般人群中的长期效应、与其他激素的相互作用以及停药后的维持情况仍属开放问题，现有数据不足以给出普遍结论。
| Property | Value | Notes |
|---|---|---|
| Molecular weight | Approximately 5,136 Da | Based on the 44-amino-acid peptide backbone and N-terminal modification. |
| Appearance | White to off-white lyophilized powder | Usually supplied in single-use vials for reconstitution. |
| Solubility | Freely soluble in water; slightly soluble in some organic solvents | Peptide nature supports aqueous reconstitution. |
| Typical storage | 2–8 °C, protected from light | Refrigeration reduces degradation; avoid freezing unless specified. |
| Common analytical method | Reverse-phase high-performance liquid chromatography | Used for identity, purity, and quantification. |
| Synonyms | Tesamorelin, TH9507, GHRH(1-44) analog | Generic descriptors; avoid proprietary names. |
Tesamorelin is a synthetic peptide that acts as an analog of growth hormone-releasing hormone, a natural hypothalamic signal. Its sequence corresponds to the forty-four amino acid form of the human hormone, with a small acyl group attached near the amino terminus. That modification slows enzymatic breakdown and extends the time the peptide remains active in circulation. The compound was developed as a pharmacological way to raise endogenous growth hormone output rather than supplying the hormone directly.
After injection, the peptide binds receptors on somatotroph cells in the anterior pituitary. Receptor activation raises intracellular cyclic AMP and triggers release of stored growth hormone into the bloodstream. Because the compound works through the body's own regulatory system, growth hormone pulses retain much of their normal feedback control. Repeated administration also raises insulin-like growth factor 1, a hormone produced mainly in the liver. Investigators treat that rise as a marker that the pituitary axis has been engaged.
Clinical study of tesamorelin has centered on adults with HIV-associated lipodystrophy, a condition in which abdominal fat accumulates while peripheral fat is lost. In controlled trials, treated participants showed reductions in visceral adipose tissue measured by imaging, alongside modest shifts in some lipid values. Effects on subcutaneous fat were smaller and less consistent across studies. Whether these changes translate into fewer cardiovascular events remains an open question, because the trials were not designed or powered to answer it.
Lamina propria: is mimicked by seeding oral fibroblasts, producing extracellular matrix, into a biocompatible (porous) scaffold and culturing them in a fibroblast differentiation medium. Basement membrane: containing type IV collagen, laminin, fibronectin and integrins. Ideally, the basement membrane must contain a lamina lucida and a lamina densa. Stratified squamous epithelium: is simulated by oral keratinocytes cultured in a medium containing keratinocyte growth factors such as the epidermal growth factor (EGF). To obtain the best results, the type and origin of the fibroblasts and keratinocytes used in oral mucosa tissue engineering are important factors to hold into account. Fibroblasts are usually taken from the dermis of the skin or oral mucosa. Kertinocytes can be isolated from different areas of the oral cavity (such as the palate or gingiva). It is important that the fibroblasts and keratinocytes are used in the earliest stage possible as the function of these cells decreases with time. The transplanted keratinocytes and fibroblasts should adapt to their new environment and adopt their function. There is a risk of losing the transplanted tissue if the cells do not adapt properly. This adaptation goes more smoothly when the donor tissue cells resemble the cells of the native tissue.
==== Collagen deposition ==== One of fibroblasts' most important duties is the production of collagen. Collagen deposition is important because it increases the strength of the wound; before it is laid down, the only thing holding the wound closed is the fibrin-fibronectin clot, which does not provide much resistance to traumatic injury. Also, cells involved in inflammation, angiogenesis, and connective tissue construction attach to, grow and differentiate on the collagen matrix laid down by fibroblasts. Type III collagen and fibronectin generally begin to be produced in appreciable amounts at somewhere between approximately 10 hours and 3 days, depending mainly on wound size. Their deposition peaks at one to three weeks. They are the predominating tensile substances until the later phase of maturation, in which they are replaced by the stronger type I collagen. Even as fibroblasts are producing new collagen, collagenases and other factors degrade it. Shortly after wounding, synthesis exceeds degradation so collagen levels in the wound rise, but later production and degradation become equal so there is no net collagen gain. This homeostasis signals the onset of the later maturation phase. Granulation gradually ceases and fibroblasts decrease in number in the wound once their work is done. At the end of the granulation phase, fibroblasts begin to commit apoptosis, converting granulation tissue from an environment rich in cells to one that consists mainly of collagen.
=== Laser treatment === Nonablative lasers, such as the 585 nm pulsed dye laser, 1064 nm and 1320 nm Nd:YAG, or the 1540 nm Er:Glass are used as laser therapy for hypertrophic scars and keloids. There is tentative evidence for burn scars that they improve the appearance. Ablative lasers such as the carbon dioxide laser (CO2) or Er:YAG offer the best results for atrophic and acne scars. Like dermabrasion, ablative lasers work by removing the epidermis. Healing times for ablative therapy are much longer and the risk profile is greater compared to nonablative therapy; however, nonablative therapy offers only minor improvements in cosmetic appearance of atrophic and acne scars.
Sources: en.wikipedia.org
The Weekly with Charlie Pickering is an Australian news satire series on the ABC. The series premiered on 22 April 2015, and Charlie Pickering as host with Tom Gleeson, Adam Briggs, Kitty Flanagan (2015–2018) in the cast, and Judith Lucy joined the series in 2019. The first season consisted of 20 episodes and concluded on 22 September 2015. The series was renewed for a second season on 18 September 2015, which premiered on 3 February 2016. The series was renewed for a third season with Adam Briggs joining the team and began airing from 1 February 2017. The fourth season premiered on 2 May 2018 at the later timeslot of 9:05pm to make room for the season return of Gruen at 8:30pm, and was signed on for 20 episodes. Flanagan announced her departure from The Weekly With Charlie Pickering during the final episode of season four, but returned for The Yearly with Charlie Pickering special in December 2018. In 2019, the series was renewed for a fifth season with Judith Lucy announced as a new addition to the cast as a "wellness expert". The show was pre-recorded in front of an audience in ABC's Ripponlea studio on the same day of its airing from 2015 to 2017. In 2018, the fourth season episodes were pre-recorded in front of an audience at the ABC Southbank Centre studios. In 2020, the show was filmed without a live audience due to COVID-19 pandemic restrictions and comedian Luke McGregor joined the show as a regular contributor.
To overcome the limit, a small part of the system is treated quantum-mechanically (typically active-site of an enzyme) and the remaining system is treated classically. In more sophisticated implementations, QM/MM methods exist to treat both light nuclei susceptible to quantum effects (such as hydrogens) and electronic states. This allows generating hydrogen wave-functions (similar to electronic wave-functions). This methodology has been useful in investigating phenomena such as hydrogen tunneling. One example where QM/MM methods have provided new discoveries is the calculation of hydride transfer in the enzyme liver alcohol dehydrogenase. In this case, quantum tunneling is important for the hydrogen, as it determines the reaction rate.
== Further reading == Aikin, Jane (2010). "Histories of the Library of Congress". Libraries & the Cultural Record. 45 (1): 5–24. doi:10.1353/lac.0.0113. S2CID 161865550. Anderson, Gillian B. (1989), "Putting the Experience of the World at the Nation's Command: Music at the Library of Congress, 1800–1917", Journal of the American Musicological Society, 42 (1): 108–49, doi:10.2307/831419, JSTOR 831419 Bisbort, Alan, and Linda Barrett Osborne. The Nation's Library: The Library of Congress, Washington, D. C. (Library of Congress, 2000) Cole, John Young. Jefferson's legacy: a brief history of the Library of Congress (Library of Congress, 1993) Cole, John Young. "The library of congress becomes a world library, 1815–2005." Libraries & culture (2005) 40#3: 385–398. in Project MUSE Cope, R. L. "Management Review of the Library of Congress: The 1996 Booz Allen & Hamilton Report," Australian Academic & Research Libraries (1997) 28#1 online Mearns, David Chambers. The Story Up to Now: The Library of Congress, 1800–1946 (1947), detailed narrative Ostrowski, Carl. Books, Maps, and Politics: A Cultural History of the Library of Congress, 1783–1861 (2004) Rosenberg, Jane Aiken. The Nation's Great Library: Herbert Putnam and the Library of Congress, 1899–1939 (University of Illinois Press, 1993) Shevlin, Eleanor F.; Lindquist, Eric N. (2010). "The Center for the Book and the History of the Book". Libraries & the Cultural Record. 45 (1): 56–69. doi:10.1353/lac.0.0112. S2CID 161311744. Tabb, Winston; et al. (2003). "Library of Congress". Encyclopedia of Library and Information Science.
Sources: en.wikipedia.org
Following this incident, Biko's captors forced him to remain standing and shackled to the wall. The police later said that Biko had attacked one of them with a chair, forcing them to subdue him and place him in handcuffs and leg irons. Biko was examined by a doctor, Ivor Lang, who stated that there was no evidence of injury on Biko. Later scholarship has suggested Biko's injuries must have been obvious. He was then examined by two other doctors who, after a test showed blood cells to have entered Biko's spinal fluid, agreed that he should be transported to a prison hospital in Pretoria. On 11 September, police loaded him into the back of a Land Rover, naked and manacled, and drove him 740 miles (1,190 km) to the hospital. There, Biko died alone in a cell on 12 September 1977. According to an autopsy, an "extensive brain injury" had caused "centralisation of the blood circulation to such an extent that there had been intravasal blood coagulation, acute kidney failure, and uremia". He was the twenty-first person to die in a South African prison in twelve months, and the forty-sixth political detainee to die during interrogation since the government introduced laws permitting imprisonment without trial in 1963.
Plasmids are double-stranded extra chromosomal and generally circular DNA sequences that are capable of replication using the host cell's replication machinery. Plasmid vectors minimalistically consist of an origin of replication that allows for semi-independent replication of the plasmid in the host. Plasmids are found widely in many bacteria, for example in Escherichia coli, but may also be found in a few eukaryotes, for example in yeast such as Saccharomyces cerevisiae. Bacterial plasmids may be conjugative/transmissible and non-conjugative:
In her ruling, she cited Jacobson v Massachusetts, a 1905 U.S. Supreme Court case that upheld the authority of U.S. states to compel people to get vaccinations. On March 25, 2020, Pritzker announced the extension of Illinois's tax filing deadline from April 15 to July 15. He also announced three new emergency assistance programs that allowed small businesses to access more than $90 million in aid. On April 23, 2020, Pritzker extended the stay-at-home order through May 29 with some modifications. Churches were prohibited from holding meetings that had more than 10 people in attendance. Some churches defied Pritzker, held meetings, and filed federal lawsuits. On May 1, 2020, Pritzker enacted a statewide mask mandate. On May 5, 2020, Pritzker announced his reopening plan, "Restore Illinois". The plan had five phases and split the state's 11 existing Emergency Medical Services Regions into four reopening regions. The regions could reopen independently of one another. All regions were then in Phase Two, which allowed retail curbside pickup and delivery along with outdoor activities such as golf, boating, and fishing. Phase Three would allow manufacturing, offices, retail, barbershops, and salons to reopen with capacity limits, along with gatherings of fewer than 10 people. In Phase 4, gatherings of up to 50 people were allowed, restaurants and bars could reopen, travel resumed, and child care and schools reopened under guidance from the IDPH. In Phase 5, the economy fully reopened.
In late October, Gaza's premature babies faced a critical situation as Medical Aid for Palestinians and UNICEF warned that 130 infants were at risk of death due to a hospital fuel shortage caused by Israel's siege. The lack of fuel led to power outages, endangering premature babies in neonatal intensive care units (NICUs). Despite assurances from the IDF to assist in evacuations, the Gaza Health Ministry reported a lack of evacuation mechanisms, resulting in the deaths of several infants. The situation escalated in mid-November when Israel launched a raid on al-Shifa Hospital. Evacuations eventually occurred, facilitated by the Palestinian Red Crescent, World Health Organization, and UNOCHA, with 31 premature babies moved to southern Gaza, with most then to Egypt. Not all infants were accompanied by their parents, and two died at al-Shifa before the evacuation. The distress extended to Al-Nasr Children's Hospital, bombed by the IDF in early November, where medical workers had to leave babies in incubators during evacuation. Video footage later revealed the aftermath, with five premature babies found dead in their incubators. The IDF initially denied responsibility, though an Israel official was heard providing assurances to evacuate the hospital in a released audio. In mid-December, a military siege on Kamal Adwan Hospital worsened the situation, as IDF soldiers reportedly prevented staff from supporting 12 babies in intensive care.
Sources: en.wikipedia.org
It is a synthetic peptide analog of human growth hormone-releasing hormone. It is used clinically to reduce excess visceral abdominal fat in adults with HIV-associated lipodystrophy. It works by stimulating pituitary growth hormone release.
Pivotal trials enrolled adults with HIV and excess visceral abdominal fat, often in the context of antiretroviral therapy. Participants were assessed mainly by computed tomography for visceral adipose tissue. The approved indication remains specific to that population.
Long-term effects on cardiovascular events, mortality, and sustained fat distribution are not well established. Most trials measured changes over months rather than years. Open questions also include whether benefits persist after treatment stops.
tesamorelin 属 GHRH 类似物，作用于垂体受体以促进内源生长激素释放；生长激素本身是直接补充的外源激素。两者在给药逻辑、作用位点和反馈调控路径上并不相同。