This is a working overview of visceral fat, written for readers who want more than a one-paragraph summary but less than a textbook.
This page was last updated on 2026-03-26 and is reviewed periodically as new material appears.
Tesamorelin is a synthetic peptide that belongs to the growth hormone-releasing hormone family and contains the same forty-four amino acid sequence as endogenous GHRH, extended at the amino terminus by a trans-3-hexenoyl group. That small fatty acid modification protects the peptide from rapid cleavage by dipeptidyl peptidase-4, the enzyme that shortens the half-life of native GHRH to only a few minutes. Chemically the compound is produced by solid-phase peptide synthesis, purified by chromatography, and supplied as a sterile lyophilized powder for reconstitution.
Regulatory approval in the United States came in 2010, when the Food and Drug Administration cleared the peptide for the reduction of excess abdominal fat in adults with HIV infection and associated lipodystrophy. The decision rested mainly on two randomized phase 3 trials that enrolled roughly eight hundred patients and ran for twenty-six weeks. Participants receiving active drug showed substantially greater declines in visceral adipose tissue than those receiving placebo, while total body weight changed comparatively little. A reformulated presentation was later approved, and the product has remained a niche therapy rather than a general weight-loss agent.
监管记录显示，特沙莫瑞林于 2010 年在美国首次获得批准，用于人类免疫缺陷病毒感染相关的脂肪营养不良患者。批准依据来自降低内脏脂肪的临床试验，而非体重或瘦体重的普遍改善。后续出现了不同制剂版本，但其核心适应症保持一致。关于长期心血管结局和死亡率影响，现有证据仍不充分。
在临床研究之外，特沙莫瑞林常被讨论为生长激素分泌促进剂，但这一说法需要限定。它并不等同于生长激素本身，也不属于普通减重药物。部分研究关注其减少腹部脂肪和改善脂质谱的潜力，另一些研究则关注胰岛素抵抗和 IGF-1 升高等信号。这些效应的临床意义仍在评估中，尚未形成统一结论。
特沙莫瑞林是一种合成肽，其序列与人生长激素释放激素的 44 个氨基酸形式相关。它在 N 端带有反式-3-己烯酰基修饰，这一改动可减缓二肽基肽酶 IV 的降解。该化合物属于生长激素释放激素受体激动剂，可刺激垂体释放生长激素。研究文献通常将其归入合成肽类药物，而非小分子化合物。
| Property | Value | Notes |
|---|---|---|
| Peptide class | Synthetic GHRH analogue | 44 residues; N-terminal trans-3-hexenoyl group |
| First approval year | 2010 | United States; HIV-associated abdominal fat accumulation |
| Administration route | Subcutaneous injection | Abdominal site; clinician-administered or self-injected |
| Common synonyms | TH9507; tesamorelin acetate | Development code and acetate salt form |
| Originator | Canadian biotechnology firm | Original developer and regulatory sponsor |
Tesamorelin is a synthetic peptide that belongs to the growth hormone-releasing hormone (GHRH) family. Its sequence corresponds to the fully active 44-amino-acid form of human GHRH, with a single structural modification: the addition of a trans-3-hexenoyl group at the N-terminus. That modification is not found in the naturally occurring hormone and was introduced deliberately during development to improve stability against enzymatic degradation. The compound is therefore best described as a stabilized analogue rather than a naturally occurring peptide.
The native hormone is produced in the hypothalamus and acts on the anterior pituitary. Binding of GHRH to its receptor stimulates synthesis and release of growth hormone into circulation. Because the analogue retains the receptor-binding region of the parent sequence, it engages the same receptor and triggers the same downstream signaling. The result is increased growth hormone secretion from pituitary cells, which in turn influences hepatic production of insulin-like growth factor 1. This axis is the basis for the compound's measured biological effects.
Interest in this peptide developed because native GHRH has a short circulating lifetime. The N-terminal modification slows cleavage by dipeptidyl peptidase IV, an enzyme that removes the first two residues of many peptides and terminates their activity. Slower degradation means a longer window of receptor stimulation per administration. This design logic parallels other modified peptide hormones, where a small chemical change at a vulnerable site yields a more durable molecule without altering the core mechanism of action.
The hexenoyl cap slows the enzyme step that trims the amino terminus of native GHRH, the same step that shortens its active lifetime in circulation. As a result, the modified peptide persists longer in plasma than the unmodified hormone in side-by-side comparison. Receptor activity stays broadly comparable, because the added group sits away from the residues that contact the binding site. This combination, preserved receptor activity with reduced degradation, explains why the analog was developed instead of the native sequence.
Several compounds share the GHRH framework, including sermorelin, the shorter 1-29 fragment, and other analogs built on the full 1-44 chain. Naming follows a common convention: a stem that identifies the peptide plus a suffix marking analog status. Reports may describe tesamorelin by its sequence fragment, as a GHRH(1-44) analog, or by its amino-terminal modification. Indexing the compound therefore requires searching all of these forms, since some older literature predates the current international nonproprietary name.
Metabolic interest in this compound centers on fat distribution rather than on hormone levels alone. Imaging trials in adults with excess abdominal fat report reductions in visceral adipose tissue, while subcutaneous depots change comparatively little. Growth hormone and IGF-1 are presumed to carry the effect, but the separate contribution of each is not firmly established. Whether these changes persist after treatment stops, and whether they alter longer-term health outcomes, remain open questions that published work does not answer consistently.
Tesamorelin is a synthetic peptide of forty-four amino acids whose sequence reproduces human growth hormone-releasing hormone. Its distinguishing feature sits at the amino terminus, where a trans-3-hexenoyl group replaces the free amine. That acylation slows cleavage by dipeptidyl peptidase IV, an enzyme that otherwise removes the first two residues and inactivates the natural hormone quickly. The modified peptide therefore persists longer in circulation while keeping the same receptor target. It is handled as a lyophilized solid and dissolved shortly before use.
Tesamorelin binds to growth hormone-releasing hormone receptors on the surface of pituitary somatotroph cells. This binding activates adenylate cyclase, raising intracellular cyclic AMP levels and triggering the release of growth hormone into circulation. The elevated growth hormone then stimulates hepatic production of insulin-like growth factor 1. Because the effect is mediated through the endogenous axis, secretion remains subject to feedback regulation. This distinguishes it from direct growth hormone administration, which bypasses pituitary control entirely.
Clinical investigation has focused on HIV-associated lipodystrophy, a condition in which antiretroviral therapy contributes to abnormal fat distribution. Excess visceral adipose tissue accumulates in the abdomen while peripheral fat may be lost. Tesamorelin was evaluated for reducing this visceral fat depot, with trials measuring changes in abdominal fat by imaging rather than by body weight alone. The rationale rests on the known lipolytic effects of growth hormone. Effects on visceral fat are documented, while long-term outcomes regarding cardiovascular risk remain less clearly established.
This inherited condition can be diagnosed with a blood test. If the total cholinesterase activity in the patient's blood is low, this may suggest an atypical form of the enzyme is present, putting the patient at risk of sensitivity to suxamethonium and related drugs. Inhibition studies may also be performed to give more information about potential risk. In some cases, genetic studies may be carried out to help identify the form of the enzyme that is present. Patients with known butyrylcholinesterase deficiency may wear a medic-alert bracelet that will notify healthcare workers of increased risk from administration of succinylcholine, and use a non-depolarising neuromuscular-blocking drug for general anesthesia, such as rocuronium. Prognosis for recovery following administration of succinylcholine is excellent when medical support includes close monitoring and respiratory support measures. In nonmedical settings in which subjects with butyrylcholinesterase deficiency are exposed to cocaine, sudden cardiac death can occur.
== Early life and education == Culp was born on August 16, 1930, in either Oakland, California, or Berkeley, California. He was the only child of Crozier Cordell Culp, an attorney, and his wife, Bethel Martin Culp (née Collins). He graduated from Berkeley High School, where he was a pole vaulter and took second place at the 1947 CIF California State Meet. Culp attended the University of the Pacific in Stockton, California, and later Washington University in St. Louis, San Francisco State, and the University of Washington School of Drama, but never completed an academic degree. He also received acting training at HB Studio in New York City.
Biden campaigned heavily for Democrats in the 2010 midterm elections, maintaining an attitude of optimism in the face of predictions of large-scale losses for the party. After big Republican gains in the elections and Emanuel's departure, Biden's past relationships with Republicans in Congress became more important. He led the successful administration effort to gain Senate approval for the New START treaty. In December 2010, Biden's advocacy for a middle ground, followed by his negotiations with Senate minority leader Mitch McConnell, were instrumental in producing the administration's compromise tax package that included a temporary extension of the Bush tax cuts. The package passed as the Tax Relief, Unemployment Insurance Reauthorization, and Job Creation Act of 2010. Obama delegated Biden to lead negotiations with Congress during the 2011 U.S. debt ceiling crisis. Biden's relationship with McConnell brought about the Budget Control Act of 2011 that solved the crisis. Some reports suggest that Biden opposed proceeding with the May 2011 U.S. mission to kill Osama bin Laden, lest failure adversely affect Obama's reelection prospects. In 2012, Biden made the case for Obama's reelection: "Osama bin Laden is dead and General Motors is alive." Obama named Biden to head the Gun Violence Task Force, created to address the causes of school shootings and consider possible gun control measures in the aftermath of the Sandy Hook Elementary School shooting, in December 2012.
=== United States === The rate of obesity among children and adolescents in the United States has nearly tripled between the early 1980s and 2000. It has, however, not changed significantly between 2000 and 2006, with the most recent statistics showing a level just over 17 percent. In 2008, the rate of overweight and obese children in the United States was 32%, and had stopped climbing. In 2011, a national cohort study of infants and toddlers found that nearly one-third of US children were overweight or obese at nine months and two years old. In a follow-up study, infant weight status (healthy and obese) was strongly associated with preschool weight status.
Sources: en.wikipedia.org
=== Selected articles === White, S. H. (1986). The physical nature of planar bilayer membranes. In Ion Channel Reconstitution (Chris Miller, Ed.). Plenum Press: New York. pp. 3–35. Wiener, M. C. and White, S. H. (1992). The structure of a fluid dioleoylphosphatidylcholine bilayer determined by joint refinement using x-ray and neutron diffraction data. III. The complete structure. Biophys. J. 61:434–447. White, S. H., Wimley, W. C., Ladokhin, A. S., and Hristova, K. (1998). Protein folding in membranes: Determining the energetics of peptide–bilayer interactions. Methods Enzymol. 295:62–87. White, S. H. and Wimley, W. C. (1999). Membrane protein folding and stability: Physical principles. Annu. Rev. Biophys. Biomolec. Struct. 28:319–365 Hessa, T., Meindl-Beinker, N. M., Bernsel, A., Kim, H., Sato, Y., Lerch, M. B., Nilsson, I., White, S. H., and von Heijne, G. (2007). The molecular code for transmembrane-helix recognition by the Sec61 translocon. Nature 450:1026-1030. Cymer, F., von Heijne, G., & White S.H. (2015). Mechanisms of integral membrane protein insertion and folding. J Mol Biol 427:999-1022. Roussel, G., Lindner, E., & White, S. H. (2022). Topology of the SecA ATPase Bound to Large Unilamellar Vesicles. Journal of Molecular Biology, 434(12), 167607.
The xanthophyll cycle involves the enzymatic removal of epoxy groups from xanthophylls (e.g. violaxanthin, antheraxanthin, diadinoxanthin) to create so-called de-epoxidised xanthophylls (e.g. diatoxanthin, zeaxanthin). These enzymatic cycles were found to play a key role in stimulating energy dissipation within light-harvesting antenna proteins by non-photochemical quenching- a mechanism to reduce the amount of energy that reaches the photosynthetic reaction centers. Non-photochemical quenching is one of the main ways of protecting against photoinhibition. In higher plants, there are three carotenoid pigments that are active in the xanthophyll cycle: violaxanthin, antheraxanthin, and zeaxanthin. During light stress, violaxanthin is converted, i.e. reduced, to zeaxanthin via the intermediate antheraxanthin, which plays a direct photoprotective role acting as a lipid-protective anti-oxidant and by stimulating non-photochemical quenching within light-harvesting proteins. This conversion of violaxanthin to zeaxanthin is done by the enzyme violaxanthin de-epoxidase (EC 1.23.5.1), while the reverse reaction, i.e. oxidation, is performed by zeaxanthin epoxidase (EC 1.14.15.21). In diatoms and dinoflagellates, the xanthophyll cycle consists of the pigment diadinoxanthin, which is transformed into diatoxanthin (diatoms) or dinoxanthin (dinoflagellates) under high-light conditions. Wright et al.
=== Cookbooks === American Gastronomy: An Illustrated Portfolio of Recipes and Culinary history (1974), ISBN 978-0809283415 The Bakery Restaurant Cookbook (1980), ISBN 978-0843621952 The Chef's New Secret Cookbook (1975), ISBN 978-0809283545 The Chef's Secret Cook Book: A Practical, Personal Invitation to Classic Cookery (1971), ISBN 978-0812902136 Sears Gourmet Cooking Forum (1969)
== Symptoms == EPM6 is classically characterised by first beginning motor delay, decreased muscle tone, gait issues, absent reflexes. At around age 4, patients usually develop ataxia; later (around age 6), they develop myoclonus. Myoclonus is more prominient in upper extremity than in lower, also they can experience myoclonus of tongue and around the mouth. Before age 20, patients might also develop epileptic seizures, also during the first decade, patients experience dysarthric speech; later, around the second/third decade, some patients experience dysphagia. Scoliosis (abnormal curvature of spine) can be seen in patients before first/second decade, also most of the patients became wheelchair-bound (around at the age 13). Increased creatine kinase levels can be seen, in addition patients usually have preserved cognition until late course of the disorder.
In plant anatomy, tissues are categorized broadly into three tissue systems: the epidermis, the ground tissue, and the vascular tissue. Epidermis – Cells forming the outer surface of the leaves and of the young plant body. Vascular tissue – The primary components of vascular tissue are the xylem and phloem. These transport fluids and nutrients internally. Ground tissue – Ground tissue is less differentiated than other tissues. Ground tissue manufactures nutrients by photosynthesis and stores reserve nutrients. Plant tissues can also be divided differently into two types:
Sources: en.wikipedia.org
Management of depression is the treatment of depression that may involve a number of different therapies: medications, behavior therapy, psychotherapy, and medical devices. Depression is a symptom of some physical diseases; a side effect of some drugs and medical treatments; and a symptom of some mood disorders such as major depressive disorder or dysthymia. Physical causes are ruled out with a clinical assessment of depression that measures vitamins, minerals, electrolytes, and hormones. Though psychiatric medication is the most frequently prescribed therapy for major depression, psychotherapy may be effective, either alone or in combination with medication. Given an accurate diagnosis of major depressive disorder, in general the type of treatment (psychotherapy or antidepressants, alternate or other treatments, or active intervention) is "less important than getting depressed patients involved in an active therapeutic program." Psychotherapy is the treatment of choice in those under the age of 18, with medication offered only in conjunction with the former and generally not as a first line agent. The possibility of depression, substance misuse or other mental health problems in the parents should be considered and, if present and if it may help the child, the parent should be treated in parallel with the child.
Among the most important governance standards are rights vote for who is on the board of directors for investors of labour and capital. A Draft Fifth Company Law Directive proposed in 1972, which would have required EU-wide rights for employees to vote for boards stalled mainly because it attempted to require two-tier board structures, although most EU member states have codetermination today with unified boards. The Shareholder Rights Directive 2007 requires shareholders be able to make proposals, ask questions at meetings, vote by proxy and vote through intermediaries. This has become increasingly important as most company shares are held by institutional investors (primarily asset managers or banks, depending on the member state) who are holding "other people's money". A large proportion of this money comes from employees and other people saving for retirement, but who do not have an effective voice. Unlike Switzerland after a 2013 people's initiative, or the U.S. Dodd-Frank Act 2010 in relation to brokers, the EU has not yet prevented intermediaries casting votes without express instructions of beneficiaries. This concentrates power into a small number of financial institutions, and creates the potential for conflicts of interest where financial institutions sell retirement, banking or products to companies in which they cast votes with other people's money. A series of rights for ultimate investors exist in the Institutions for Occupational Retirement Provision Directive 2003.
From its founding until the early 1990s, the menu at Domino's Pizza was kept simple relative to other fast food restaurants, to ensure efficiency of delivery. Historically, Domino's menu consisted solely of one style of pizza crust in two sizes (12-inch and 16-inch), eleven toppings, and Coca-Cola as the only soft drink option. The first menu expansion occurred in 1989, with the debut of Domino's deep dish. Its introduction followed market research showing that 40% of pizza customers preferred thick crusts. The new product launch cost approximately $25 million, of which $15 million was spent on new sheet metal pans with perforated bottoms. Domino's started testing extra-large-size pizzas in early 1993, starting with the 30-slice, yard-long "The Dominator". Domino's tapped into a market trend toward bite-size foods with spicy "Buffalo Chicken Kickers", as an alternative to Buffalo wings, in August 2002. The breaded, baked, white-meat fillets, similar to chicken fingers, are packaged in a custom-designed box with two types of sauce to "heat up" and "cool down" the chicken.
Because genome-wide data still separate the lineages, they remain distinct species even though their history cannot be depicted by a simple bifurcating tree. Keuler and colleagues recommend routine hybridisation tests (e.g., gene-tree comparison, HybridDetective) in intensive delimitation projects. Overall, such studies highlight how cryptic and dynamic lichen species can be, and they continue to drive up recognized species numbers.
Sources: en.wikipedia.org
It is a laboratory-made peptide of forty-four amino acids whose sequence matches human growth hormone-releasing hormone, with a modified amino terminus. The modification is a short unsaturated fatty acid chain attached to the first residue. This change slows enzymatic breakdown and lengthens the time the peptide stays active in circulation.
The clinical program was designed around HIV-associated lipodystrophy, a condition in which fat accumulates abnormally around the internal organs. Trials enrolled that specific population, so the evidence base covers it rather than the general population. Regulators approved the drug for the studied indication only, and promotion outside it is not permitted.
Growth hormone therapy supplies the finished hormone directly, while this peptide acts upstream and asks the pituitary to secrete its own. That difference means the response depends on a functioning pituitary and on the body's normal feedback loops. It also means the circulating hormone profile is pulsatile rather than a flat, injected level.
特沙莫瑞林是国际非专利名称，指一种经过 N 端修饰的生长激素释放激素类似物。它被归类为合成肽，序列与 GHRH(1-44) 密切相关。该名称不指代任何特定品牌或剂型。