Cardiovascular outcomes trials with incretin-based medications: a critical review of data available on GLP-1 receptor agonists and DPP-4 inhibitors
METABOLISM-CLINICAL AND EXPERIMENTAL
Authors: Sachinidis, Alexandros; Nikolic, Dragana; Stoian, Anca Pantea; Papanas, Nikolaos; Tarar, Omer; Rizvi, Ali A.; Rizzo, Manfredi
Abstract
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dipeptidyl peptidase-4 (DPP-4) inhibitors are so called "incretin-based therapies" (IBTs) that represent innovative therapeutic approaches and are commonly used in clinical practice for the treatment of type 2 diabetes mellitus (T2DM). The cardiovascular outcome trials (CVOTs) have provided useful information that has helped to shape changes in clinical practice guidelines for the management of T2DM. At the same time, the mechanisms that may explain the nonglycemic and cardiovascular (CV) benefits of these medications are still being explored. A summary of the main findings from CVOTs performed to-date with particular emphasis on various outcomes and inconsistencies observed in the trials is provided. Overall, available data is favourable to the early deployment of GLP-1RAs in clinical practice, fully in line with recommendations from international scientific guidelines, and based on their effects on glucose metabolism parameters, body weight reduction and CV outcomes. Evidence further suggest that the CV benefits of GLP-1RAs may not be a class effect, with GLP-1 analogues having a greater benefit rather than exendin-based agents. (C) 2020 Elsevier Inc. All rights reserved.
Computational investigation of flavonol-based GLP-1R agonists using DFT calculations and molecular docking
COMPUTATIONAL AND THEORETICAL CHEMISTRY
Authors: Zhang, Min; Zhu, Xiaohui
Abstract
Glucagon-like peptide 1 receptor agonists (GLP-1RA) have excellent performance in the treatment of diabetes, but the drugs used in the clinic are all macromolecular peptide injections. Therefore, non-peptide small molecule drugs that can be taken orally have become the research and development trend of GLP-1RA. Some flavonols have been proved to be small molecule GLP-1RA. We have conducted DFT and molecular docking studies on reported flavonol-based non-peptide GLP-1RA. Flavone, flavonol, 4'-hydroxyflavonol, 3',4'-dihydroxyflavonol and quercetin were investigated at B3LYP [6-311G (d, p)/6-311 +G (d, p)/6-311 + +G (d, p)] levels in gas and water phase. The calculation was performed on their equilibrium structures and harmonic frequencies in gas and water phase, respectively. Vibration frequency and infrared spectrum of O-H and C=O can be used to identify structural analogs of this type of compounds. The topological properties of the IMHB for flavonols have been investigated using the atoms-in-molecules (AIM) approach. Electrostatic potential (ESP), conceptual density functional theory (CDFT) and condensed dual descriptor (CDD) were used for molecular reactivity studies. The preliminary investigations of binding details between flavonols and GLP-1R are explored by molecular docking technology. The results of this study are expected to aid the design and analyze of new flavonol-based small molecule GLP-1RA with improved properties.