The short version of Visceral adiposity fits in a sentence. The long version — which is the one that helps — is below.
This page was last updated on 2025-10-16 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.
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.
| 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 |
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.
Tesamorelin is a synthetic peptide built from 44 amino acids and classified with the growth hormone–releasing hormone family. Its sequence corresponds to the human GHRH(1-44) backbone, carrying one structural change at the amino terminus. That change is a trans-3-hexenoyl group placed where the natural peptide would have an unmodified end. The modification is the feature that separates the compound from the endogenous hormone in name, in stability, and in how it is handled in the laboratory.
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.
Binding of tesamorelin to GHRH receptors on pituitary somatotroph cells triggers cyclic AMP signaling and the release of growth hormone into circulation. Because the peptide acts upstream of the growth hormone axis, its effects are partly mediated by hepatic insulin-like growth factor 1 (IGF-1) production. The pulsatile character of endogenous growth hormone secretion is preserved rather than replaced. Whether amplified signaling produces effects beyond those of native GHRH remains an area of ongoing investigation.
A documented effect of tesamorelin is a reduction in visceral adipose tissue in some study populations. Researchers have reported decreases in trunk fat measured by computed tomography alongside changes in lipid markers. The mechanism is thought to involve growth hormone-mediated lipolysis, though the precise contribution of direct versus indirect pathways is not fully resolved. Studies have generally examined defined groups over finite periods, so long-term outcomes are less well characterized. Findings have not been uniform across all trials.
If a cleft palate is present, the repair normally takes place at 9–12 months old. Before surgery, a polysomnography with a palatal plate in place is needed. This may predict the postoperative situation and gives insight on the chance of the presence of sleep apnea (OSAS) after the operation. Hearing loss is treated by bone conduction amplification, speech therapy, and educational intervention to avoid language/speech problems. The bone-anchored hearing aid is an alternative for individuals with ear anomalies. Zygomatic and orbital reconstruction is performed when the cranio-orbitozygomatic bone is completely developed, usually at the age of 5–7 years. In children, an autologous bone graft is mostly used. In combination with this transplantation, lipofilling can be used in the periorbital area to get an optimal result of the reconstruction. Reconstruction of the lower eyelid coloboma includes the use of a myocutaneous flap, which is elevated and in this manner closes the eyelid defect. External ear reconstruction is usually done when the individual is at least eight years old. Sometimes, the external auditory canal or middle ear can also be treated. The optimal age for the maxillomandibular reconstruction is controversial; as of 2004, this classification has been used: Type I (mild) and Type IIa (moderate) 13–16 years Type IIb (moderate to severe malformation) at skeletal maturity Type III (severe) 6–10 years When the teeth are cutting, the teeth should be under supervision of an orthodontist to make sure no abnormalities occur.
N-acetyl Aspartate (NAA): with its major resonance peak at 2.02 ppm, decrease in levels of NAA indicate loss or damage to neuronal tissue, which results from many types of insults to the brain. Its presence in normal conditions indicates neuronal and axonal integrity. Choline: with its major peak at 3.2 ppm, choline is known to be associated with membrane turnover, or increase in cell division. Increased choline indicates increase in cell production or membrane breakdown, which can suggest demyelination or presence of malignant tumors. Creatine and phosphocreatine: with its major peak at 3.0 ppm, creatine marks metabolism of brain energy. Gradual loss of creatine in conjunction with other major metabolites indicates tissue death or major cell death resulting from disease, injury or lack of blood supply. Increase in creatine concentration could be a response to cranialcerebral trauma. Absence of creatine may be indicative of a rare congenital disease. Lipids: with their major aliphatic peaks located in the 0.9–1.5 ppm range, increase in lipids is seen is also indicative of necrosis. These spectra are easily contaminated, as lipids are not only present in the brain, but also in other biological tissue such as the fat in the scalp and area between the scalp and skull. Lactate: Is an AX3 system which results in a doublet (two symmetric peaks) centered about 1.31 ppm, and a quartet (four peaks with relative peak heights of 1:2:2:1) centered about 4.10 ppm.
The report of the Royal Commission, published in 1937, recommended the establishment of a Regional Council for Northumberland and Tyneside (to be called the "Northumberland Regional Council") to administer services that needed to be exercised over a wide area, with a second tier of smaller units for other local-government purposes. The second-tier units would form by amalgamating the various existing boroughs and districts. The county boroughs in the area would lose their status. Within this area, a single municipality would be formed covering the four county boroughs of Newcastle, Gateshead, Tynemouth, South Shields and other urban districts and boroughs. A minority report proposed amalgamation of Newcastle, Gateshead, Wallsend, Jarrow, Felling, Gosforth, Hebburn and Newburn into a single "county borough of Newcastle-on-Tyneside". The 1937 proposals never came into operation: local authorities could not agree on a scheme and the legislation of the time did not allow central government to compel one. Tyneside (excluding Sunderland) was a special review area under the Local Government Act 1958. The Local Government Commission for England came back with a recommendation to create a new county of Tyneside based on the review area, divided into four separate boroughs. This was not implemented. The Redcliffe-Maud Report proposed a Tyneside unitary authority, again excluding Sunderland, which would have set up a separate East Durham unitary authority.
=== Embryology === Retinoic acid via the retinoic acid receptor influences the process of cell differentiation and, hence, the growth and development of embryos. During development, there is a concentration gradient of retinoic acid along the anterior-posterior (head-tail) axis. Cells in the embryo respond to retinoic acid differently depending on the amount present. For example, in vertebrates, the hindbrain transiently forms eight rhombomeres and each rhombomere has a specific pattern of genes being expressed. If retinoic acid is not present the last four rhombomeres do not develop. Instead, rhombomeres 1–4 grow to cover the same amount of space as all eight would normally occupy. Retinoic acid has its effects by turning on a differential pattern of Homeobox (Hox) genes that encode different homeodomain transcription factors which in turn can turn on cell type-specific genes. Deletion of the Homeobox (Hox-1) gene from rhombomere 4 makes the neurons growing in that region behave like neurons from rhombomere 2. Retinoic acid is not required for patterning of the retina as originally proposed, but retinoic acid synthesized in the retina is secreted into the surrounding mesenchyme where it is required to prevent overgrowth of perioptic mesenchyme which can cause microphthalmia, defects in the cornea and eyelid, and rotation of the optic cup.
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After Count Henry's death in 1112, Teresa ruled Portugal as queen. Her close association from 1121 with Fernando Pérez de Traba, a Galician noble, displeased the local nobility, who sided with her son, Afonso Henriques, defeating her and her supporters at the Battle of São Mamede in 1128. The following year, Afonso claimed sole authority over the entire county, free from foreign influence. According to legend, he won the Battle of Ourique and took the title of King in 1139. Afonso's claim was implicitly recognised by Alfonso VII of León at the Conference of Zamora in 1143, and by Pope Alexander III in 1179 through the papal bull Manifestis Probatum. With the support of north-European crusaders and Christian military and religious orders, Afonso Henriques and his successors continued pushing south until the capture of Algarve, the southernmost region of mainland Portugal, which was recognised by the Kingdom of Castile as Portuguese territory in 1267. With minor readjustments, Portugal's borders have largely remained the same since the signing of the Treaty of Alcañices between Denis of Portugal and Fernando IV of Castile in 1297. Between the 14th and early 15th century, Portugal was struck by several outbreaks of the plague, civil wars, invasions, famines, and natural disasters that led to a population decrease, labour shortages, and rise in antisemitism.
=== Reduction factor === Reduction factor (RF) for a virus removal or inactivation step is calculated using the following equation: RFstep = log10 [(V1 x T1)/(V2 x T2)] Where: V1 = volume of spiked feedstock prior to the clearance step; T1 = virus concentration of spiked feedstock prior to the clearance step; V2 = volume of material after the clearance step; and T2 = virus concentration of material after the clearance step. The reduction factor needed for a certain process stream is dependent on many different factors, some of which include:
== Contraindications == Prior to administration of the first dose, the corrected QT (QTc) must be determined. If the QTc is greater than 440 msec (or 500 msec in patients with ventricular conduction abnormalities), dofetilide is contraindicated. If heart rate is less than 60 bpm, the uncorrected QT interval should be used. After each subsequent dose of dofetilide, QTc should be determined and dosing should be adjusted. If at any time after the second dose of dofetilide the QTc is greater than 500 msec (550 msec in patients with ventricular conduction abnormalities), dofetilide should be discontinued.
The most widely used method to determine absolute molar mass is size-exclusion chromatography (SEC) coupled with multi-angle laser light scattering (MALS). SEC can separate macromolecules based on their size by passing an analyte containing molecules of different sizes through a column containing porous substrate. Larger components of the analyte spend less time traveling through these pores and therefore elute faster, while smaller components can access more of these pores and are therefore retained longer. However, molar masses determined through SEC require calibration curves constructed from standards, and calculating absolute molar masses require absolute detection systems. The two primary detection systems used to determine absolute molar mass are light scattering photometers and viscometers. Static light scattering (SLS) experiments measure the difference between the light scattered by a dilute solution and the light scattered through pure solvent. Given a dilute enough solution and at an angle of θ = 0° between the incident light and the scattering direction, this difference, known as the excess Rayleigh ratio ΔR(θ), can be approximately related to the weight-average molar mass Mw through the equation:
Abortive initiation, also known as abortive transcription, is an early process of genetic transcription in which RNA polymerase binds to a DNA promoter and enters into cycles of synthesis of short mRNA transcripts which are released before the transcription complex leaves the promoter. This process occurs in both eukaryotes and prokaryotes. Abortive initiation is typically studied in the T3 and T7 RNA polymerases in bacteriophages and in E. coli. Abortive initiation occurs prior to promoter clearance. RNA polymerase binds to promoter DNA to form an RNA polymerase-promoter closed complex RNA polymerase then unwinds one turn of DNA surrounding the transcription start site to yield an RNA polymerase-promoter open complex RNA polymerase enters into abortive cycles of synthesis and releases short RNA products (contains less than 10 nucleotides) RNA polymerase escapes the promoter and enters into the elongation step of transcription
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The ACAM2000 vaccine is produced from the vaccinia virus, which is sufficiently closely related to smallpox to provide immunity, but the ACAM2000 vaccine cannot cause smallpox because it does not contain the smallpox virus. Other vaccines containing live viruses include measles, mumps, rubella, polio and chickenpox. The vaccine is administered using a bifurcated stainless steel needle. The needle is dipped into the vaccine solution and used to prick the skin several times in the upper arm. The vaccinia virus will begin to grow at the injection site. It will cause a localized infection, with a red itchy sore produced at the vaccination site within three to four days. If the infection occurs, that is an indication that the vaccine was successful. Ultimately, the sore turns into a blister and then dries up. A scab forms and then falls off in the third week, leaving a small scar behind.
Common donors in oligosaccharide synthesis are glycosyl halides, glycosyl acetates, thioglycosides, trichloroacetimidates, pentenyl glycosides, and glycals. Of all these donors, glycosyl halides are classic donors, which played a historical role in the development of glycosylation reactions. Thioglycoside and trichloroacetimidate donors are used more than others in contemporary glycosylation methods. When it comes to the trichloroacetimidate method, one of the advantages is that there is no need to introduce heavy metal reagents in the activation process. Moreover, using different bases can selectively lead to different anomeric configurations. (Scheme 2) As to the thioglycosides, the greatest strength is that they can offer temporary protection to the anomeric centre because they can survive after most of the activation processes. Additionally, a variety of activation methods can be employed, such as NIS/ AgOTf, NIS/ TfOH, IDCP (iodine dicollidine perchlorate), iodine, and Ph2SO/ Tf2O. Furthermore, in the preparation of 1, 2-trans glycosidic linkage, using thioglycosides and imidates can promote the rearrangement of the orthoester byproducts, since the reaction mixtures are acidic enough.
Patients present with protrusion of the brain tissue and degeneration of the retina; an individual who has family members with the disorder is at an increased risk of developing it themselves since there is a hereditary link.
Fission produces 133Xe, 137Xe, and 135Xe in roughly equal amounts but, after neutron capture, fission caesium contains more stable 133Cs (which however can become 134Cs on further neutron activation) and highly radioactive 137Cs than 135Cs.
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.
It is a laboratory-made peptide that mimics growth hormone-releasing hormone. It prompts the pituitary gland to release growth hormone and has been studied mainly in adults with HIV-associated lipodystrophy.