THERAPY OF ENDOCRINE DISEASE: Amylin and calcitonin – physiology and pharmacology

Abstract

Type 2 diabetes is a common manifestation of metabolic dysfunction due to obesity and constitutes a major burden for modern health care systems, in concert with the alarming rise in obesity worldwide. In recent years, several successful pharmacotherapies improving glucose metabolism have emerged, and some of these also promote weight loss, thus, ameliorating insulin resistance. However, the progressive nature of type 2 diabetes is not halted by these new anti-diabetic pharmacotherapies. Therefore, novel therapies promoting weight loss further and delaying diabetes progression are needed. Amylin, a beta cell hormone, has satiating properties and it also delays gastric emptying and inhibits postprandial glucagon secretion with the net result of reducing postprandial glucose excursions. Amylin acts through the three amylin receptors, which have partial identity to the calcitonin receptor. Calcitonin, derived from thyroid C cells, is best known for its role in humane calcium metabolism, where it inhibits osteoclasts and reduces circulating calcium. However, calcitonin, particularly of salmon origin, has also been shown to affect insulin sensitivity, reduce gastric emptying rate and promote satiation. Pre-clinical trials with agents targeting the calcitonin receptor and the amylin receptors, which are based on the calcitonin core receptor, show improvements in several parameters of glucose metabolism including insulin sensitivity and some of these agents are currently undergoing clinical trials. Here, we review the physiological and pharmacological effects of amylin and calcitonin and discuss the future potential of amylin and calcitonin-based treatments for patients with type 2 diabetes and obesity.

Profiles of Intestinal Flora in Breastfed Obese Children and Selecting Functional Strains Against Obesity

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Untangling the mess of CGRP levels as a migraine biomarker: an in-depth literature review and analysis of our experimental experience

“…This discovery has the potential to ease the methodology of sample processing for CGRP determinations. Although this is a disruptive finding, data should come with no surprise as other neuropeptides with similar and even shorter half-life than CGRP, such as vasoactive intestinal peptide (VIP) [ 85 ], amylin [ 86 ], and pituitary adenylate cyclase activating peptide-38 (PACAP-38) [ 87 ] are being measured without controversy over the sample processing time [ 33 , 51 , 88 ].…”

Human Amylin as a Novel Diagnostic Marker for Hypothyroidism in Iraqi Patients

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