Sitagliptin: Difference between revisions
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< | <StructureSection load='' size='340' side='right' caption='Sitagliptin, better known as Januvia, ([[1x70]])' scene='Sitagliptin/Sitagliptin/1'> | ||
===Better Known as: Januvia=== | ===Better Known as: Januvia=== | ||
* Marketed By: | * Marketed By: Merck & Co. | ||
* Major Indication: | * Major Indication: [[Hyperglycemia & Type II Diabetes]] | ||
* Drug Class: | * Drug Class: Dipeptidyl Peptidase-4 (DPP-4) Inhibitor | ||
* Date of FDA Approval (Patent Expiration): | * Date of FDA Approval (Patent Expiration): 2006 (2017) | ||
* 2009 Sales: | * 2009 Sales: $2.4 Billion | ||
* Importance: | * Importance: One of the best selling treatments for Type II [[Diabetes]]. Often used in combination with Metformin, the first line anti-diabetic medication (Combination sold as Janumet). Has an excellent side-effect profile with a relatively low incidence of hypoglycemia an weight gain. Increasing evidence that all DPP-4 inhibitors can to certain malignant cancers.<ref>PMID:15735018</ref> | ||
* See [[Pharmaceutical Drugs]] for more information about other drugs and diseases. | * See [[Pharmaceutical Drugs]] for more information about other drugs and diseases. | ||
===Mechanism of Action=== | ===Mechanism of Action=== | ||
Dipeptidyl Peptidase-4 (DPP-4) is an antigenic membrane serine exopeptidase that cleaves proline dipeptides form the N-terminal end of protein substrates. DPP-4 plays a major role in [[Carbohydrate Metabolism|glucose metabolism]] as it is responsible for the degradation of incretins, most notably Glucagon-like peptide-1 (GLP-1) and Glucose-dependent insulinotropic polypeptide (GIp). Incretins are a group of gastrointestinal hormones that stimulate insulin biosynthesis and inhibit glucagon secretion after consuming high glucose meals. Since [[Diabetes]] is typically caused by a deficiency in [[insulin]] secretion or by increased hepatic glucose production, preventing incretin degradation is a viable treatment for diabetics. Sitagliptin is a <scene name='Sitagliptin/Dpp4/2'>competitive inhibitor of DPP-4</scene>. By inhibiting DPP-4 and subsequently preventing the enzymatic degradation of GLP-1 and GIP, these incretins are able to potentiate the secretion of insulin and suppress the release of glucagon by the pancreas, resulting in controlled blood-glucose levels.<ref>PMID:17073841</ref> The active site of DPP-4 consists of a <scene name='Sitagliptin/Hdryo/1'>hydrophobic "S1" pocket</scene> and several <scene name='Sitagliptin/Hbond/2'>hydrogen bonding residues</scene>, ideal for binding terminal dipeptides. <scene name='Sitagliptin/Bound/3'>Sitagliptin binds to the active site of DPP-4</scene> with great specificity (DPP-4 [[Pharmacokinetics#Inhibitory_Concentration_.28IC50.29|IC<sub>50</sub>]]: 18 nM vs. >50,000 nM for other DPPs), situating its trifluorophenyl moiety within the S1 hydrophobic pocket, forming four hydrogen bond interactions with residues Tyr 662, Glu 205, & Glu 206, and burying its trifluoro group within a a very tight pocket formed by residues Ser 209 and Arg 358.<ref>PMID:15634008</ref> | |||
===Pharmacokinetics=== | ===Pharmacokinetics=== | ||
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</table> | </table> | ||
</StructureSection> | |||
===References=== | ===References=== | ||
<references/> | <references/> | ||
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