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Tesamorelina, es un análogo de la hormona liberadora de la hormona del crecimiento (GHRH) que se utiliza clínicamente para el tratamiento de la lipodistrofia (deposición disfuncional de grasa) asociada al VIH. También se está investigando por su capacidad para mejorar la salud de los nervios periféricos, ralentizar la progresión del deterioro cognitivo leve y reducir la masa grasa.
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Tesamorelin es un análogo de la hormona liberadora de la hormona del crecimiento (GHRH) que consiste en GHRH estándar a la que se le ha agregado un grupo de ácido trans-3-hexanoico adicional. Producido por Theratechnologies de Canadá, Tesamorelin se convirtió en el fármaco más nuevo aprobado por la FDA para su uso en la lipodistrofia asociada al VIH en 2010. El péptido también ha sido investigado por su capacidad para mejorar la regeneración de los nervios periféricos y como una posible intervención para el deterioro cognitivo leve. (DCL), el precursor de la demencia.
como unGHRHanálogo, tesamorelin tiene los mismos efectos que GHRH y análogos de GHRH comosermorelina, GRF (1-29), CJC-1295, etc. La adición de ácido trans-3-hexanoico a la tesamorelina la hace más estable en el plasma humano y, por lo tanto, aumenta su vida media. A pesar de este aumento en la vida media, la tesamorelina, como CJC-1295, preserva la acción fisiológica de la GHRH y, por lo tanto, tiene menos efectos secundarios que moléculas similares que anulan la liberación pulsátil normal de la hormona del crecimiento (GH).
El uso principal de tesamorelina es el tratamiento de la lipodistrofia asociada al VIH, que surge como consecuencia de la infección por VIH y como efecto secundario de la terapia antirretroviral. En la lipodistrofia la grasa se acumula en exceso tanto en el abdomen como en otras zonas del cuerpo. El mecanismo fisiológico responsable de esto no se comprende claramente, pero se cree que los inhibidores de proteasa comúnmente utilizados desempeñan un papel importante en la patogénesis de la lipodistrofia.[1].
Patients suffering from lipodystrophy initially had diet, exercise, and a handful of ineffective medications to rely on for treatment. If those did not work, surgery was a last-ditch, often ineffective, and frequently complicated solution. In 2010, however, the FDA approved tesamorelin specifically for the treatment of HIV-associated lipodystrophy. The drug has been found to reduce adiposity by nearly 20% in this population [1]. Research suggests that tesamorelin is approximately 4 times more effective in reducing adiposity than all of the other available therapies combined [2].
People with HIV are at increased risk of developing cardiovascular disease (CVD), in part due to abnormal fat deposition and in part due to the actions of antiretroviral drugs themselves. Prevention of CVD in HIV-positive individuals is considered to be the most important medical intervention for long-term well-being, after highly active antiretroviral therapy (HAART) of course. Until recently, statins have been the cornerstone of medical management in this population.
Research shows that tesamorelin, in addition to decreasing lipodystrophy, also reduces triglyceride levels, total cholesterol levels, and non-HDL-C levels in HIV-positive patients. A 15% reduction in visceral adipose tissue by tesamorelin correlates with a 50 mg decrease in trigylceride levels[3], [4].
It is worth noting that ectopic fat deposition, as seen in lipodystrophy, is associated with inflammation. Inflammation of any kind is a risk factor for CVD. Visceral adipose tissue, liver fat, and epicardial fat are all independently associated with increased risk of CVD. By reducing ectopic fat deposition, tesamorelin directly decreases inflammation and an individual’s risk for CVD.
Recent evidence suggests that HAART is associated with a number of endocrine and metabolic problems, including growth hormone (GH) deficiency. It appears that the pituitary gland is altered in HIV infection and, as a consequence, approximately one third of patients with HIV who are taking HAART have GH deficiency[5]. This may, to some extent, explain why lipodystrophy is so common in individuals with HIV and also why tesamorelin is such an effective treatment. Tesamorelin is a safer and more effective way to raise GH levels than administration of exogenous GH, particularly in HIV-positive individuals.
Peripheral nerve damage can be a consequence of injury, diabetes, or even surgical interventions. It often results in debilitating problems with both motor and sensory function in the affected area, but there is little that can be done to correct the problem because nerve cells are notoriously difficult to regenerate. Research, however, suggests that therapies based on growth hormone manipulation may improve peripheral nerve injury and increase both rate and extent of healing[6]. Tesamorelin is currently the leading candidate for such intervention, in part because it already has FDA approval.
There is now evidence to suggest that GHRH analogues, like tesamorelin, are effective in enhancing cognition in patients suffering from the early stages of dementia. A large, randomized, double-blind, placebo-controlled study at the University of Washington School of Medicine, carried out over twenty weeks, suggests that tesamorelin and other GHRH analogues may impact dementia by increase gamma-aminobutyric acid (GABA) levels in the brain and by decreasing myo-insoitol (MI) levels[7]. These findings open up a pathway for using tesamorelin in the treatment of dementia, but also suggest new areas for scientists to explore as they look for a cure or a preventative.
Because it is FDA approved for use in humans, tesamorelin is an attractive peptide for ongoing clinical research. It is currently under review for its ability to reduce cardiovascular disease in HIV, improve healing of peripheral nerves following injury, and slow the progression of dementia. Clinical trials are already underway in several different areas.
Tesamorelin exhibits minimal side effects, low oral and excellent subcutaneous bioavailability in mice. Per kg dosage in mice does not scale to humans. Tesamorelin for sale at
The above literature was researched, edited and organized by Dr. Logan, M.D. Dr. Logan holds a doctorate degree from Case Western Reserve University School of Medicine and a B.S. in molecular biology.
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