PMID-29202475 – Discovery and Clinical Development of Glucagon-Like Peptides

PMID-29202475 – Discovery and Clinical Development of Glucagon-Like Peptides

Drucker DJ, Habener JF, Holst JJ. Discovery, Characterization, and Clinical Development of the Glucagon-Like Peptides. J Clin Invest. 2017;127(12):4217-4227.

Quick Reference

Property Value
PMID 29202475
DOI 10.1172/JCI97233
Year 2017
Journal Journal of Clinical Investigation
Study Type Narrative Review
Evidence Level V
Sample N/A (landmark historical review by the three discoverers)
Peptide(s) Studied GLP-1 (Native), GLP-2

Key Findings

  • Traces the full discovery arc from cloning of the proglucagon gene (Habener lab, early 1980s) through identification of GLP-1 as an incretin (Holst lab) and GLP-2 as an intestinotrophic factor (Drucker lab)
  • Proglucagon undergoes tissue-specific post-translational processing: pancreatic alpha-cells produce glucagon, while intestinal L-cells produce GLP-1, GLP-2, oxyntomodulin, and glicentin
  • GLP-1 clinical development yielded two major drug classes: GLP-1 receptor agonists (exenatide, liraglutide, semaglutide) and DPP-4 inhibitors (sitagliptin, etc.), now used by tens of millions of patients
  • GLP-2 clinical development led to teduglutide (Gattex/Revestive), the first approved therapy for short bowel syndrome with intestinal failure
  • The review highlights how basic proglucagon biology research, spanning over 30 years, produced multiple blockbuster therapeutic classes
  • Both GLP-1 and GLP-2 are rapidly degraded by DPP-4, and therapeutic analogs required engineering for protease resistance (acylation for GLP-1RAs, Gly2 substitution for teduglutide)

Study Design

Historical narrative review authored jointly by the three principal investigators whose laboratories discovered and characterized the glucagon-like peptides. Provides a first-person account of the scientific discoveries, translational milestones, and clinical development programs that led to approved therapies.

Limitations

  • Written as a historical perspective rather than a systematic review of efficacy data
  • Published before the obesity-focused GLP-1RA trials (STEP, SURMOUNT) that dramatically expanded the therapeutic scope of GLP-1 pharmacology
  • Naturally reflects the perspectives and contributions of the three co-authors, with less emphasis on competing research groups

Clinical Relevance

This is an essential reference for understanding the scientific lineage of both GLP-1 and GLP-2 therapeutics. For the Ageless Pep Academy, it provides the origin story for two major peptide families covered across multiple modules. The proglucagon processing framework helps clinicians understand why GLP-1 and GLP-2 are co-secreted and how their distinct receptor systems produce complementary metabolic and intestinal effects. Bridges Module 5 (Weight Loss) and Module 8 (GI & Gut Health).

Related

#research #narrative-review #glp-1 #glp-2 #evidence-level-V