The Many Facets of PPAR-γ Agonism in Obesity and Associated Comorbidities: Benefits, Risks, Challenges, and Future Directions.

IF 9.5 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Dimitris Kounatidis, Natalia G Vallianou, Eleni Rebelos, Marina Kouveletsou, Paraskevi Kontrafouri, Ioanna Eleftheriadou, Evanthia Diakoumopoulou, Irene Karampela, Nikolaos Tentolouris, Maria Dalamaga
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引用次数: 0

Abstract

Purpose of review: Obesity is strongly associated with cardiometabolic disorders and certain malignancies, emphasizing the key role of adipose tissue in human health. While incretin mimetics have shown effectiveness in glycemic control and weight loss, a holistic strategy for combating obesity and associated comorbidities remains elusive. This review explores peroxisome proliferator-activated receptor gamma (PPAR-γ) agonism as a potential therapeutic approach, highlighting its benefits, addressing its limitations, and outlining future directions for developing more effective treatment strategies.

Recent findings: Both natural and synthetic PPAR-γ agonists hold significant therapeutic potential as insulin sensitizers, while also demonstrating anti-inflammatory properties and playing a critical role in regulating lipid metabolism. However, the clinical use of natural agonists is limited by poor bioavailability, while synthetic agents like thiazolidinediones are associated with adverse effects, including fluid retention, weight gain, and bone loss. Current research is focused on developing modified, tissue-specific PPAR-γ agonists, as well as dual PPAR-α/PPAR-γ agonists, with improved safety profiles to mitigate these side effects. Nanotechnology-based drug delivery systems also hold promise for enhancing bioavailability and therapeutic efficacy. Furthermore, the transformative potential of machine learning and artificial intelligence offers opportunities to accelerate advancements in this field. PPAR-γ agonists exhibit significant potential in addressing metabolic syndrome, cardiovascular disease, and cancer. However, their clinical use is restricted by safety concerns and suboptimal pharmacokinetics. Innovations in modified PPAR-γ agonists, nanotechnology-based delivery systems, and computational tools hold promise for creating safer and more effective therapeutic options for obesity and its associated disorders.

肥胖和相关合并症中PPAR-γ激动作用的许多方面:益处、风险、挑战和未来方向
综述目的:肥胖与心脏代谢紊乱和某些恶性肿瘤密切相关,强调脂肪组织在人类健康中的关键作用。虽然模拟肠促胰岛素在血糖控制和体重减轻方面显示出有效性,但对抗肥胖和相关合并症的整体策略仍然难以捉摸。这篇综述探讨了过氧化物酶体增殖物激活受体γ (PPAR-γ)激动剂作为一种潜在的治疗方法,强调了它的优点,解决了它的局限性,并概述了未来发展更有效的治疗策略的方向。最新发现:天然和合成的PPAR-γ激动剂作为胰岛素增敏剂具有显著的治疗潜力,同时也显示出抗炎特性并在调节脂质代谢中发挥关键作用。然而,天然激动剂的临床使用受到生物利用度差的限制,而合成药物如噻唑烷二酮类药物与不良反应有关,包括液体潴留、体重增加和骨质流失。目前的研究重点是开发修饰的、组织特异性的PPAR-γ激动剂,以及PPAR-α/PPAR-γ双激动剂,以提高安全性以减轻这些副作用。基于纳米技术的药物传递系统也有望提高生物利用度和治疗效果。此外,机器学习和人工智能的变革潜力为加速这一领域的发展提供了机会。PPAR-γ激动剂在治疗代谢综合征、心血管疾病和癌症方面显示出巨大的潜力。然而,它们的临床使用受到安全性问题和次优药代动力学的限制。改良的PPAR-γ激动剂、基于纳米技术的输送系统和计算工具的创新有望为肥胖及其相关疾病创造更安全、更有效的治疗选择。
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来源期刊
Current Obesity Reports
Current Obesity Reports Medicine-General Medicine
CiteScore
16.40
自引率
1.10%
发文量
25
期刊介绍: The main objective of Current Obesity Reports is to provide expert review articles on recent advancements in the interdisciplinary field of obesity research. Our aim is to offer clear, insightful, and balanced contributions that will benefit all individuals involved in the treatment and prevention of obesity, as well as related conditions such as cardiovascular diseases, endocrine disorders, gynecological issues, cancer, mental health, respiratory complications, and rheumatological diseases. We strive to redefine the way knowledge is expressed and provide organized content for the benefit of our readership.
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