Structural Refinement of Glucagon for Therapeutic Use

J Med Chem. 2020 Apr 9;63(7):3447-3460. doi: 10.1021/acs.jmedchem.9b01493. Epub 2019 Dec 18.

Abstract

Glucagon counters insulin's effects on glucose metabolism and serves as a rescue medicine in the treatment of hypoglycemia. Acute hypoglycemia, a common occurrence in insulin-dependent diabetes, is the central obstacle to correcting high blood glucose, a primary cause of long-term microvascular complications. As a result, there has been a resurgence of interest in improved glucagon therapy, including nonconventional liquid formulations, alternative routes of administration, and novel analogs with optimized biophysical properties. These options collectively minimize the complexity of glucagon delivery and enable its application in ways not feasible with conventional emergency rescue kits. These advances have indirectly promoted the integrated use of glucagon agonism with other hormones in a manner that runs counter to the long-standing pursuit of glucagon antagonism. This review summarizes novel approaches to glucagon optimization, methods with potential application to the broader family of therapeutic peptides, where biophysical challenges may be encountered.

Publication types

  • Review

MeSH terms

  • Amino Acid Sequence
  • Animals
  • Drug Delivery Systems
  • Glucagon / chemistry*
  • Glucagon / therapeutic use*
  • Humans
  • Hypoglycemia / drug therapy
  • Molecular Structure
  • Protein Stability
  • Solubility
  • Structure-Activity Relationship

Substances

  • Glucagon