Gcc agonist

Respondents found guanylyl cyclase C (GCC) agonist most satisfying when treating their patients. Among the 69% of respondents who were aware of published guidelines, only 50% found them helpful in prioritizing treatment choices and 69% of respondents indicated that a treatment algorithm, applicable to Canadian practice, would be valuable.

Gcc agonist. Guanylyl cyclase (also known as guanylate cyclase) is an enzyme that catalyzes the synthesis of cyclic guanosine 3′,5′-monophosphate (cGMP) from guanosine 5' triphosphate (GTP). Guanylyl cyclase exists in both a membrane-bound and soluble form in the cell. The membrane-bound form is a plasma membrane receptor, while soluble forms of guanylyl cyclase undergo activation by nitric oxide ...

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Jan 7, 2015 · The bacterial enterotoxin ST of Escherichia coli, which is responsible for travelers’ diarrhea, is a guanylate cyclase C (GC-C) receptor agonist that results in water and electrolyte secretion and diarrhea. The GC-C receptor is a membrane-spanning protein containing an extracellular binding domain and intracellular protein kinase and catalytic domains. Based on the structure and function of ... Alpha-adrenergic agonist. Alpha-adrenergic agonists are a class of sympathomimetic agents that selectively stimulates alpha adrenergic receptors. The alpha-adrenergic receptor has two subclasses α 1 and α 2. Alpha 2 receptors are associated with sympatholytic properties. Alpha-adrenergic agonists have the opposite function of alpha …We here review recent experimental evidence that agonist-induced internalization of the two receptors differs markedly and that modifications of the ligand structures, as in co-agonists, profoundly influence these cellular processes and may explain that an antagonist may activate while an agonist may block receptor signaling. Prior treatment in the past week with plecanatide, linaclotide, or other agent whose primary mechanism of action is that of a GCC agonist; History of allergic reactions attributed to compounds of similar chemical or biologic composition of plecanatide or linaclotide; Use of any other investigational agents =< 12 weeks prior to registration Liraglutide, a GLP-1 receptor agonist, is now approved for the treatment of obesity in patients without type 2 diabetes. New GLP-1/GIP agonists show even greater reductions in hemoglobin A1c and weight. 10. Tirzepatide is a dual GLP-1/GIP agonist that shows real promise for the treatment of diabetes and weight in patients with type 2 …Objectives: Linaclotide and plecanatide are guanylate cyclase-C (GCC) agonists for the treatment of chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). Our objective is to evaluate the efficacy and tolerability of GCC agonists based on data from multiple randomized controlled trials (RCTs).Based on published studies, the most prevalent asthma treatment in these countries are fixed dose combinations (FDC) of inhaled corticosteroid and long-acting beta-agonist (ICS/LABA). This study is a rapid review of the literature on: (a) factors associated with asthma control in the GCC countries and (b) generalisability of ICS/LABA FDC …

Objectives: Linaclotide and plecanatide are guanylate cyclase-C (GCC) agonists for the treatment of chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). Our objective is to evaluate the efficacy and tolerability of GCC agonists based on data from multiple randomized controlled trials (RCTs).The company expects the reductions to be completed this quarter. Sales of Linzess for the nine months ended Sept. 30, 2013, were $67.7 million. Linzess is a guanylate cyclase C ( GCC; GUCY2C) agonist. In addition to Linzess, Ironwood is developing IW-9179, a GCC agonist that is in Phase II testing to treat functional dyspepsia. At Sept. 30 ...One of the most common treatments for patients with a low platelet count, medically known as thrombocytopenia, is prescription glucocorticoids, immunosuppressive drugs or thrombopo...To study this aspect of functional relevance of GCC in the gut, we synthesized a 14–amino acid GCC agonist peptide STcore (STc), which contains the GCC binding/activating region of heat-stable enterotoxin 2 (STa2) and a peptide very similar to clinically used Lc (Supplemental Figure 1A; supplemental material available online with this article ...Compositions comprising a guanylyl cyclase C agonist formulated for intravenous delivery in an amount effective to suppress appetite when administered intravenously to an individual are also disclosed. Methods of suppressing appetite in an individual are disclosed.Guanylate cyclase-C (GCC) agonist: Linaclotide: Oral capsule: GCC agonist that acts on the luminal surface of intestinal epithelium. Intestinal fluid increases and GI transit time decreases. Increased extracellular cGMP may also decrease visceral pain by reducing pain‐sensing nerve activity. Treatment of CIC and IBS‐C in adults.

The effects of Escherichia coli heat-stable enterotoxin (ST) and uroguanylin were examined on the proliferation of T84 and Caco2 human colon carcinoma cells that express guanylyl cyclase C (GC-C) and SW480 human colon carcinoma cells that do not express this receptor. ST or uroguanylin inhibited pro …The aforementioned second strategy for developing a unimolecular GLP-1R/GcgR dual-agonist, which is the half-life protracted oxyntomodulin-based DualAG, demonstrates superior body weight and food intake reductions to that of a matched GLP-1R mono-agonist control (GLPAG) in WT mice [140]. The body weight lowering efficacy of DualAG is reliant on ...GCC agonist cyclic peptides can be prepared by methods known in the art. For example, macrocyclization is often accomplished by forming an amide bond between the peptide N- and C-termini, between a side chain and the N- or C-terminus [e.g., with K 3 Fe(CN) 6 at pH 8.5] (Samson et al., Endocrinology, 137: 5182-5185 (1996)), or between two amino ...2. Mechanism of action of GLP-1 hormone and its pleiotropic effects. Multiple organ dysfunction, with macrovascular and microvascular complications, represent an effect and also a perpetuating factor in diabetes, determining hyperglycemia due to insulin resistance, hence the systemic feature of this disease ().Hyperglycemia produces non …

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Dec 4, 2020 · Our data suggest that USP33 constitutively deubiquitinates the GCGR, whereas both STAMBP and USP33 deubiquitinate agonist-activated GCGRs at early endosomes. A mutant GCGR with all five intracellular lysines altered to arginines remains deubiquitinated and shows augmented trafficking to Rab4a recycling endosomes compared with the WT, thus ... Download scientific diagram | GCC and its downstream targets. (A) The domain structure of GCC. (B) Key proximal effectors activated by GCC in intestinal epithelial cells upon catalytic conversion ...This 14-amino-acid peptide is a first-in-class compound that acts as an agonist of human guanylate cyclase C (GC-C), a transmembrane protein located in intestinal epithelial cells. Activation of intestinal GC-C induces secretion of fluid, sodium and bicarbonate in the intestinal lumen.The purpose of this review is to provide an analysis of these trials. The GLP-1 RA head-to-head clinical studies have demonstrated that all GLP-1 RA agents are effective therapeutic options at reducing A1C. However, differences exist in terms of magnitude of effect on A1C and weight as well as frequency of adverse effects. Keywords: GLP-1 ...

Aug 3, 2022 · Guanylyl cyclase C is a receptor expressed in the intestinal tract, where it regulates fluid secretion and prevents tumor formation. Beyond its function in the healthy intestine, it is expressed in colorectal tumors, and other types of cancer, where it regulates transformation. The unimolecular GIP and GLP-1 receptor agonist tirzepatide (Mounjaro; Eli Lilly and Company, Indianapolis, IN, USA), which was approved by the US Food and Drug Administration on May 13, 2022, causes significant and clinically meaningful reductions in glycated haemoglobin A 1c (HbA 1c) and bodyweight, as well as improvements in …Clinical trials of GUCY2C (GCC) agonists for colorectal cancer prevention [abstract]. In: Proceedings of the Second Biennial NCI Meeting: Translational Advances in Cancer Prevention Agent Development (TACPAD); 2022 Sep 7-9.The transmembrane receptor guanylyl cyclase-C (GC-C), expressed on enterocytes along the intestine, is the molecular target of the GC-C agonist peptide linaclotide, an FDA-approved drug for treatment of adult patients with Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipatio …This Research Topic features a collection of 2 original research articles and 3 review articles that compile and disseminate recent evidence and knowledge regarding the therapeutic effects and the underlying mechanisms of these incretin agonists in the treatment of obesity. Exenatide, the first clinically used GLP-1 receptor agonist, has …Treatment with the GCC agonist plecanatide or with the PDE5 inhibitor sildenafil has recently been shown to suppress polyp multiplicity in inflammation-driven models of colon cancer in mice . To better understand the inhibitory mechanism, this study compared the two approaches to cGMP elevation in a noninflammatory model of …In honor of International Holocaust Remembrance Day, TikTok launched a portal on its Discover page this morning, intended to educate users about the historic catastrophe, as well a...There are currently seven approved GLP-1 receptor agonists ( Table 1 ); exenatide twice daily, lixisenatide once daily, liraglutide once daily, exenatide once weekly, dulaglutide once weekly, semaglutide once weekly, and oral semaglutide once daily. Of note, due to steady decline in sales, albiglutide (a once weekly GLP-1 RA) was discontinued ...

Here we discuss the mechanisms by which GC-C agonists target the GC-C/cyclic guanosine-3',5'-monophosphate (cGMP) pathway, resulting in visceral analgesia as well as clinically relevant relief of abdominal pain and other sensations in IBS patients. Due to the preponderance of evidence we focus on linaclotide, a 14-amino acid GC-C agonist with ...

Jul 1, 2023 · The GcgR (ant)agonist 1-N-α-trinitrophenylhistidine,12-homo-arginine)Glucagon (TH-Glucagon), despite evidence suggesting a lack of a GcgR-mediated cAMP response up to 1 μM stimulation, has shown considerable efficacy (40% of that of native glucagon) in stimulating glucose production and ureagenesis in isolated rat hepatocytes and guinea pigs ... May 27, 2020 · The studies supporting antidiabetic and weight-reducing actions of GIP and GIP co-agonists date back to an early study in rodents with a monomolecular GIP-GLP-1 co-agonist, which was found to both enhance glucose tolerance and to lower body weight . This was of cause unexpected since GIP in humans, as previously discussed, exerted opposite ... Background. Glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) are an established treatment for patients with type 2 diabetes (T2D). Differences between GLP‐1RAs in pharmacokinetics, dosing regimens and clinical effects, including cardiovascular (CV) outcomes, mean there may be benefits to switching from one to …Summary. Guanylyl cyclase C (GCC) is the receptor expressed by intestinal cells for the paracrine hormones guanylin and uroguanylin that coordinate mucosal homeostasis and its silencing contributes to intestinal transformation. It orchestrates proliferative and metabolic circuits by limiting the cell cycle and programming metabolic transitions ...GLP-1 RAs may be a suitable alternative for patients who are overweight or obese. ASCVD indicates atherosclerotic cardiovascular disease; CKD, chronic kidney disease; GLP-1 RA, glucagon-like peptide-1 receptor agonist; HF, heart failure; SGLT-2i, sodium glucose cotransporter type 2 inhibitor; and T2DM, type 2 diabetes mellitus.Co-stimulatory receptors mediate the anticancer immune response. This Review discusses the current efforts in targeting co-stimulatory receptors with agonist antibodies and the landscape of ...Sep 7, 2018 ... Brown, R. L., Kazan, K., McGrath, K. C., Maclean, D. J. & Manners, J. M. A role for the GCC-box in jasmonate-mediated activation of the PDF1.

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A guanylate cyclase-C agonist used to treat different types of constipation, such as irritable bowel syndrome-related constipation, idiopathic constipation, and functional constipation. Dolcanatide: Dolcanatide has been investigated in Exposure. PraliciguatThe transmembrane receptor guanylyl cyclase‐C (GC ‐C), expressed on enterocytes along the intestine, is the molecular target of the GC ‐C agonist peptide linaclotide, an FDA ‐approved drug for treatment of adult patients with Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation.GLP-1 RAs may be a suitable alternative for patients who are overweight or obese. ASCVD indicates atherosclerotic cardiovascular disease; CKD, chronic kidney disease; GLP-1 RA, glucagon-like peptide-1 receptor agonist; HF, heart failure; SGLT-2i, sodium glucose cotransporter type 2 inhibitor; and T2DM, type 2 diabetes mellitus.Abstract. Agonists of the transmembrane intestinal receptor guanylyl cyclase C (GCC) have recently attracted interest as promising human therapeutics. …This early phase I trial studies the guanylyl cyclase C (GCC) agonist effect on cGMP signal in duodenal tissue. Plecanatide and linaclotide are drugs approved by the Food and Drug … Objectives: Linaclotide and plecanatide are guanylate cyclase-C (GCC) agonists for the treatment of chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). Our objective is to evaluate the efficacy and tolerability of GCC agonists based on data from multiple randomized controlled trials (RCTs). 742. Overall, Kristensen and colleagues’ updated meta-analysis nicely synthesises the data from all the major GLP-1 receptor agonist cardiovascular outcome trials reported so far, providing novel insights into these important data. However, many questions remain to be answered, especially regarding benefit in primary prevention patients.Linaclotide and plecanatide are synthetic peptide agonists of guanylate cyclase-C (GC-C), a transmembrane receptor that is predominantly located on intestinal epithelial cells. These medications have very low oral bioavailability, which, when combined with the expression profile of GC-C, provides a mechanism of action ‘targeted to the gut’.Guanylate cyclase-C (GCC) agonist: Linaclotide: Oral capsule: GCC agonist that acts on the luminal surface of intestinal epithelium. Intestinal fluid increases and GI transit time decreases. Increased extracellular cGMP may also decrease visceral pain by reducing pain‐sensing nerve activity. Treatment of CIC and IBS‐C in adults. ….

Agonists of the transmembrane intestinal receptor guanylyl cyclase C (GCC) have recently attracted interest as promising human therapeutics. Peptide ligands that can specifically induce GCC signaling in the intestine include endogenous hormones guanylin and uroguanylin, diarrheagenic bacterial enterotoxins (ST), and synthetic drugs linaclotide ...Mar 21, 2018 ... Agonist binding to the extracellular domain of GC-C activates ... 50 As a GC-C agonist, lina- ... Loss of guanylyl cyclase C (GCC) signaling leads ...Feb 8, 2017 · Respondents found guanylyl cyclase C (GCC) agonist most satisfying when treating their patients. Among the 69% of respondents who were aware of published guidelines, only 50% found them helpful in ... Here we discuss the mechanisms by which GC-C agonists target the GC-C/cyclic guanosine-3’,5’-monophosphatec (GMP) pathway, resulting in visceral analgesia as well … Treatment of Apc Min/+ mice with the receptor guanylyl-cyclase C (GCC) agonist linaclotide, or the phosphodiesterase-5 (PDE5) inhibitor sildenafil, significantly reduced the number of polyps per mouse (67% and 50%, respectively). Neither of the drugs affected mean polyp size, or the rates of apoptosis and proliferation. Agonists of the transmembrane intestinal receptor guanylyl cyclase C (GCC) have recently attracted interest as promising human therapeutics. Peptide ligands that can specifically induce GCC ...responsible for travelers’ diarrhea, is a guanylate cyclase C (GC-C) receptor agonist that results in water and elec-trolyte secretion and diarrhea. The GC-C receptor is a …Guanylyl cyclase C, GUCY2C, is a transmembrane receptor predominantly expressed apically on intestinal crypt and villus cells . The endogenous hormone ligands uroguanylin and guanylin are synthesized as propeptides by secretory epithelial cells and processed into biologically active 16-mer (uroguanylin), or 15-mer (guanylin), peptides [ 28 ... Gcc agonist, The first synthetic GCC agonist entering the clinic has been linaclotide (Ironwood Pharmaceuticals Inc, Boston, MA, USA and Forest Laboratories Inc, New York, NY, USA), an ST analog cyclopeptide of 14 amino acids (Figure 1) which increases intestinal motility and fluid secretion, while decreasing visceral pain in preclinical models., Liraglutide, a GLP-1 receptor agonist, is now approved for the treatment of obesity in patients without type 2 diabetes. New GLP-1/GIP agonists show even greater reductions in hemoglobin A1c and weight. 10. Tirzepatide is a dual GLP-1/GIP agonist that shows real promise for the treatment of diabetes and weight in patients with type 2 diabetes. 10., The GLP‐1R/GIPR dual agonist NNC 0090‐2746 (Novo Nordisk) significantly improved hemoglobin A1c (A1c) in T2DM (a reduction of −0.96% vs placebo) over a 12-week period, accompanied by a reduction in body weight. 23 When compared with liraglutide, the same agent reduced A1c by an equivalent amount but led to a …, Take Me to Church The Agonist. 2. Thank You, Pain The Agonist. 3. Danse Macabre The Agonist. 4. Business Suits and Combat Boots. 6. The Tempest (The Siren's Song, The Banshee's Cry) The Agonist., Anti-CD3: the agonist and the ecstasy. Studies published in the 1960s and 1970s began to solidify the concept that human type 1 diabetes (T1D) is an autoimmune disease ( Milestone 2 ). This was an ..., Our data suggest that USP33 constitutively deubiquitinates the GCGR, whereas both STAMBP and USP33 deubiquitinate agonist-activated GCGRs at early endosomes. A mutant GCGR with all five intracellular lysines altered to arginines remains deubiquitinated and shows augmented trafficking to Rab4a recycling endosomes compared with the WT, thus ..., Results: Optimized triagonists normalize body weight in DIO mice and enhance energy expenditure in a manner superior to that of GLP-1R mono-agonists and GLP-1R/GIPR co-agonists. Conclusions: These pre-clinical data suggest unimolecular poly-pharmacology as an effective means to target multiple mechanisms contributing to obesity and further ..., What are Guanylate cyclase-C agonists? Guanylate cyclase-C agonists are used to treat irritable bowel syndrome with constipation and chronic constipation of unknown cause (idiopathic constipation). They work by increasing intestinal fluid secretion, which can soften stools and stimulate bowel movements., Between Dec 18, 2019, and Dec 28, 2020, 210 people were screened, of whom 72 were enrolled, received at least one dose of study drug, and were included in safety analyses. 15 participants had placebo, five had dulaglutide 1·5 mg and, for LY3437943, nine had 0·5 mg, nine had 1·5 mg, 11 had 3 mg, 11 had 3/6 mg, and 12 had 3/6/9/12 mg. 29 participants discontinued the study prematurely., GCC Agonist Signal in the Small Intestine October 12, 2023 updated by: National Cancer Institute (NCI) Pilot Study of GCC Agonists to Identify a Cyclic-GMP Signal in Duodenal Tissue of Volunteers. This early phase I trial studies the guanylyl cyclase C (GCC) agonist effect on cGMP signal in duodenal tissue., Despite recent clinical success with the GCC-agonist Linzess® (linaclotide) in treating constipation, few studies have examined the effect of these agents in colitis or colon cancer models. In addition, a paucity of work focusing on the effects of cGMP elevating agents in wild type mice have left signaling downstream of cGMP and the …, Guanylate cyclase-C agonists as peripherally acting treatments of chronic visceral pain. Trends Pharmacol Sci. 2022 Feb;43 (2):110-122. doi: 10.1016/j.tips.2021.11.002. Epub …, The invention provides low-dose formulations of guanylate cyclase-C ("GCC") agonist peptides and methods for their use. The formulations of the invention can be administered either alone or in combination with one or more additional therapeutic agents, preferably an inhibitor of cGMP-dependent phosphodiesterase or a laxative., Linaclotide is a potent agonist of the guanylyl cyclase C (GC-C) receptor, which is located on the luminal surface of intestinal epithelial cells (ICE) throughout the gut mucosa (Li and Goy 1993). This first-in-class synthetic GC-C agonist is composed of a 14 amino acid peptide that is converted in vivo by carboxypeptidase A into a 13 amino ..., Guanylyl cyclase C, GUCY2C, is a transmembrane receptor predominantly expressed apically on intestinal crypt and villus cells . The endogenous hormone ligands uroguanylin and guanylin are synthesized as propeptides by secretory epithelial cells and processed into biologically active 16-mer (uroguanylin), or 15-mer (guanylin), peptides [ 28 ... , conjugates (ADCs) by conjugating a STING agonist through a cleavable linker to anti-bodies targeting tumor cells. Systemic administration of these ADCs was well tolerated and exhibited potent antitumor efficacy in syngeneic mouse tumor models. The STING ADC further synergized with an anti-PD-L1 antibody to achieve superior …, The primary agonist muscles used during a shoulder press are the anterior deltoids and the triceps brachii, while the primary antagonist muscles are the latissimus dorsi and the bi..., GC-C or guanylate cyclase-C agonists are used to treat irritable bowel syndrome and chronic constipation. They work by increasing an enzyme in the lining of the intestine, which in turn helps speed up transit through the intestine and reduce intestinal pain. Why are gc-c agonists prescribed? Constipation (56%) Irritable Bowel Syndrome (44%), Guanylate cyclase-C (GCC) agonist: Linaclotide: Oral capsule: GCC agonist that acts on the luminal surface of intestinal epithelium. Intestinal fluid increases and GI transit time decreases. Increased extracellular cGMP may also decrease visceral pain by reducing pain‐sensing nerve activity. Treatment of CIC and IBS‐C in adults., GCC agonist - stimulates secretion of chloride and bicab into the intestine which results in increased fluid and accelerated GI transit. How it Linzess taken? one capsule by mouth daily; 30 minutes before first meal of the day. Amitiza (Lubiprostone) mechanism., Here we discuss the mechanisms by which GC-C agonists target the GC-C/cyclic guanosine-3',5'-monophosphate (cGMP) pathway, resulting in visceral analgesia as well as clinically relevant relief of abdominal pain and other sensations in IBS patients. Due to the preponderance of evidence we focus on linaclotide, a 14-amino acid GC-C agonist with ..., 2) Agents that target multiple symptoms in IBS-C are linaclotide and plecanatide (guanylate cyclase-C [GCC] agonists) or lubiprostone (a chloride channel activator). Plecanatide binding to GCC receptors is pH-dependent, which is why its activity is mostly confined to the proximal small intestine., Glucocorticoids (or, less commonly, glucocorticosteroids) are a class of corticosteroids, which are a class of steroid hormones.Glucocorticoids are corticosteroids that bind to the glucocorticoid receptor that is present in almost every vertebrate animal cell. The name "glucocorticoid" is a portmanteau (glucose + cortex + steroid) and is composed from its …, GCC mutations are linked to obstructed bowel or MI and diarrhea in similar populations (10, 11). Also, the secretory impetus of GCC agonist (linaclotide, Lc) in the …, The company expects the reductions to be completed this quarter. Sales of Linzess for the nine months ended Sept. 30, 2013, were $67.7 million. Linzess is a guanylate cyclase C ( GCC; GUCY2C) agonist. In addition to Linzess, Ironwood is developing IW-9179, a GCC agonist that is in Phase II testing to treat functional dyspepsia. At Sept. 30 ..., Indices Commodities Currencies Stocks, Jun 29, 2022 · Keywords: cGMP (cyclic GMP), guanylyl cyclase C, guanylyl cyclase C agonists, intestine, colorectal cancer type Introduction Beginning in the 1970s, over a decade of research aimed at identifying the receptor for Escherichia coli heat-stable enterotoxin (ST) in intestinal epithelial cells led to the cloning and characterization of the receptor ... , Also, the secretory impetus of GCC agonist (linaclotide, Lc) in the intestine is clinically exploited to alleviate constipation in irritable bowel syndrome (IBS) patients (12, 13). F508del, the most common CF-causing mutation in CFTR, generates a pronounced processing defect and ER retention, transitioning it to a proteosomal degradation …, The early GLP-1R agonist has many defects, such as multiple injections and a high incidence of adverse reactions in the digestive tract, which limits its clinical application. PEX-168 is a new agent of long-acting GLP-1R agonist, which is molecularly modified from EX via amino acid modification and PEGylation ( 119 ), the first GLP-1R …, Sep 13, 2023 ... They share a high degree of sequence homology but have different functionalities. Unimolecular dual agonists of both receptors developed ..., The first GLP-1R agonist approved by the US Food and Drug Administration (FDA) for the treatment of T2D was exenatide in 2005, followed by others like liraglutide (2010), dulaglutide (2014 ..., Since 37.5 mg/kg of the LA-Agonist (equivalent to 239.5 nmol/kg LA-Agonist) is a supra-pharmacological dose, we confirmed that both DA-GIP and the peptide portion of the LA-Agonist both at 250 ..., The aforementioned second strategy for developing a unimolecular GLP-1R/GcgR dual-agonist, which is the half-life protracted oxyntomodulin-based DualAG, demonstrates superior body weight and food intake reductions to that of a matched GLP-1R mono-agonist control (GLPAG) in WT mice [140]. The body weight lowering efficacy of DualAG is reliant on ...