From the Guidelines
Incretins, specifically GLP-1 receptor agonists, reduce inflammation through multiple mechanisms, including inhibition of pro-inflammatory cytokines and modulation of immune cell function, as demonstrated in the most recent and highest quality study by 1. The anti-inflammatory effects of GLP-1 receptor agonists, such as liraglutide, semaglutide, and exenatide, have been shown to decrease markers of inflammation, including C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6), in patients with type 2 diabetes and other inflammatory conditions. Some key points about the anti-inflammatory effects of incretins include:
- The anti-inflammatory effects occur through direct activation of GLP-1 receptors on immune cells and indirect effects via improved glycemic control and weight reduction.
- Typical therapeutic doses of GLP-1 receptor agonists have shown these anti-inflammatory benefits within 3-6 months of treatment.
- DPP-4 inhibitors, such as sitagliptin and saxagliptin, also demonstrate modest anti-inflammatory effects by increasing endogenous incretin levels.
- The most recent study 1 highlights the benefits of GLP-1 receptor agonists in reducing albuminuria and slowing eGFR decline, which may contribute to their cardiovascular and renal protective effects.
- The study also notes that GLP-1 receptor agonists, such as liraglutide, semaglutide, and dulaglutide, are preferred agents due to their demonstrated cardiovascular and CKD benefits. Overall, the evidence suggests that incretins, particularly GLP-1 receptor agonists, have anti-inflammatory properties that may contribute to their therapeutic benefits in patients with type 2 diabetes and other inflammatory conditions, as supported by the most recent and highest quality study 1.
From the Research
Incretins and Inflammation Reduction
- Incretins, such as GLP-1 receptor agonists, have been shown to have anti-inflammatory effects 2.
- These effects are thought to be mediated by the reduction of neuroinflammation, promotion of nerve growth, and improvement of heart function 2.
- GLP-1 receptor agonists have also been found to have cardiovascular protective effects, which may be related to their anti-inflammatory properties 3, 4.
Studies Demonstrating Inflammation Reduction
- A study published in 2021 found that GLP-1 receptor agonists have multiple biological effects, including reducing neuroinflammation and promoting nerve growth 2.
- Another study published in 2022 found that semaglutide, a GLP-1 receptor agonist, has cardiovascular benefits and can reduce various CV risk factors in patients with established CV disorders 4.
- A pooled analysis of two trials found that semaglutide and liraglutide, both GLP-1 receptor agonists, had kidney-protective effects in patients with type 2 diabetes, which may be related to their anti-inflammatory properties 5.
Mechanisms of Action
- GLP-1 receptor agonists work by augmenting hyperglycemia-induced insulin secretion, suppressing glucagon secretion, decelerating gastric emptying, and reducing calorie intake and body weight 3.
- They also have effects on the nervous, cardiovascular, and endocrine systems, and may have anti-tumorigenic effects 2, 6.
- The exact mechanisms by which GLP-1 receptor agonists reduce inflammation are not fully understood, but may involve the reduction of pro-inflammatory cytokines and the promotion of anti-inflammatory pathways 2.