GLP-1 5mg

▎ Kūlana GLP-1

▎ ʻImi GLP-1

He aha ke kumu noiʻi o GLP-1?

ʻO GLP-1 kahi kanaka glucagon-like peptide-1 (GLP-1) analogue, nona ka papa o nā lāʻau agonist receptor GLP-1. ʻO GLP-1 kahi hormone kūlohelohe maoli i hūnā ʻia e nā ʻōpū o ka ʻōpū ma hope o ka ʻai ʻana, e hoʻoikaika ana i ka huna ʻana o ka insulin a kāohi i ka huna ʻana o ka glucagon e hoʻoponopono i nā pae glucose koko. Hoʻokumu ʻia ka hoʻomohala ʻana o GLP-1 mai ka noiʻi hohonu e pili ana i nā hana physiological o GLP-1. He pōkole ka hapalua o ke ola o GLP-1 i loko o ke kino, ma kahi o 1-2 mau minuke, no ka mea, ua maʻalahi ka hoʻohaʻahaʻa ʻia e nā enzymes dipeptidyl peptidase-4 (DPP-4) i ke kino. No ka lanakila ʻana i kēia palena, ua hoʻololi nā ʻepekema i ke ʻano o ka GLP-1, e hoʻolauna ana i nā hoʻololi o ka waikawa amino kikoʻī a me ka hoʻohui ʻana i nā pūʻulu pale e hoʻoikaika i kona kūʻē ʻana i nā enzyme DPP-4, a laila e hoʻolōʻihi i ka lōʻihi o ka hana i loko o ke kino ^[1] . I ke ʻano o GLP-1, ua hoʻololi ʻia ka alanine ma ke kūlana 8 e ka α-aminoisobutyric acid (Aib), ʻaʻole ia e hoʻomaikaʻi wale i ka paʻa o ka lāʻau akā hoʻonui pū i kona ikaika paʻa me nā mea hoʻokipa GLP-1 ^[2] . Hoʻohui ʻia kahi kaulahao ʻaoʻao momona momona i ka C-terminus o GLP-1, i hoʻopili ʻia i kahi koena lysine ma o γ-glutamine, e hoʻonui hou i ka hapalua o ke ola o ka lāʻau a ʻae ʻia e hoʻopaʻa ʻia i hoʻokahi pule i ka pule a i ʻole lawe waha ʻia i hoʻokahi lā ^[1] . Ua hoʻokumu mua ʻia ʻo GLP-1 ma muli o ka noiʻi a me ka hoʻololi ʻana o ka GLP-1 kūlohelohe, e manaʻo ana e hāʻawi i kahi lapaʻau ʻoi aku ka maikaʻi no nā poʻe maʻi me ka maʻi diabetes type 2 ^{[1, 2]} . Ma o kēia mau optimizations structural, ʻaʻole mālama wale ʻo GLP-1 i ka hana physiological o GLP-1 akā hoʻomaikaʻi nui hoʻi i kāna mau waiwai pharmacokinetic, a lilo i agonist receptor GLP-1 lōʻihi o ka waiwai koʻikoʻi koʻikoʻi. ʻO ka hoʻomohala ʻana o GLP-1 he mea koʻikoʻi koʻikoʻi, e lawe mai ana i nā koho lapaʻau hou no nā maʻi me ka maʻi diabetes type 2. Ma ka hoʻonui ʻana i ke ʻano o ka GLP-1 maoli, ua lanakila ʻo ia i ka palena o kona hapalua ola pōkole a hoʻomaikaʻi i ka paʻa o ka lāʻau a me ka lōʻihi o ka hana.

He aha ke ʻano o ka hana a GLP-1?

ʻO GLP-1 kahi glucagon-like peptide-1 (GLP-1) receptor agonist lōʻihi, a ua hoʻokō nui ʻia kāna ʻano hana ma o nā ʻano aʻe:

Hoʻoponopono i ka glucose koko:

ʻO GLP-1 kahi mea hou GLP-1 receptor agonist (GLP-1RA). ʻO kāna hana mua ʻo ia ka pale ʻana i ka makemake meaʻai ma ke kāohi ʻana i ka ʻai, e hōʻemi ana i ka makemake no nā meaʻai momona momona, a me ka hoʻololi ʻana i ke kikowaena hānai hypothalamic e hoʻemi i ka ʻai ʻana i ka meaʻai. Hoʻonui ia i ka māʻona, hoʻopaneʻe i ka hoʻokuʻu ʻana o ka ʻōpū, a hoʻemi i ka motility o ka ʻōpū, a laila e loaʻa ai ka pohō kaumaha. Hoʻonui kēia hoʻemi kaumaha i ka ʻike insulin a kōkua i ka hoʻoponopono ʻana i nā pae glucose koko ^[3] . Hoʻoulu ʻo GLP-1 i ka pohō kaumaha o nā rodents ma o nā ala neural puʻupuʻu. Hōʻike nā haʻawina e hana ia ma ka lolo, ka nucleus septal, a me ka hypothalamus akā ʻaʻole ia e hele i ka pale koko-lolo. Akā, pili ia me ka lolo ma o nā ʻāpana circumventricular a me nā wahi ventricular-proximal. Hoʻoikaika ʻo GLP-1 i nā c-Fos ma nā ʻāpana lolo he ʻumi, me nā wahi hindbrain i kuhikuhi pololei ʻia a me nā ʻāpana lua e like me ka nucleus parabrachial lateral me ka ʻole o ka pilina GLP-1R. Hōʻike nā loiloi aunoa i ka hoʻoulu ʻana e pili ana i nā neurons parabrachial nucleus lateral e kāohi ana i ka hoʻopau ʻana i ka meaʻai, pēlā e hoʻoponopono ai i ka glucose koko ^[4] .

Hoʻoponopono ʻana i ka ʻōpū:

Hana ʻo GLP-1 i nā mea loaʻa GLP-1 i loko o ka ʻōpū, me ka hoʻohana ʻana i ke ala nerve vagus e hoʻololi i ka motility gastrointestinal. Hoʻopaʻa ia i nā ʻokiʻoki antral, hoʻoikaika i ka ʻāʻī o ka sphincter pyloric, a hoʻolōʻihi i ka mālama ʻana i ka meaʻai o ka ʻōpū, hoʻopaneʻe i ke komo ʻana o ka duodenal a pale i ka piʻi ʻana o ka glucose koko postprandial, e alakaʻi ana i nā pae paʻa ^[5] . Hoʻohui ʻia, pili ka GLP-1 i nā mea loaʻa GLP-1 kikowaena, ʻoi loa i ka hypothalamic arcuate a me ka paraventricular nuclei. Hoʻopili ia i nā mea hoʻoulu ʻai e like me ka neuropeptide Y (NPY) a me ka agouti-related protein (AgRP), ʻoiai e hoʻāla ana i nā neurons proopiomelanocortin (POMC) e hoʻoikaika i ka alpha-melanocyte-stimulating hormone (α-MSH) huna ^[5] . Hoʻoulu kēia mau hana i ka māʻona, hoʻemi i ka pōloli, a hoʻemi i ka ʻai ʻana i ka meaʻai, kōkua i ka mālama ʻana i ke kaumaha a hoʻomaikaʻi pololei ʻole i ka mana glucose koko.

Ka mālama ʻana i ka maʻi cardiovascular:

Hoʻolaha ʻo GLP-1 i ka hoʻokuʻu ʻana o ka nitric oxide (NO) a me nā mea vasodilator ʻē aʻe mai nā pūnaewele endothelial vascular, hoʻonui i ka vasodilation a me ke kahe koko. Hoʻopaʻa pū ia i ka mumū a me ke kaumaha oxidative, e hōʻemi ana i ka pōʻino endothelial a me ka pilikia atherosclerosis. Ma ke kāohi ʻana i ka ʻai a me ka ʻai ʻana i ka meaʻai, kōkua ia i ka pohō kaumaha, hoʻomaikaʻi i ka maʻi diabetes lipid, hoʻohaʻahaʻa i nā triglycerides a me ka lipoprotein cholesterol haʻahaʻa (LDL-C), a hoʻonui i ka cholesterol lipoprotein kiʻekiʻe (HDL-C). Eia kekahi, hiki ke hoʻopōmaikaʻi i ke koko ma o ka hoʻololi ʻana i ka hemodynamics renal a me ka hana neuroendocrine, hoʻohaʻahaʻa i ka maʻi hypertension a me ka hōʻemi ʻana i nā kumu pilikia o ka maʻi cardiovascular ^[6] .

ʻO GLP-1 a me ka hoʻoponopono transcriptional o WAT i ka hoʻololi ʻana o BAT a me ka hoʻoulu ʻana o BAT.

Puna: PubMed ^[13]

Nā hoʻokolohua koʻikoʻi a me ka noiʻi

I ka ʻōlelo o ka hoʻolālā hoʻolālā kemika a me ka optimization, i ka wā o ka hoʻolālā ʻana o GLP-1, ua hoʻohana ʻia kahi ala o ka hoʻopaʻa ʻana i ka albumin e hoʻolōʻihi i ka lōʻihi o ka hana o ka lāʻau. Ma ka hoʻoholo ʻana i ka hui maikaʻi loa o nā ʻakika momona a me nā loulou, ua hoʻonui ʻia ka hiki ke hoʻopaʻa i ka albumin i ka wā e mālama ana i ka pono ma ka GLP-1 receptor (GLP-1R) (Knudsen LB, 2019).

Ma ke ʻano o ka hoʻohana ʻana i ka lāʻau lapaʻau, ʻoi aku ka maikaʻi o ka hopena o ka pohō kaumaha o GLP-1. ʻO GLP-1 he glucagon-like peptide-1 receptor agonist (GLP-1 RA) me ka lōʻihi o ka hoʻopau ʻana i ka hapalua o ke ola, e ʻae ana i ka hoʻokele subcutaneous i kēlā me kēia pule. He mea kupaianaha kona hopena kaumaha. I nā poʻe maʻi me ka maʻi diabetes type 2 (T2DM), ʻoi aku ka maikaʻi o ka hoʻokele subcutaneous o GLP-1 i kēlā me kēia pule no ka pohō kaumaha ma mua o nā GLP-1RA i kēlā me kēia pule. I ka hoʻāʻo ʻana o ka loaʻa ʻana o ka dosis II no nā maʻi obese me ka ʻole o T2DM, ʻoi aku ka maikaʻi o ka hoʻokele subcutaneous o GLP-1 i hoʻokahi lā i kēlā me kēia lā ma mua o ka placebo a me 3.0mg liraglutide i kēlā me kēia lā. ʻO ka pohō kaumaha i hoʻokumu ʻia e GLP-1 ma kēia noiʻi ua ʻoi aku ma mua o ka maʻamau no nā lāʻau anti-obesity i hoʻonohonoho ʻia e ka European Medicines Agency (EMA) a me ka US Food and Drug Administration (FDA), me ka ʻole o nā pilikia palekana, e hōʻike ana i kēlā me kēia lā subcutaneous injection o GLP-1 hiki ke lilo i lāʻau hoʻemi kaumaha e hiki mai ana ^[7] .

Hiki i ka GLP-1 ke hoʻomaikaʻi i ka hana naʻau a hoʻohana ʻia no ka mālama ʻana i nā maʻi cardiovascular. Ua hoʻolaha ʻia nā hopena o ka hoʻāʻo STEP-HFpEF, kahi antidiabetic glucagon-like peptide 1 agonist GLP-1 i hoʻomaikaʻi nui i nā hōʻailona o ka pau ʻole o ka naʻau me ka haʻihaʻi ejection mālama ʻia (HFpEF) a hoʻemi i nā pae N-terminal pro-B-type natriuretic peptide (NT-proBNP). Ua hoʻāʻo ka haʻawina i ka hopena o ka mālama ʻana i ka GLP-1 ma luna o ka trabeculae kanaka pono a ʻike ʻia ua hoʻonui ʻo GLP-1 i ka hoʻopaʻapaʻa o ke kanaka atrial trabeculae ma mua o ʻekolu mau manawa ma ke ʻano i hilinaʻi ʻia, me ka hoʻonui ʻole ʻana i ke ʻano o ka arrhythmias. Loaʻa paha kēia hopena ma muli o ka hoʻonui ʻana i ka sarcoplasmic reticulum Ca2+ uptake. ʻO ka mālama ʻana i ka GLP-1 kiʻekiʻe i ka poʻe maʻi hōʻeha puʻuwai hiki ke hoʻomaikaʻi i ka hana atrial a no laila e hoʻēmi i nā hōʻailona ^[8] .

Ke aʻo ʻia nei ka GLP-1 no ka mālama ʻana i ka steatohepatitis non-alcoholic (NASH). Ua hāʻawi nui kāna hoʻolālā noʻonoʻo i ka hoʻomaikaʻi ʻana i ka mana glucose koko, ke kaumaha, ke koko, nā lipids, ka hana β-cell, a me ka ʻōnaehana cardiovascular i nā maʻi me ka maʻi diabetes type 2. Eia kekahi, ʻo ka hoʻomohala ʻana i kahi hoʻopuka waha o GLP-1 hiki ke hāʻawi i nā pono hou aku i nā mea maʻi e pili ana i ka mālama ʻana i ka mālama ʻana ^[9] .

Nā ʻokoʻa i nā hopena hoʻemi kaumaha o GLP-1 ma waena o nā lehulehu

Nā hopena hoʻemi kaumaha i nā mākua me ka maʻi maʻi cardiovascular e kū nei, ke kaumaha nui a i ʻole ka momona me ka maʻi diabetes: 

I ka SELECT cardiovascular results trial, GLP-1 i hoemi nui adverse cardiovascular hanana (MACE) e 20% i loko o 17,604 kanaka makua i loaʻa ka maʻi cardiovascular, overweight a obesity, a me ka diabetes ^[10] . I loko o kēia loiloi i ho'ākāka mua ʻia, ua nānā nā mea noiʻi i nā hopena o ka GLP-1 ma ke kaumaha, nā hopena anthropometric, palekana, a me ka hoʻomanawanui e ka baseline body mass index (BMI). ʻO nā poʻe maʻi e loaʻa ana i ka GLP-1 ua loaʻa i ka pohō kaumaha ma mua o 65 mau pule, e hoʻomau ana a hiki i 4 mau makahiki. Ma nā pule he 208, ua alakaʻi ʻo GLP-1 i ka emi ʻana o ke kaumaha (-10.2%), ka ʻapo o ka pūhaka (-7.7 cm), a me ka ratio pūhaka-a-kiʻekiʻe (-6.9%) i hoʻohālikelike ʻia me ka placebo (-1.5%, -1.3 cm, a me -1.0%; ʻO nā ʻano kino kino, a me nā ʻāpana o GLP-1 i pili me ka liʻiliʻi o nā hanana koʻikoʻi koʻikoʻi No kēlā me kēia ʻano BMI (<30, 30 a <35, 35 a <40, a me ≥40 kg/m²), he haʻahaʻa haʻahaʻa ko GLP-1 (nā hanana i kēlā me kēia 100 kanaka-makahiki: 43.4,7,43,43,43,43. vs. 50.48, 49.66, 52.73, a me 60.85 no ka placebo).

Nā hopena hoʻemi kaumaha i ka poʻe obese a i ʻole ke kaumaha me ka maʻi diabetes:  

Ua loiloi ʻia kahi loiloi ʻōnaehana i ka maikaʻi a me ka palekana o GLP-1 i nā poʻe momona a momona ʻole me ka maʻi diabetes ^[11] . Hoʻopili kēia loiloi i nā hopena mai nā hoʻokolohua lapaʻau he nui, e hōʻike ana i ka hopena o GLP-1 i ka pohō kaumaha, nā ʻāpana metabolic, a me nā hopena olakino holoʻokoʻa. Ua hōʻike ʻia nā ʻike i pili ʻia ʻo GLP-1 me ka nui o ka pohō kaumaha a me ka hoʻomaikaʻi ʻana i nā metric olakino pili i ka momona, e hōʻike ana i kona hiki ke lilo i koho lapaʻau koʻikoʻi no nā maʻi obese. 

Nā hopena o ke kaumaha i nā maʻi maʻi maʻi ʻole (nā hōʻike mai nā RCT he nui): 

Eha randomized controlled trials (RCTs) e pili ana i ka poʻe maʻi me ka baseline paona o 96-105 kg i loiloi ʻia i kēlā me kēia pule 2.4 mg subcutaneous GLP-1 me nā hana o ke ola (aʻoaʻo, ʻai, hana kino) no ka pohō kaumaha ^[12] . Hoʻokahi RCT i loko o nā maʻi maʻi maʻi ʻole (N = 1,961) i hōʻike i ke kaumaha o ke kaumaha o 15% (15 kg) vs. 2% (3 kg) me kahi placebo ma hope o 68 mau pule (he nui ka helu helu). ʻO ka hapa o nā maʻi e loaʻa ana i ka ≥5% ka pohō kaumaha he 86% vs. 32% (helu e pono ai e mālama i [NNT] = 2), a me ≥10% pohō kaumaha he 69% vs. 12% (NNT = 2). Hoʻemi ʻia ke kaumaha ma ~60 pule. Loaʻa nā hanana ʻino (AEs) i ka 74% vs. 48% (helu pono e hōʻeha [NNH] = 3). ʻO ka hoʻopau ʻana ma muli o nā AE he 7% vs. 3% (NNH = 25). Uaʻikeʻia nā hopena like ma kekahi RCT me ka hana ola kino (N = 611): GLP-1 i hoʻokomo i ka 16% (17 kg) vs. 6% (6 kg) ke kaumaha kaumaha. I loko o kahi RCT no ka ʻimi ʻana i nā maʻi maʻi ʻole (N = 1,210), 2.4 mg GLP-1 i kēlā me kēia pule, 1.0 mg GLP-1, a i ʻole placebo i hāʻawi ʻia i nā poho kaumaha o 10%, 7%, a me 3% ma hope o 68 pule. ʻO 69% (2.4 mg), 57% (1.0 mg), a me 29% (placebo) ka nui o ka loaʻa ʻana o ≥5% pohō kaumaha. No ka 2.4 mg vs. 1.0 mg, NNT = 9. Ua like nā kiʻi AE ma waena o nā doses. Ma kahi RCT mālama paona (N = 803), ua loaʻa i nā poʻe maʻi maʻi ʻole he 2.4 mg GLP-1 i kēlā me kēia pule no 20 mau pule, a laila ua koho ʻia e hoʻomau i ka GLP-1 a i ʻole e hoʻololi i kahi placebo. Ma hope o 48 pule, hoʻomau nā mea hoʻohana GLP-1 ua nalowale 8% vs. placebo mea hoʻohana i loaʻa 7%. 

I ka hōʻuluʻulu ʻana, ʻo GLP-1 kahi agonist receptor GLP-1 me ka waiwai noiʻi multi-domain. I ka mālama ʻana i ka maʻi diabetes, hoʻopaʻa ʻo ia i nā mea loaʻa GLP-1 e hoʻoikaika i ka huna ʻana o ka insulin a keʻakeʻa i ka hoʻokuʻu ʻana o ka glucagon, ka mālama pono ʻana i nā pae glucose koko a hāʻawi i kahi koho lapaʻau koʻikoʻi no nā poʻe maʻi me ka maʻi diabetes type 2. Ma ke kahua o ka mālama ʻana i ka momona, hiki i ka GLP-1 ke hōʻemi nui i ka lawe ʻana i ka ikehu ma o nā hana e like me ka hoʻopau ʻana i ka ʻai waena a me ka hoʻopaneʻe ʻana o ka ʻōpū, e kōkua ana i ka poʻe maʻi obese e lilo ke kaumaha a hoʻomaikaʻi i ko lākou kūlana metabolic. Hoʻohui ʻia, hōʻike ʻo GLP-1 i nā manaʻo noi no ka pale ʻana a me ka mālama ʻana i nā maʻi cardiovascular, a ʻo kāna hoʻomaikaʻi ʻana i nā kumu pilikia cardiovascular e hāʻawi i kahi ala hou e hōʻemi ai i ka hanana o nā hanana cardiovascular. ʻAʻole hoʻonui wale ka puka ʻana o GLP-1 i nā ala lapaʻau no nā maʻi pili akā lawe pū kekahi i ka manaʻolana hou no ka hoʻomaikaʻi ʻana i ka maikaʻi o ke ola a me ke olakino.

No ka mea kakau

ʻO nā mea i ʻōlelo ʻia ma luna nei ua noiʻi ʻia, hoʻoponopono ʻia a hōʻuluʻulu ʻia e Cocer Peptides.

Mea kākau moʻolelo ʻepekema

He mea noiʻi ʻo Hegner P ma ke Kulanui o Regensburg. ʻO kāna hana e pili ana i ka Chemistry, Cardiovascular System, a me Cardiology. Ma Chemistry, ʻimi ʻo ia i nā hopena e pili ana i ke olakino cardiovascular. Ma nā haʻawina ʻo Cardiovascular System, ʻimi ʻo ia i nā hana o ka naʻau a me ka moku, e ʻimi ana i nā ʻike therapeutic. ʻO kāna noiʻi Cardiology e pili ana i ka pale ʻana i ka maʻi naʻau, ka ʻike, a me ka mālama ʻana.

He mea nui nā haʻawina a Hegner. Ua hoʻoulu ʻia kāna mau ʻike kemika i ka hoʻomohala ʻana i ka lāʻau lapaʻau cardiovascular hou. ʻO kāna hana ma ka puʻuwai a me nā mīkini moku ua hoʻonui i ka ʻike o nā maʻi cardiovascular. Ma ke kino, ua hoʻomaikaʻi kāna noiʻi i ka mālama ʻana i ka maʻi puʻuwai, e hoʻonui ana i nā kūlana o ka mālama maʻi. Ma ke ʻano holoʻokoʻa, hoʻomaikaʻi ʻo Hegner multidisciplinary i ka lāʻau lapaʻau cardiovascular, hāʻawi i ka manaʻolana no ka hōʻemi ʻana i nā kaumaha maʻi a me nā hopena maʻi maikaʻi aʻe. Ua helu ʻia ʻo Hegner P ma ka ʻōlelo kuhikuhi [8].

▎ Nā ʻōlelo pili

[1] Memon A, Tehrim M, Kumari B. GLP-1: wanaʻao hou no ka maʻi maʻi maʻi [J]. Nūpepa o ka Hui Lapaʻau Pakistan, 2023,73(3):721.DOI:10.47391/JPMA.7558.

[2] Ma H, Huang W, Wang X, et al. Nā ʻike hoʻolālā i ka hoʻoulu ʻana o GLP-1R e kahi agonist mole liʻiliʻi [J]. Noiʻi Pūnaewele, 2020,30(12):1140-1142.DOI:10.1038/s41422-020-0384-8.

[3] ʻO Kim HS, Jung CH. Oral GLP-1, ka mea hoʻomaʻamaʻa mua ʻo Glucagon-Like Peptide-1 Receptor Agonist: Hiki paha ke lilo i Bullet Magic no ka maʻi maʻi type 2? [J]. Ka Nupepa International of Molecular Sciences, 2021,22(18).DOI:10.3390/ijms22189936.

[4] Gabery S, Salinas CG, Paulsen SJ, et al. Hoʻohaʻahaʻa ka GLP-1 i ke kaumaha o ke kino i nā rodents ma o nā ala neural puʻupuʻu [J]. Jci Insight, 2020,5(6).DOI:10.1172/jci.insight.133429.

[5] Katsurada K, Yada T. Nā hopena neural o ka glucagon-like peptide-1 i loaʻa i ka ʻōpū a me ka lolo a me kāna agonist receptor [J]. Nūpepa o ka maʻi diabetes Investigation, 2016,7:64-69.DOI:10.1111/jdi.12464.

[6] Ryan DH, Lingvay I, Colhoun HM, et al. Nā hopena o GLP-1 i nā hopena o ka maʻi maʻi maʻi i ka poʻe me ke kaumaha nui a i ʻole ka momona (SELECT) kumu kumu a me ka hoʻolālā[J]. Puʻuwai Puʻuwai ʻAmelika, 2020,229:61-69.DOI:10.1016/j.ahj.2020.07.008.

[7] Christou GA, Katsiki N, Blundell J, et al. ʻO GLP-1 ma ke ʻano he lāʻau lapaʻau antiobesity [J]. Nā Manaʻo Obesity, 2019,20(6):805-815.DOI:10.1111/obr.12839.

[8] Hegner P, Seitz S, Schopka S, et al. Hoʻomaikaʻi ʻo GLP-1 i ka hana contractile i ka atrium kanaka kaʻawale [J]. Puʻuwai Puʻuwai ʻEulopa, 2024,45.DOI:10.1093/eurheartj/ehae666.3729.

[9] Knudsen LB, Lau J. ʻO ka ʻike a me ka hoʻomohala ʻana o Liraglutide a me GLP-1 [J]. Nā palena i ka Endocrinology, 2019,10.DOI:10.3389/fendo.2019.00155.

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ʻO nā ʻatikala a me nā ʻike huahana i hāʻawi ʻia ma kēia pūnaewele pūnaewele wale nō no ka hoʻolaha ʻana i ka ʻike a me nā kumu hoʻonaʻauao.  

ʻO nā huahana i hāʻawi ʻia ma kēia pūnaewele i manaʻo wale ʻia no ka noiʻi in vitro. Hana ʻia ka noiʻi in vitro (Latin: *i ke aniani*, ʻo ia hoʻi i ka ipu aniani) ma waho o ke kino kanaka. ʻAʻole kēia mau huahana i lāʻau lapaʻau, ʻaʻole i ʻae ʻia e ka US Food and Drug Administration (FDA), a ʻaʻole pono e hoʻohana ʻia no ka pale ʻana, mālama a hoʻōla i kekahi maʻi olakino, maʻi, a i ʻole maʻi. Ua pāpā loa ʻia e ke kānāwai ke hoʻokomo i kēia mau huahana i loko o ke kino kanaka a holoholona paha ma kekahi ʻano.