Pramlintide

Pramlintide is a synthetic analog of amylin that mimics the physiological functions of endogenous amylin. Amylin acts by binding to amylin receptors. Amylin receptors are composite G protein-coupled receptors composed of the calcitonin receptor (CTR) and receptor activity-modifying proteins (RAMPs). Depending on the type of RAMP, they are classified as AMY1 (CTR + RAMP1), AMY2 (CTR + RAMP2), and AMY3 (CTR + RAMP3). Amylin receptors can couple to multiple G protein signaling pathways in different tissues, including Gs, Gi/o, and Gq, with downstream effects involving cAMP, cytosolic calcium concentration, and neural signal regulation. Through pathways related to the central nervous system and the vagus nerve, amylin can suppress glucagon secretion, reduce gastric motility, and delay gastric emptying.