Two main strategies have been used to modify the sequences of semaglutide and tirzepatide (red circles) and increase their bioavailability: 1) removal of the DPP-4 cleavage site, replacing alanine with an analogous molecule (-aminoisobutyric acid (Aib)), but not recognized by the enzyme
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Further enzymatic reactions occur after the formation of formylkynurenine and it is then converted into NAD+ using several enzymes, one of which is 3-hydroxyanthranilic acid 3, 4-dioxygenase (3-HAAO)
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