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Exendin-700DX is an investigational targeted photodynamic therapy (tPDT) agent being developed by Radboud University Medical Center and the LightCure/BetaCure consortia. It consists of exendin-4, a peptide that selectively binds to the glucagon-like peptide 1 receptor (GLP-1R) expressed on pancreatic beta cells, conjugated to the near-infrared photosensitizing dye IRDye 700DX. Upon administration, Exendin-700DX binds to and is internalized by hyperfunctioning beta cells. Subsequent local irradiation with near-infrared laser light activates the photosensitizer, generating reactive oxygen species (ROS) that selectively destroy the diseased beta cells while sparing surrounding healthy tissue. This targeted approach is being developed for the treatment of congenital hyperinsulinism (CHI), insulinomas, and adult hyperinsulinemic hypoglycemia (AHH), aiming to normalize blood glucose levels and avoid the need for extensive pancreatic resection.
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