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Exendin 9-39 is a synthetic peptide fragment derived from the N-terminal truncation of exendin-4. It acts as a potent and selective antagonist or inverse agonist of the glucagon-like peptide 1 receptor (GLP-1R). By competitively binding to GLP-1R on pancreatic beta cells and other tissues, it blocks the action of endogenous GLP-1 and related agonists. This results in inhibition of GLP-1–stimulated insulin secretion and an increase in plasma glucose levels. Exendin 9-39 has been primarily developed as a research tool to delineate the physiological role of GLP‑1 signaling but is also under clinical development for therapeutic use in conditions such as congenital hyperinsulinism (HI) and post-bariatric hypoglycemia[1][3][4][6][7]. The drug is being advanced under the name "avexitide" for these indications.
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