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Just like retinol, the acidity destabilizes peptide bonds

Rarely, serious side effects such as pancreatitis and thyroid cancer can occur

At the residue level, signaling initiation by either peptide 20, tirzepatide or endogenous peptide hormones rendered a common arrangement of residue contacts for the three receptors 29,30 , including the reorganization of the central polar network that located just below the peptide binding site, opening of the hydrophobic packing to favor the formation of TM6 kink at the PXXG motif and the rearrangement of two polar networks (HETX motif and TM2-6-7-helix 8) at the cytoplasmic face

However, several genes, such as AHCY, were identified without characterized ARE motifs

20.22 and 20.23)