GLP-1 Receptor Agonists: The Next Multifunctional Class of Drugs

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are well established for the management of type 2 diabetes mellitus and obesity. However, growing evidence suggests that their therapeutic effects extend beyond glycemic control and weight reduction. This review summarizes the emerging pleiotropic effects of GLP-1 RAs on cardiovascular, renal, neurological, inflammatory, dermatological and vascular systems. Evidence indicates that GLP-1 RAs may improve endothelial function, reduce oxidative stress and inflammation, promote natriuresis and vasodilation, and provide cardioprotective and renoprotective effects. Potential benefits have also been reported in heart failure, aging-related cellular dysfunction, psoriasis, neurodegenerative disorders, cancer biology, and vascular smooth muscle dysfunction. These effects are associated with modulation of signalling pathways including cAMP/PKA, PI3K/Akt and AMPK, along with regulation of oxidative and inflammatory processes. Although cardiovascular and renal benefits have comparatively stronger clinical evidence, several other applications remain emerging and require further clinical investigation. Overall, GLP-1 RAs represent a promising multifunctional class of drugs with therapeutic potential beyond diabetes and obesity. Keywords: cardiovascular disease; Inflammation; GLP-1 receptor agonists; GLP-1; cardioprotection; nephroprotection; neuroprotection; obesity; type 2 diabetes mellitus; pleiotropic effects