What is Semaglutide?
Semaglutide belongs to a class of glucagon-like peptide 1 (GLP-1) receptor agonists. Its main indication is the treatment of type 2 diabetes mellitus. It is approved for use as monotherapy as both subcutaneous and newly a novel oral dosage form, which makes it the first oral GLP-1 receptor agonist [1, 2].
Semaglutide works by binding to the same receptors as the gut hormone GLP-1, and mimics several of its roles in the complex process of postprandial digestion, including its contribution to the maintenance of typical insulin responses after eating, and thus the avoidance of hyperglycaemia, in people with type 2 diabetes [3].
A Semaglutide brand name is Ozempic and its first FDA approval was in 2017 as a treatment for type 2 diabetes [4].
Another brand name is Wegovy, the only weight-loss approved formulation of Semaglutide that has currently been approved by FDA for long-term weight management in adults with obesity or overweight accompanied by at least one weight-related condition such as high blood pressure, type 2 diabetes, or high cholesterol [4].
What does Semaglutide do?
Besides its use in managing type 2 diabetes, preliminary data shows that Semaglutide might have a role in managing other conditions, including type 1 diabetes, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, kidney disease, Alzheimer’s disease and pulmonary diseases [1].
Semaglutide has also been considered an anti-obesity medication, where it showed superior weight-loss potential to other GLP-1 receptor agonists in individuals with type 2 diabetes or obesity [5, 6].
Besides lowering blood glucose, Semaglutide decreases body weight and systolic blood pressure [7], but it increases the risk of nausea, vomiting and diarrhoea [7, 8].
What is an Autoimmune Disease?
An autoimmune disease is a condition that arises when the immune system attacks the body’s healthy tissues, organs and cells under the mistaken belief that they are foreign, dangerous agents, instead of normal and vital parts of the body. Under normal circumstances, the immune system has the very important job of defending the body against harmful foreign invaders, including bacteria, viruses, toxic chemicals and other substances. But with autoimmune disease, the immune system erroneously attacks healthy cells, including those from the body’s tissues and organs. This damage could occur even in the absence of an infection or other external threat [9].
Autoimmune diseases tend to be organ-specific or systemic. When they are organ-specific, they target a particular location in the body – for example, in type 1 diabetes, the immune system attacks the pancreas [10]. The list of recognised autoimmune diseases is long, containing more than 80 distinct types. Any part of the body can be targeted. Some of the best-known autoimmune diseases include alopecia areata (hair loss), Graves’ disease, Hashimoto’s thyroiditis, lupus, multiple sclerosis, psoriasis, rheumatoid arthritis (inflammation of synovial tissues) and type 1 diabetes [11, 9].
What are the causes of Autoimmune Diseases?
There are no clear causes for Autoimmune Diseases, but they’re believed to be a combination of genetic factors and environmental and hormonal triggers.
Genetic predisposition is an important risk factor for Autoimmune Disease. Some individuals have the unfortunate luck to inherit genes that increase their risk of Autoimmune Disease. But research repeatedly shows that, even if you have these genes, you still won’t necessarily develop an Autoimmune Disease. At least 50-70 genes have been identified as risk factors for autoimmune disease. Environmental predisposition is an important risk factor for Autoimmune Disease [10, 9].
Environmental factors appear to have a role in the development of Autoimmune Diseases, too, with the risk for the development of an Autoimmune Disease possibly elevated by environmental exposures, including some chemicals, sunlight, cigarette smoke and some bacterial and viral infections [10].
Hormonal shifts, including those of pregnancy and postpartum, can also trigger Autoimmune Disease, for example, one paper reported a case in which a woman had developed myasthenia gravis three months postpartum [12].
Ozempic, Wegovy and Autoimmune Diseases
While there is limited scientific evidence about semaglutide and autoimmune diseases, one study reports a case in which semaglutide improved the symptoms of psoriasis in a single patient.
When treating autoimmune diseases, combinations of drugs are used, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, antibodies and small molecule drugs (DMARDs) [16]. Intravenous immunoglobulin (IVIg) therapy has proven effective treatment for autoimmune diseases such as Systemic Lupus Erythematosus (SLE) [17], as well as other autoimmune conditions [18].
However, there is not a sufficient amount of evidence that suggests Ozempic and Wegovy, which are GLP-1 agonists, can be used for the treatment of Autoimmune Diseases. They can help reduce inflammation but it is not verified that they can treat certain Autoimmune Diseases, and more research has to be conducted.