The anti-emetic actions of GIP receptor agonism

Nausea and vomiting are primitive aspects of mammalian physiology and behavior that ensure survival. Unfortunately, both are ubiquitously present side effects of drug treatments for many chronic diseases with negative consequences on pharmacotherapy tolerance, quality of life, and prognosis. One of the most critical clinical examples is the profound emesis and nausea that occur in patients undergoing chemotherapy, which continue to be among the most distressing side effects, even with the use of modern anti-emetic medications. Similarly, anti-obesity/diabetes medications that target the glucagon-like peptide-1 (GLP-1) system, despite their remarkable metabolic success, also cause nausea and vomiting in a significant number of patients. These side effects hider the ability to administer higher dosages for optimal glycemic and weight management and represent the major reasons for treatment discontinuation. Our inability to effectively control these side effects highlights the need to anatomically, molecularly, and functionally characterize novel neural substrates that drive and inhibit nausea and emesis. Here, we discuss clinical and pre-clinical evidence that highlight the glucose-dependent insulinotropic peptide receptor (GIPR) system as a novel therapeutic central target for management of nausea and emesis.