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Exendin-4 enhances the binding of heat shock factor 1 to the promoter of heat shock protein (HSP) genes through SIRT1-mediated deacetylation, which then increased the expression of molecular chaperones HSP70 and HSP40 to alleviate lipid-induced hepatic ER stress.78 ER oxidoreductase mediates the inhibitory effects of exendin-4 on ER stress, ameliorating hyperhomocysteinemia-induced endothelial dysfunction.79 ER protein 46, a new member of the thioredoxin family, highly expressed in pancreatic -cells, may mediate GLP-1 regulation of ER stress and thus increase the protection of pancreatic cells.80,81 These studies suggest the complexity of GLP-1 RA in regulating ER stress

These ingredients should be used with caution, since they can pose the risk for side effects

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