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Milena A Malcharek M Malcharek, Pharmacology, University of Cambridge, Cambridge, United Kingdom of Great Britain and Northern Ireland

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Abigail Pearce A Pearce, Pharmacology, University of Cambridge, Cambridge, United Kingdom of Great Britain and Northern Ireland

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Cheryl A Brighton C Brighton, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals RandD, AstraZeneca UK Limited, Cambridge, United Kingdom of Great Britain and Northern Ireland

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David C Hornigold D Hornigold, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals RandD, AstraZeneca UK Limited, Cambridge, United Kingdom of Great Britain and Northern Ireland

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Graham Ladds G Ladds, Pharmacology, University of Cambridge, Cambridge, United Kingdom of Great Britain and Northern Ireland

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Receptor activity-modifying proteins (RAMPs) modulate the expression and activity of numerous G protein-coupled receptors, primarily those within class B1. These receptors have important physiological roles, including in the regulation of food intake, energy metabolism, and glucose homeostasis. Dysregulation of these pathways can lead to obesity and diabetes mellitus, which present an ever-expanding global challenge. Whilst the roles of class B1 receptors and their peptide agonists in obesity and diabetes have been investigated, the contribution of RAMPs is less well understood. This review summarises the results of RAMP knockout studies, highlighting the involvement of these proteins in the incidence of disease. It then moves to discuss how receptor, RAMP, and agonist expression changes in disease states, and the benefits (or detriments) of these agonists to the pathways implicated in disease pathophysiology. Whilst much of the data centres around the calcitonin family of receptors, as their interactions with RAMPs are well established, this review then discusses receptors whose role in obesity and diabetes is well founded, but the significance of whose interactions with RAMPs is more recently emerging. The conclusion of this study of the literature is, however, that the information surrounding RAMPs is conflicting and multifaceted, and more research is required to fully understand their contribution to obesity and diabetes.

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