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Kato S, Utsumi D, Matsumoto K. G protein-coupled receptor 40 activation ameliorates dextran sulfate sodium-induced colitis in mice via the upregulation of glucagon-likepeptide-2. J Pharmacol Sci 2019; 140:144-152. [DOI: 10.1016/j.jphs.2019.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 12/18/2022] Open
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Lee J, Kim M, Kim DW. Dose-dependent elevation in amylase and lipase in response to teduglutide administration. Clin Case Rep 2019; 7:960-963. [PMID: 31110724 PMCID: PMC6509918 DOI: 10.1002/ccr3.2127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 02/26/2019] [Accepted: 03/04/2019] [Indexed: 01/12/2023] Open
Abstract
Teduglutide has been used for patients with short bowel syndrome. Teduglutide can be a dose-dependent triggering factor to increased amylase and lipase. Serum amylase and lipase levels should be monitored routinely for patients on teduglutide, and they should be screened before the initiation of treatment.
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Affiliation(s)
- Joshua Lee
- Boston University School of MedicineBostonMassachusetts
| | - Myoung Kim
- Boston University School of MedicineBostonMassachusetts
| | - Dong Wook Kim
- Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight ManagementBoston University School of MedicineBostonMassachusetts
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Welcome MO, Mastorakis NE, Pereverzev VA. Sweet taste receptor signaling network: possible implication for cognitive functioning. Neurol Res Int 2015; 2015:606479. [PMID: 25653876 PMCID: PMC4306214 DOI: 10.1155/2015/606479] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 12/20/2014] [Indexed: 01/01/2023] Open
Abstract
Sweet taste receptors are transmembrane protein network specialized in the transmission of information from special "sweet" molecules into the intracellular domain. These receptors can sense the taste of a range of molecules and transmit the information downstream to several acceptors, modulate cell specific functions and metabolism, and mediate cell-to-cell coupling through paracrine mechanism. Recent reports indicate that sweet taste receptors are widely distributed in the body and serves specific function relative to their localization. Due to their pleiotropic signaling properties and multisubstrate ligand affinity, sweet taste receptors are able to cooperatively bind multiple substances and mediate signaling by other receptors. Based on increasing evidence about the role of these receptors in the initiation and control of absorption and metabolism, and the pivotal role of metabolic (glucose) regulation in the central nervous system functioning, we propose a possible implication of sweet taste receptor signaling in modulating cognitive functioning.
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Affiliation(s)
- Menizibeya O. Welcome
- World Scientific and Engineering Academy and Society, Ag. Ioannou Theologou 17-23, Zografou, 15773 Athens, Greece
| | - Nikos E. Mastorakis
- World Scientific and Engineering Academy and Society, Ag. Ioannou Theologou 17-23, Zografou, 15773 Athens, Greece
- Department of Industrial Engineering, Technical University of Sofia, 8 Kl. Ohridski Boulevard, 1000 Sofia, Bulgaria
| | - Vladimir A. Pereverzev
- Department of Normal Physiology, Belarusian State Medical University, Dzerzhinsky Avenue 83, 220116 Minsk, Belarus
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Abstract
BACKGROUND Insulin and incretin agents (dipeptidyl peptidase-4 inhibitors [DPP4is] and glucagon-like peptide-1 receptor agonists [GLP1 RAs]) are second-line treatment options in patients with type 2 diabetes (T2D) not achieving glycemic targets with metformin. Combinations of insulin with incretin agents have been explored in randomized controlled trials (RCTs) and retrospective studies. However, the optimal approach is still elusive; numerous combination regimens can be envisioned, differing in composition and in order of addition. SCOPE A systematic survey was conducted of RCTs testing insulin/DPP4i or insulin/GLP1 RA regimens. PubMed and other online databases were queried using 'insulin' and the names of all incretin agents available in Canada, along with 'combination', 'concomitant', 'concurrent', and 'add-on'. Web of Science and clinicaltrials.gov were searched to identify unpublished trials. FINDINGS Fifteen placebo-controlled or active-comparator RCTs were identified, reporting outcomes for regimens combining insulins and incretin agents available in Canada. DPP4i add-on to insulin therapy (six trials) leads to modest A1c lowering, with weight neutrality. GLP1 RA and insulin combination therapy (GLP1 RA add-on, five trials; insulin add-on, two trials) is associated with significant A1c lowering, with beneficial effects on body weight. A single proof-of-concept trial compared GLP1 RA to DPP4i add-on to insulin, and only one RCT examined simultaneous introduction of an incretin agent with insulin. Adding an incretin agent to established basal insulin therapy may represent a useful alternative to insulin intensification with prandial or premixed insulin. Initial introduction of an incretin agent, with subsequent introduction of insulin, offers potential practical advantages. No study directly comparing order of addition has yet been reported. CONCLUSIONS Insulin/incretin combination therapy comprises a variety of efficacious, weight-sparing regimens and may be considered for many patients who do not achieve glycemic targets when treated with insulin or an incretin agent.
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Abstract
Hepatocellular accumulation of free fatty acids (FFAs) in the form of triglycerides constitutes the metabolic basis for the development of nonalcoholic fatty liver disease (NAFLD). Recent data demonstrate that excess FFA hepatocyte storage is likely to lead to lipotoxicity and hepatocyte apoptosis. Hence, FFA-mediated hepatocyte injury is a key contributor to the pathogenesis of nonalcoholic steatohepatitis (NASH). Nonalcoholic steatohepatitis, obesity, type 2 diabetes, essential hypertension, and other common medical problems together comprise metabolic syndrome. Evidence suggests that peptide hormones from the L cells of the distal small intestine, which comprise the core of the enteroendocrine system (EES), play two key roles, serving either as incretins, or as mediators of appetite and satiety in the central nervous system. Recent data related to glucagon-like peptide-1 (GLP-1) and other known L-cell hormones have accumulated due to the increasing frequency of bariatric surgery, which increase delivery of bile salts to the hindgut. Bile acids are a key stimulus for the TGR5 receptor of the L cells. Enhanced bile-salt flow and subsequent EES stimulation may be central to elimination of hepatic steatosis following bariatric surgery. Although GLP-1 is a clinically relevant pharmacological analogue that drives pancreatic β-cell insulin output, GLP-1 analogues also have independent benefits via their effects on hepatocellular FFA metabolism. The authors also discuss recent data regarding the role of the major peptides released by the EES, which promote satiety and modulate energy homeostasis and utilization, as well as those that control fat absorption and intestinal permeability. Taken together, elucidating novel functions for EES-related peptides and pharmacologic development of peptide analogues offer potential far-ranging treatment for obesity-related human disease.
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Affiliation(s)
- Jamie Eugene Mells
- Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia
| | - Frank A. Anania
- Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia
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Feng XH, Zhou LH, Wang D, Yuan X. GLP-1 expression in von Ebner's gland of diabetic rats. Peptides 2012; 38:137-41. [PMID: 22986021 DOI: 10.1016/j.peptides.2012.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 09/01/2012] [Accepted: 09/02/2012] [Indexed: 12/25/2022]
Abstract
GLP-1, a peptidergic endocrine hormone, which associate with appetite control, glucose homeostasis and satiety. It might play an important role in the gustatory system. We tried to investigate the expression of GLP-1 in von Ebner's gland of diabetic and control rats, and the ultrastructure changes on von Ebner's gland of diabetes rats. GLP-1 expression in von Ebner's gland was evaluated by immunohistochemistry. The number of GLP-1 positive cells in diabetic rat von Ebner's gland was significantly higher than that in normal controls. Electron micrographs showed that a series of pathologic changes in von Ebner's gland of diabetes rats. The results suggest that GLP-1 have some effects within the gustatory systems, and elevated von Ebner's gland GLP-1 expression may be one cause of diabetic taste impairment.
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Affiliation(s)
- Xiao-hong Feng
- Department of Endocrinology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China.
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Gaisano GG, Park SJ, Daly DM, Beyak MJ. Glucagon-like peptide-1 inhibits voltage-gated potassium currents in mouse nodose ganglion neurons. Neurogastroenterol Motil 2010; 22:470-9, e111. [PMID: 20003076 DOI: 10.1111/j.1365-2982.2009.01430.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Glucagon-like peptide-1 (GLP-1) is a major hormone known to regulate glucose homeostasis and gut function, and is an important satiety mediator. These actions are at least in part mediated via an action on vagal afferent neurons. However, the mechanism by which GLP-1 activates vagal afferents remains unknown. We hypothesized that GLP-1 acts on nodose ganglion neuron voltage-gated potassium (KV) channels, increasing membrane excitability. METHODS Employing perforated patch clamp recordings we examined the effects of GLP-1 on membrane properties as well as voltage-gated potassium currents. Extracellular recordings of jejunal afferents were performed to demonstrate the functional relevance of these effects at the nerve terminal. KEY RESULTS Glucagon-like peptide-1 depolarized a subpopulation of nodose neurons. This membrane depolarization was used to identify neurons containing functional GLP-1 receptors. In these neurons, GLP-1 decreased rheobase and broadened the action potential, and increased the number of action potentials elicited at twice rheobase. We identified a GLP-1 sensitive current whose reversal potential shifted in a depolarizing direction when extracellular potassium was increased. We identified two macroscopic K currents, IA, an inactivating current and IK a sustained current. GLP-1 caused inhibition of these currents, IK by 45%, P < 0.05 and IA currents by 52%P < 0.01, associated with a hyperpolarizing shift of steady-state inactivation curves for both currents. In extracellular recordings of jejunal afferents, GLP-1 increased firing rate, the effect blocked by the K(+) channel antagonist 4-AP. CONCLUSIONS & INFERENCES These experiments indicate that GLP-1 receptor activation results in vagal afferent excitation, due at least in part to inhibition of sustained and inactivating potassium currents. This mechanism may be important in satiety and glucose homeostatic signals arising from the gastrointestinal tract.
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Affiliation(s)
- G G Gaisano
- Gastrointestinal Diseases Research Unit (GIDRU), Department of Medicine, Queen's University, Kingston, ON, Canada
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Upregulation of the brainstem preproglucagon system in the obese Zucker rat. Brain Res 2007; 1187:116-24. [PMID: 18022140 DOI: 10.1016/j.brainres.2007.10.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2007] [Revised: 09/27/2007] [Accepted: 10/05/2007] [Indexed: 11/21/2022]
Abstract
A group of neurons in the caudal nucleus of the solitary tract (NTS) processes preproglucagon to glucagon-like peptide 1 (GLP-1), GLP-2 and oxyntomodulin. Whereas the anorectic capacity of all three neuropeptides has been demonstrated, only relatively little is known of preproglucagon mRNA regulation in the brain stem. Using in situ hybridization and fluorescence immunohistochemistry, we examined hindbrain preproglucagon expression in lean and obese Zucker rats under different metabolic perturbations. First, the effect of an acute 48-h fast was examined in male Sprague-Dawley as well as in lean and obese Zucker rats. Whereas fasting had no effect on preproglucagon expression in either genotype, mRNA levels were strongly up regulated in obese Zucker rats. Using a direct immunostaining procedure and a monoclonal GLP-2 antibody, we found a doubling of the immunofluorescence signal emanating from the preproglucagon neurons in caudal brainstem suggesting that indeed the high mRNA levels observed using in situ hybridization histochemistry also reflect a higher translational activity. To investigate the effects of long-term body weight perturbations, lean and obese Zucker rats were either free-fed, voluntarily overfed (chocolate spread enriched chow) or food restricted for 35 days. Preproglucagon levels remained high in the obese Zucker rats irrespective of diet. Finally, in order to functionally validate the apparent hyperactivity in the preproglucagon system in the Zucker rat, we examined the effect of central GLP-1 receptor blockade. ICV administration of 20 microg of the GLP-1 receptor antagonist Des-His-Exendin-9-39 in the morning increased 4-h food intake in obese but not in lean Zucker rats, pointing to an increased activity in central preproglucagon containing pathways in leptin receptor deficient rats. Our data suggest that the preproglucagon neurons in the brainstem are influenced by leptin signaling and point to a role of preproglucagon neurons in the integration of metabolic signals that occurs in the nucleus of the solitary tract.
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Delzenne NM, Daubioul C, Neyrinck A, Lasa M, Taper HS. Inulin and oligofructose modulate lipid metabolism in animals: review of biochemical events and future prospects. Br J Nutr 2007. [DOI: 10.1079/bjn/2002545] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Inulin and oligofructose, besides their effect on the gastro-intestinal tract, are also able to exert ‘systemic’ effect, namely by modifying the hepatic metabolism of lipids in several animal models. Feeding male Wistar rats on a carbohydrate-rich diet containing 10 % inulin or oligofructose significantly lowers serum triacylglycerol (TAG) and phospholipid concentrations. A lower hepatic lipogenesis, through a coordinate reduction of the activity and mRNA of lipogenic enzymes is a key event in the reduction of very low-density lipoprotein-TAG secretion by oligofructose. Oligofructose is also able to counteract triglyceride metabolism disorder occurring through dietary manipulation in animals, and sometimes independently on lipogenesis modulation: oligofructose reduces post-prandial triglyceridemia by 50 % and avoids the increase in serum free cholesterol level occurring in rats fed a Western-type high fat diet. Oligofructose protects rats against liver TAG accumulation (steatosis) induced by fructose, or occurring in obese Zucker fa/fa rats. The protective effect of dietary inulin and oligofructose on steatosis in animals, would be interesting, if confirmed in humans, since steatosis is one of the most frequent liver disorders, occurring together with the plurimetabolic syndrome, in overweight people. The panel of putative mediators of the systemic effects of inulin and oligofructose consists in either modifications in glucose/insulin homeostasis, the end-products of their colonic fermentation (i.e. propionate) reaching the liver by the portal vein, incretins and/or the availability of other nutrients. The identification of the key mediators of the systemic effects of inulin and oligofructose is the key to identify target function(s) (or dysfunction(s)), and finally individuals who would take an advantage of increasing their dietary intake.
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Abbott CA, Yazbeck R, Geier MS, Demuth HU, Howarth GS. Dipeptidyl peptidases and inflammatory bowel disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2006; 575:155-62. [PMID: 16700518 DOI: 10.1007/0-387-32824-6_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Catherine A Abbott
- School of Biological Sciences, Flinders University, Adelaide, SA, Australia
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Thearle M, Brillantes AMB. Unique characteristics of the geriatric diabetic population and the role for therapeutic strategies that enhance glucagon-like peptide-1 activity. Curr Opin Clin Nutr Metab Care 2005; 8:9-16. [PMID: 15585995 DOI: 10.1097/00075197-200501000-00003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE OF REVIEW Care for elderly diabetic patients poses a unique clinical challenge. This review highlights distinct aspects of the pathophysiology and the risks for secondary complications in the geriatric diabetic population. Based on these considerations, we discuss emerging therapeutic options based on the actions of the incretin hormone glucagon-like peptide (GLP)-1, which may be ideal for achieving glycemic control in the elderly diabetic patient. RECENT FINDINGS Aging is associated with diminished capacity of pancreatic beta-cells to respond to glucose. This functional decline in beta-cell insulin secretion is a major contributor to the development of diabetes in the older patient. In addition, elderly diabetics suffer from a broader range of diabetic complications than do younger diabetics, warranting aggressive glycemic control. GLP-1 is known to improve beta-cell insulin secretion, increase beta-cell mass, and suppress glucagon secretion. Recent studies investigating improved GLP-1 activity have yielded promising results, with improved glycemic control in elderly patients with type 2 diabetes and without significant risk for hypoglycemia. SUMMARY Elderly diabetics are a growing subset of the type 2 diabetic population with unique pathophysiologic characteristics and diabetic risk profiles. Therapeutic strategies that incorporate enhancement of GLP-1 action on beta-cells to improve beta-cell insulin secretion and glycemic control may be ideal for this distinct population and should be validated with further long-term clinical studies.
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Affiliation(s)
- Marie Thearle
- Columbia University, Department of Medicine, Division of Endocrinology, Naomi Berrie Diabetes Center, New York, New York, USA
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Vrang N, Phifer CB, Corkern MM, Berthoud HR. Gastric distension induces c-Fos in medullary GLP-1/2-containing neurons. Am J Physiol Regul Integr Comp Physiol 2003; 285:R470-8. [PMID: 12714357 DOI: 10.1152/ajpregu.00732.2002] [Citation(s) in RCA: 159] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A group of neurons in the caudal nucleus of the solitary tract (NTS) processes preproglucagon to glucagon-like peptides (GLP)-1 and -2, peptides that inhibit food intake when administered intracerebroventricularly. The GLP-1/2-containing neural pathways have been suggested to play a role in taste aversion and nausea because LiCl activates these neurons, and LiCl-induced suppression of food intake can be blocked by the GLP-1 receptor antagonist exendin-9. As many gastrointestinal signals related to both satiety and nausea/illness travel via the vagus nerve to the caudal medulla, the present study assessed the capacity of different types of gastric distension (a purely mechanical stimulus) to activate GLP-1 neurons in the caudal NTS. Gastric balloon distension (1.4 ml/min first 5 min, 0.4 ml/min next 5 min, 9 ml total, held for 60 min) in nonanesthetized, freely moving rats produced 12- and 17-fold increases in c-Fos-expressing NTS neurons when distension was mainly in the fundus or corpus, respectively. Fundus and corpus distension increased the percentage of c-Fos-activated GLP-1 neurons to 21 +/- 9% and 32 +/- 5% compared with 1 +/- 1% with sham distension (P < 0.01). Thus gastric distension that may be considered within the physiological range activates GLP-1/2-containing neurons, suggesting some role in normal satiety. The results support the view that the medullary GLP system is involved in appetite control and is activated by stimuli within the behavioral continuum, ranging from satiety to nausea.
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Egan JM, Bulotta A, Hui H, Perfetti R. GLP-1 receptor agonists are growth and differentiation factors for pancreatic islet beta cells. Diabetes Metab Res Rev 2003; 19:115-23. [PMID: 12673779 DOI: 10.1002/dmrr.357] [Citation(s) in RCA: 160] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Glucagon-like peptide-1 (GLP-1) is an incretin hormone that, when given exogenously, is capable of normalizing blood glucose in individuals with type 2 diabetes. Until recently most of the research on this compound had been related to its insulinotropic properties. However, GLP-1 also regulates insulin synthesis and proinsulin gene expression, as well as the components of the glucose-sensing machinery. In addition to regulating insulin release, it is involved in regulating the secretion of at least two other islet hormones--glucagon and somatostatin. Extraislet effects of GLP-1 include a role in the central nervous system stress response, hypothalamic-pituitary function, and the suppression of gastric emptying. Recent studies from our own and other laboratories show that GLP-1 can regulate islet growth and is a differentiation factor of the endocrine pancreas. This leads us to propose that GLP-1 and GLP-1 receptor agonists, in the context of long-term treatment of type 2 diabetes, will have broader biological action on the endocrine pancreas than was earlier anticipated. We propose that GLP-1 is a growth factor for pancreatic endocrine cells and can increase islet cell mass. Here we review those reports that have highlighted its role as a factor for islet cell growth and differentiation.
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Affiliation(s)
- Josephine M Egan
- Diabetes Section, National Institute on Aging, NIH, Baltimore, MD, USA
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Daniel EE, Anvari M, Fox-Threlkeld JET, McDonald TJ. Local, exendin-(9-39)-insensitive, site of action of GLP-1 in canine ileum. Am J Physiol Gastrointest Liver Physiol 2002; 283:G595-602. [PMID: 12181172 DOI: 10.1152/ajpgi.00110.2002] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Glucagon-like peptide-1 (GLP-1) modulates glucose levels following a meal, including by inhibition of gastric emptying and intestinal transport. Intra-arterial injection of GLP-1 into the gastric corpus, antrum, or pylorus of anesthetized dogs had no effect on the contractile activity of the resting or neurally activated stomach. GLP-1 injected intra-arterially inhibited intestinal segments when activated by enteric nerve stimulation but not by acetylcholine. Isolated ileum segments were perfused intra-arterially, instrumented with strain gauges to record circular muscle activity and with subserosal electrodes to stimulate enteric nerves. GLP-1 caused concentration-dependent inhibition of nerve-stimulated phasic but not tonic activity. This was absent during TTX-induced activity and partly prevented by N(G)-nitro-L-arginine. Exendin-(9-39), the GLP-1 antagonist, had no intrinsic activity and did not affect the actions of GLP-1. Capsaicin mimicked the effects of GLP-1 and may have reduced the effect of subsequent GLP-1. GLP-1 may mediate paracrine action on afferent nerves in the canine ileal mucosa using an unusual receptor.
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Affiliation(s)
- E E Daniel
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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Abstract
Discovery of the leptin receptor and its downstream peptidergic pathways has reconfirmed the crucial role of the hypothalamus in the regulation of food intake and energy balance. Strategically located in the midst of the mammalian neuraxis, the hypothalamus receives at least three distinct types of relevant information via direct or indirect neural connections as well as hormone receptors and substrate sensors bestowed on hypothalamic neurons. First, the medial and to a lesser extent the lateral hypothalamus receive a rich mix of information pertaining to the internal state of relative energy repletion/depletion. Second, specific hypothalamic nuclei receive information about the behavioral state, such as diurnal clock, physical activity-level, reproductive cycle, developmental stage, as well as imminent (e.g. fight and flight) and chronic (e.g. infection) stressors, that can potentially impact on short-term availability of fuels and long-term energy balance. Third, the hypothalamus, particularly its lateral aspects, receives information from areas in the forebrain involved in the acquisition, storage, and retrieval of sensory representations of the external food space and internal food experience, as well as from the executive forebrain involved in behavior selection and initiation. In addition, rich intrahypothalamic connections facilitate further distribution of incoming information to various hypothalamic nuclei. On the other hand, the hypothalamus has widespread neural projections to the same cortical areas it receives inputs, and many hypothalamic neurons are one synapse away from most endocrine systems and from both sympathetic and parasympathetic effector organs involved in the flux, storage, mobilization, and utilization of fuels. It is argued that processing within cortico-limbic areas and communication with hypothalamic areas are particularly important in human food intake control that is more and more guided by cognitive rather than metabolic aspects in the obesigenic environment of affluent societies. A distributed neural network for the control of food intake and energy balance consisting of a central processor and several parallel processing loops is hypothesized. Detailed neurochemical, anatomical, and functional analysis of reciprocal connections of the numerous peptidergic neuron populations in the hypothalamus with extrahypothalamic brain areas will be necessary to better understand what hypothalamus, forebrain, and brainstem tell each other and who is in charge under specific conditions of internal and external nutrient availability.
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Affiliation(s)
- Hans-Rudolf Berthoud
- Neurobiology of Nutrition Laboratory, Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Road, Baton Rouge, LA 70808, USA.
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