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The receptive function of hypothalamic and brainstem centres to hormonal and nutrient signals affecting energy balance.

Abstract
The hypothalamic arcuate nucleus (ARC) and the area postrema (AP) represent targets for hormonal and metabolic signals involved in energy homoeostasis, e.g. glucose, amylin, insulin, leptin, peptide YY (PYY), glucagon-like peptide 1 (GLP-1) and ghrelin. Orexigenic neuropeptide Y expressing ARC neurons are activated by food deprivation and inhibited by feeding in a nutrient-dependent manner. PYY and leptin also reverse or prevent fasting-induced activation of the ARC. Interestingly, hypothalamic responses to fasting are blunted in different models of obesity (e.g. diet-induced obesity (DIO) or late-onset obesity). The AP also responds to feeding-related signals. The pancreatic hormone amylin acts via the AP to control energy intake. Amylin-sensitive AP neurons are also glucose-responsive. Furthermore, diet-derived protein attenuates amylin responsiveness suggesting a modulation of AP sensitivity by macronutrient supply. This review gives an overview of the receptive function of the ARC and the AP to hormonal and nutritional stimuli involved in the control of energy balance and the possible implications in the context of obesity. Collectively, there is consistency between the neurophysiological actions of these stimuli and their effects on energy homoeostasis under experimental conditions. However, surprisingly little progress has been made in the development of effective pharmacological approaches against obesity. A promising way to improve effectiveness involves combination treatments (e.g. amylin/leptin agonists). Hormonal alterations (e.g. GLP-1 and PYY) are also considered to mediate body weight loss observed in obese patients receiving bariatric surgery. The effects of hormonal and nutritional signals and their interactions might hold the potential to develop poly-mechanistic therapeutic strategies against obesity.
AuthorsThomas Riediger
JournalThe Proceedings of the Nutrition Society (Proc Nutr Soc) Vol. 71 Issue 4 Pg. 463-77 (Nov 2012) ISSN: 1475-2719 [Electronic] England
PMID22931748 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
Chemical References
  • Gastrointestinal Hormones
Topics
  • Animals
  • Appetite (physiology)
  • Arcuate Nucleus of Hypothalamus (physiology)
  • Area Postrema (physiology)
  • Bariatric Surgery
  • Energy Intake (physiology)
  • Energy Metabolism (physiology)
  • Gastrointestinal Hormones (metabolism)
  • Homeostasis
  • Humans
  • Obesity (metabolism, physiopathology, therapy)
  • Signal Transduction
  • Weight Loss

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