Anatomical mapping of the rat hypothalamus for calcitonin-induced anorexia

Deep-brain stimulation for anorexia nervosa

OBJECTIVE

Anorexia nervosa (AN) is a complex and severe, sometimes life-threatening, psychiatric disorder with high relapse rates under standard treatment. After decades of brain-lesioning procedures offered as a last resort, deep-brain stimulation (DBS) has come under investigation in the last few years as a treatment option for severe and refractory AN.

METHODS AND RESULTS

In this jointly written article, Sun et al. (the Shanghai group) report an average of 65% increase in body weight in four severe and refractory patients with AN after they underwent the DBS procedure (average follow-up: 38 months). All patients weighed greater than 85% of expected body weight and thus no longer met the diagnostic criteria of AN at last follow-up. Nuttin et al. (the Leuven group) describe other clinical studies that provide evidence for the use of DBS for AN and further discuss patient selection criteria, target selection, and adverse event of this evolving therapy.

CONCLUSION

Preliminary results from the Shanghai group and other clinical centers showed that the use of DBS to treat AN may be a valuable option for weight restoration in otherwise-refractory and life-threatening cases. The nature of this procedure, however, remains investigational and should not be viewed as a standard clinical treatment option. Further scientific investigation is essential to warrant the long-term efficacy and safety of DBS for AN.

Calcitonin increases 5-HT1A binding site densities in the brain of adrenalectomized rats

Calcitonin is a peptide which acts in the brain to modulate behavior and hormone release, possibly through an interaction with serotonergic systems. We investigated the effects of chronic systemic injections of salmon calcitonin on the [3H]-8-OHDPAT binding to 5-HT1A receptors in the frontal cortex and hippocampus in adrenalectomized and intact (non adrenalectomized) rats. The results show that salmon calcitonin increases the maximal density of 5-HT1A binding sites in both structures in adrenalectomized animals (and decreases the affinity in the frontal cortex only). Calcitonin does not alter this binding in intact rats. These results demonstrate the existence of interactions between calcitonin, serotonin and glucocorticoids, and raise the hypothesis of a neurotrophic effect of calcitonin on serotonergic neurons.

Calcitropic peptides: neural perspectives

In mammals and higher vertebrates, calcitropic peptides are produced by peripheral endocrine glands: the parathyroid gland (PTH), thyroid or ultimobranchial gland (calcitonin) and the anterior pituitary gland (growth hormone and prolactin). These hormones are, however, also found in the neural tissues of lower vertebrates and invertebrates that lack these endocrine organs, suggesting that neural tissue may be an ancestral site of calcitropic peptide synthesis. Indeed, the demonstration of CNS receptors for these calcitropic peptides and their induction of neurological actions suggest that these hormones arose as neuropeptides. Neural and neuroendocrine roles of some of these calcitropic hormones (calcitonin and parathyroid hormone) and related peptides (calcitonin gene related peptide, stanniocalcin and parathyroid hormone related peptide) are thus the focus of this review.

In vitro autoradiographic localization of the calcitonin receptor isoforms, C1a and C1b, in rat brain

In this study the distribution of the calcitonin receptor isoforms, C1a and C1b, were mapped in rat brain using in vitro autoradiography and manipulation of their different pharmacological specificities. While salmon calcitonin binds to both receptors with high affinity, only the C1a receptor interacts with human calcitonin. Thus, the distribution of C1a specific binding sites was mapped using [125I]human calcitonin. The C1b receptors were mapped using [125I]salmon calcitonin in the presence of unlabelled human calcitonin and rat amylin, displacing binding of [125I]salmon calcitonin to C1a and C3 (amylin) sites, respectively. The distribution of C1a and C1b receptors was found to predominantly overlap. Brain regions displaying C1a, but little or no C1b, binding sites included the nucleus of the solitary tract, area postrema and the intermediate lobe of the pituitary. Although there were no nuclei expressing exclusively C1b receptors, parts of the mesencephalic and pontine reticular formation, and the thalamic paraventricular nucleus were enriched in C1b receptors relative to the density of C1a receptors in other brain regions. These data indicate that the relative expression of the two receptor isoforms, although predominately parallel, is not uniform in the rat brain.

Hypothalamic and thalamic sites of action of interleukin-1 beta on food intake, body temperature and pain sensitivity in the rat

Interleukin-1beta (IL-1beta ) has anorectic, hyperthermic, and analgesic or hyperalgesic (depending on the studies) effects in the rat. These effects appear to be mediated by the central nervous system; however, the exact localization of action of IL-1beta in the brain has never been delineated with precision. The purpose of this study was to determine precisely where IL- IO acts in the hypothalamus and in the thalamus to modulate food intake, body temperature, and pain sensitivity. Animals were tested after local intracerebral microinjections of 5 ng of IL-1beta dissolved in 0.3 microl of saline, or of 0.3 microl saline alone. The results show that IL-1beta has anorectic effects in 3 diencephalic sites (the perifornical area, an area above the optic chiasma, and an area internal to the mamillo-thalamic tract), and not in 9 other sites tested. IL-1beta has hyperthermic effects in 7 sites (the media] and lateral preoptic area, the hypothalamic periventricular substance, the dorso-medial and arcuate nuclei of the hypothalamus, and the centro-medial and gelatinosus nuclei of the thalamus), and not in 6 other sites. IL-1beta has analgesic effects in the centro-medial and gelatinosus nuclei of the thalamus, and not in 7 other sites. IL-1beta also increases food intake and decreases pain sensation thresholds in the paraventricular nucleus of the hypothalamus. Therefore IL-1beta has very selective anatomical sites of action in the brain, and the paraventricular nucleus of the hypothalamus appears to have special properties regarding the effects of IL-1beta on food intake and pain sensation regulation.

Extensive brain mapping of calcitonin-induced anorexia

The purpose of this study was to compare the localization in the brain of calcitonin-induced anorexia to the distribution of calcitonin binding sites (as described by others). We, thus, performed an extensive mapping of brain structures to determine those involved in calcitonin-induced anorexia. A significant anorexia is found after injection of calcitonin (15 ng in 0.3 microliters) into several brain areas. Forebrain: lateral septum, lateral part of the anterior commissure, and bed nucleus of the stria terminalis; hypothalamus: floor of the anterior part of the hypothalamus, paraventricular nucleus and adjacent perifornical area; thalamus: nucleus reuniens, an area internal to the mamillo-thalamic tract, and medial geniculate body; other areas: amygdala, lateral hippocampus, and central gray. No significant effect is found in the following areas: forebrain: nucleus accumbens, striatum, and medial septum; hypothalamus: lateral, ventro-medial, dorso-medial, and posterior nuclei; thalamus: centro-medial nucleus, lateral part of the zona incerta, and lateral geniculate body; hippocampus: dorsal and ventral parts; midbrain: central tegmentum, ventral tegmental area, and substantia nigra. When these results are compared to the distribution of calcitonin binding sites in the brain, two types of discrepancies are found. The first is the absence of effect in areas containing receptors: these areas may be involved in calcitonin-induced behaviors other than food intake. The second is the occurrence of anorexia in areas where no receptors are found: this finding is not easy to explain and raises some speculative hypotheses. In conclusion, calcitonin is active to decrease food intake in several brain areas, the strongest effect occurring in the paraventricular/perifornical area.(ABSTRACT TRUNCATED AT 250 WORDS)

Dietary calcium and blood pressure in experimental models of hypertension. A review

More than 80 studies have reported lowered blood pressure after dietary calcium enrichment in experimental models of hypertension. The evidence presented here suggests that dietary calcium may act concurrently through a number of physiological mechanisms to influence blood pressure. The importance of any given mechanism may vary depending on the experimental model under consideration. Supplemental dietary calcium is associated with reduced membrane permeability, increased Ca(2+)-ATPase and Na,K-ATPase, and reduced intracellular calcium. These results suggest that supplemental calcium may limit calcium influx into the cell and improve the ability of the VSMC to extrude calcium. This could be a direct effect of calcium on the VSMC or an indirect effect mediated hormonally. The calcium-regulating hormones have all been found to have vasoactive properties and therefore may influence blood pressure. Furthermore, CGRP and the proposed parathyroid hypertensive factor are both vasoactive substances that are responsive to dietary calcium. Therefore, diet-induced variations in calcium-regulating hormones may influence blood pressure. Modulation of the sympathetic nervous system is another important way that dietary calcium can influence blood pressure. There is evidence of altered norepinephrine levels in the hypothalamus as a consequence of manipulations of dietary calcium as well as changes in central sympathetic nervous system outflow. Dietary calcium has also been shown to specifically modify alpha 1-adrenergic receptor activity in the periphery. In some experimental models of hypertension, dietary calcium may alter blood pressure by changing the metabolism of other electrolytes. For example, the ability of calcium to prevent sodium chloride-induced elevations in blood pressure may be attributed to natriuresis. However, natriuresis does not account for all of the interactive effects of calcium and sodium chloride on blood pressure. Sodium chloride-induced hypertension may be due in part to calcium wasting and subsequent elevation of calcium-regulating hormones. Chloride is an important mediator of this effect because it appears that sodium does not cause calcium wasting when it is not combined with chloride. More attention to the central nervous system effects of dietary calcium is needed. Not only can calcium itself influence neural function, but many of the calcium-regulating hormones appear to affect the central nervous system. The influence of calcium and calcium-regulating hormones on central nervous system activity may have important implications for blood pressure regulation and also may extend to other aspects of physiology and behavior.

Medial diencephalic sites involved in calcitonin-induced hyperthermia and analgesia

Calcitonin is a peptide hormone which can act centrally to decrease food intake and locomotor activity, and increase body temperature and nociceptive thresholds. In a previous study we showed that the brain sites involved in the food intake and locomotion decreases were mostly the paraventricular nucleus, the perifornical area and the preoptic area above the optic chiasma. We now study the diencephalic sites involved in calcitonin-induced increases in body temperature and nociceptive thresholds. Salmon calcitonin (15 ng in 0.3 microliters) was injected in several diencephalic sites, and the effects on body temperature and nociceptive thresholds compared with a saline injection. The results show that the sensitive sites are the dorsomedial nucleus of the hypothalamus, the preoptic area and the centromedial nucleus of the thalamus, and not the paraventricular nucleus and adjacent perifornical area. Therefore, different kinds of central effects of calcitonin can be differentiated on an anatomical basis.

Antagonism of calcitonin-induced anorexia by chronic, but not acute, tricyclic antidepressants in the rat

Intraperitoneal or intracerebral injections of calcitonin in the rat produce several behavioral and hormonal effects which have some analogies with the human depressive syndrome. To determine if calcitonin effects are sensitive to antidepressant drugs, the ability of antidepressants and other psychotropic drugs to interact with calcitonin-induced anorexia was tested. The results show that chronic treatments (21 days) with tricyclic, or with tetracyclic, antidepressants significantly tend to neutralize the anorectic effect of calcitonin. Other antidepressants and other psychotropic drugs had no significant effect. The acute administration (24 h) of clomipramine did not antagonize the effect of calcitonin, and even significantly enhanced it. These results allow the author to propose the effects of calcitonin in the rat as a new animal model of depression, and to raise the hypothesis that a possible mechanism of action of tricyclic antidepressant treatments is to counteract the effects of certain brain peptides.

Central nervous system binding sites for calcitonin and calcitonin gene-related peptide

Alternative splicing of the primary RNA transcript of the calcitonin gene leads to the generation of two distinct peptides, calcitonin (CT) and calcitonin gene-related peptide (CGRP). These peptides share only limited sequence homology and generally subserve different biological functions through their own distinct binding sites, which differ in specificity and distribution. Additionally, a binding site with high-affinity binding for both peptides that has a restricted pattern of distribution has been identified. The present article reviews the biochemical and morphological characteristics of centra CT and CGRP binding sites.

Regulation of plasma calcium and phosphate in calcitonin-infused rats

The effects of long-term constant infusion of moderate doses (2-32 ng/h) of salmon calcitonin (sCT) on plasma Ca (and its radionuclide 45Ca), Pi, Mg, and on endogenous rat CT (rCT) metabolism were investigated in the rat. Daily variations were included. 1) The plasma concentrations of Ca and Pi fell and that of Mg increased transiently during infusion, with the duration of responses (1-3 days) depending on the sCT dose. Rats infused with 8 ng/h sCT remained sensitive to CT after 7 and 14 days, as indicated by the effects of minipump removal and of a bolus injection of exogenous sCT on plasma mineral concentrations. 2) In contrast to control rats, the well-established daily variations in plasma Ca and Pi levels were no longer observed after 7 and 14 days of sCT infusion (8 ng/h), but normal variations persisted for plasma Mg, circulating rCT, rCT mRNA, and rCT thyroid content. 3) Statistical analysis of plasma mineral data, collected at five sequential times during days 7 and 14, showed that the means were not significantly different and that the daily variations were essentially identical on days 7 and 14 in control rats. In contrast, the variability of measurements for plasma Ca and Pi, but not for Mg, increased significantly between days 7 and 14 in infused rats, and the mean differences were significantly lower in infused rats on day 7 than in control rats. These results are consistent with a transitory loss of the daily variations for Ca and Pi (day 7) and the later (day 14) spontaneous recovery of some variations in these parameters, although the individuals remain unsynchronized.(ABSTRACT TRUNCATED AT 250 WORDS)

Behavioral effects of diltiazem injected into the paraventricular nucleus of the hypothalamus

The calcium channel inhibitor diltiazem is widely used as a medication for cardiovascular diseases. Some side effects have been reported after its administration, including changes in activity (apathy or hyperactivity) and feeding behavior (anorexia). Previous experiments have found that local administration of various peptides into the paraventricular nucleus of the hypothalamus can have profound effects on these two behaviors. In the present study, effects of local infusions of diltiazem into the paraventricular nucleus on locomotor activity and food intake have been tested. A marked hyperactivity, greater than the hyperactivity caused by intraperitoneal injection of amphetamine was produced. Feeding behavior was not affected one hour after the infusions but intraventricular diltiazem infusions decreased feeding behavior. It is concluded that the paraventricular nucleus of the hypothalamus has an important role in the regulation of locomotor activity and that diltiazem can act at this level to produce behavioral changes.

Anorectic effect of calcitonin, neurotensin and bombesin infused in the area of the rostral part of the nucleus of the tractus solitarius in the rat

The three neuropeptides calcitonin, neurotensin and bombesin can decrease food intake in the rat when injected into the cerebral ventricles or into the paraventricular nucleus of the hypothalamus. The paraventricular nucleus of the hypothalamus is an important site for the integration of visceral and endocrine systems, and has connections with the nucleus of the tractus solitarius which is a major locus for visceral afferents. Since calcitonin, neurotensin and bombesin, or their receptors, have been found to be present in the nucleus of the tractus solitarius, we tested the effects of local infusions of these peptides on food intake. The peptides were microinjected in a 0.25 microliter volume in rats trained to eat for only 3 hours per day. The injections were made in the rostral part of the nucleus and surrounding areas, through the lateral vestibular nuclei, to avoid leakage of the peptides into the cerebrospinal fluid. In the nucleus of the tractus solitarius the three peptides decreased food intake by more than 50%. The peptides were also active in the spinal trigeminal nucleus oralis, and, for calcitonin and bombesin, in the reticular formation under the nucleus of the tractus solitarius. A local diffusion from the point of injection may explain some of these results. Therefore, the area of the nucleus of the tractus solitarius is a nonhypothalamic site where these peptides can act to produce anorexia.

Intrahypothalamic microinjection of calcitonin prevents stress-induced gastric lesions in rats

Injection of salmon calcitonin into the lateral ventricle or the cisterna magna was reported to potently inhibit gastric lesions induced by cold restraint stress. The forebrain sites of action were investigated using unilateral microinjection of salmon calcitonin prior to exposing conscious pylorus-ligated rats to cold restraint stress for 2 hr. Calcitonin (100 ng), microinjected in 100 nl volume by pressure ejection from glass micropipette positioned into the lateral or ventromedial hypothalamus or the paraventricular nucleus, prevented the development of gastric lesions whereas microinjections into the caudate putamen, the cerebral cortex or the hippocampus were ineffective. The antiulcerogenic effect of lateral hypothalamic injection was dose dependent and specific since calcitonin gene-related peptide, tested under the same conditions, had no effect. Microinjection of calcitonin at 100 ng dose into the ventromedial hypothalamus did not modify gastric secretion whereas microinjection into the lateral hypothalamus or the paraventricular nucleus induced 75-82% inhibition of gastric acid output in pylorus-ligated rats exposed to restraint stress. These results demonstrate that the hypothalamus including the lateral, ventromedial and paraventricular nuclei are responsive sites of action for calcitonin-induced inhibition of cold restraint stress ulcers. The antiulcerogenic effect may be related to suppression of gastric acid secretion along with other mechanisms that remain to be elucidated.

Regional localization of the antagonism of amphetamine-induced hyperactivity by intracerebral calcitonin injections

Calcitonin receptors are found in the brain, and intracerebral infusions of calcitonin can produce behavioral effects. Among these behavioral effects are decreases in food intake and decreases in amphetamine-induced locomotor activity. In previous experiments we found that decreases in food intake were induced by local administration of calcitonin into several hypothalamic sites and into the nucleus accumbens. In the present experiment calcitonin decreased locomotor activity when locally injected into the same sites where it decreases food intake. The areas where calcitonin is most effective in decreasing locomotor activity are located in the hypothalamus and nucleus accumbens, suggesting that these areas are the major sites of action of calcitonin in inhibiting amphetamine-induced locomotor activity.