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Pho H, Amorim MR, Qiu Q, Shin M, Kim LJ, Anokye‐Danso F, Jun JJ, Ahima RS, Branco LGS, Kuhn DM, Mateika JH, Polotsky VY. The effect of brain serotonin deficiency on breathing is magnified by age. Physiol Rep 2022; 10:e15245. [PMID: 35581741 PMCID: PMC9114658 DOI: 10.14814/phy2.15245] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/25/2022] [Accepted: 03/13/2022] [Indexed: 11/24/2022] Open
Abstract
Serotonin is an important mediator modulating behavior, metabolism, sleep, control of breathing, and upper airway function, but the role of aging in serotonin-mediated effects has not been previously defined. Our study aimed to examine the effect of brain serotonin deficiency on breathing during sleep and metabolism in younger and older mice. We measured breathing during sleep, hypercapnic ventilatory response (HCVR), CO2 production (VCO2 ), and O2 consumption (VO2 ) in 16-18-week old and 40-44-week old mice with deficiency of tryptophan hydroxylase 2 (Tph2), which regulates serotonin synthesis specifically in neurons, compared to Tph2+/+ mice. As expected, aging decreased VCO2 and VO2 . Tph2 knockout resulted in an increase in both metabolic indexes and no interaction between age and the genotype was observed. During wakefulness, neither age nor genotype had an effect on minute ventilation. The genotype did not affect hypercapnic sensitivity in younger mice. During sleep, Tph2-/- mice showed significant decreases in maximal inspiratory flow in NREM sleep, respiratory rate, and oxyhemoglobin saturation in REM sleep, compared to wildtype, regardless of age. Neither serotonin deficiency nor aging affected the frequency of flow limited breaths (a marker of upper airway closure) or apneas. Serotonin deficiency increased the amount and efficiency of sleep only in older animals. In conclusion, younger Tph2-/- mice were able to defend their ventilation and phenotypically did not differ from wildtype during wakefulness. In contrast, both young and old Tph2-/- mice showed sleep-related hypoventilation, which was manifested by hypoxemia during REM sleep.
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Affiliation(s)
- Huy Pho
- Division of Pulmonary and Critical Care MedicineDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Mateus R. Amorim
- Division of Pulmonary and Critical Care MedicineDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Qingchao Qiu
- Department of PhysiologyWayne State UniversityDetroitMichiganUSA
| | - Mi‐Kyung Shin
- Division of Pulmonary and Critical Care MedicineDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Lenise J. Kim
- Division of Pulmonary and Critical Care MedicineDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Frederick Anokye‐Danso
- Division of Endocrinology, Diabetes, and MetabolismDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Jonathan J. Jun
- Division of Pulmonary and Critical Care MedicineDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Rexford S. Ahima
- Division of Endocrinology, Diabetes, and MetabolismDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Luiz G. S. Branco
- Dental School of Ribeirão PretoUniversity of São PauloSão PauloBrazil
| | - Donald M. Kuhn
- Department of Psychiatry and Behavioral NeurosciencesWayne State University School of MedicineDetroitMichiganUSA
- John D. Dingell Veterans Affairs Medical CenterDetroitMichiganUSA
| | - Jason H. Mateika
- Department of PhysiologyWayne State UniversityDetroitMichiganUSA
- John D. Dingell Veterans Affairs Medical CenterDetroitMichiganUSA
- Department of Internal MedicineWayne State University School of MedicineDetroitMichiganUSA
| | - Vsevolod Y. Polotsky
- Division of Pulmonary and Critical Care MedicineDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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Petersen N, Greiner TU, Torz L, Bookout A, Gerstenberg MK, Castorena CM, Kuhre RE. Targeting the Gut in Obesity: Signals from the Inner Surface. Metabolites 2022; 12:metabo12010039. [PMID: 35050161 PMCID: PMC8778595 DOI: 10.3390/metabo12010039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/26/2021] [Accepted: 12/31/2021] [Indexed: 12/17/2022] Open
Abstract
Obesity is caused by prolonged energy surplus. Current anti-obesity medications are mostly centralized around the energy input part of the energy balance equation by increasing satiety and reducing appetite. Our gastrointestinal tract is a key organ for regulation of food intake and supplies a tremendous number of circulating signals that modulate the activity of appetite-regulating areas of the brain by either direct interaction or through the vagus nerve. Intestinally derived messengers are manifold and include absorbed nutrients, microbial metabolites, gut hormones and other enterokines, collectively comprising a fine-tuned signalling system to the brain. After a meal, nutrients directly interact with appetite-inhibiting areas of the brain and induce satiety. However, overall feeding behaviour also depends on secretion of gut hormones produced by highly specialized and sensitive enteroendocrine cells. Moreover, circulating microbial metabolites and their interactions with enteroendocrine cells further contribute to the regulation of feeding patterns. Current therapies exploiting the appetite-regulating properties of the gut are based on chemically modified versions of the gut hormone, glucagon-like peptide-1 (GLP-1) or on inhibitors of the primary GLP-1 inactivating enzyme, dipeptidyl peptidase-4 (DPP-4). The effectiveness of these approaches shows that that the gut is a promising target for therapeutic interventions to achieve significant weigh loss. We believe that increasing understanding of the functionality of the intestinal epithelium and new delivery systems will help develop selective and safe gut-based therapeutic strategies for improved obesity treatment in the future. Here, we provide an overview of the major homeostatic appetite-regulating signals generated by the intestinal epithelial cells and how these signals may be harnessed to treat obesity by pharmacological means.
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Affiliation(s)
- Natalia Petersen
- Global Obesity and Liver Disease Research, Global Drug Discovery, Novo Nordisk A/S, Novo Park 1, 2670 Måløv, Denmark; (L.T.); (M.K.G.); (R.E.K.)
- Correspondence:
| | - Thomas U. Greiner
- The Wallenberg Laboratory and Sahlgrenska Center for Cardiovascular and Metabolic Research, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, 405 30 Gothenburg, Sweden;
| | - Lola Torz
- Global Obesity and Liver Disease Research, Global Drug Discovery, Novo Nordisk A/S, Novo Park 1, 2670 Måløv, Denmark; (L.T.); (M.K.G.); (R.E.K.)
- Department of Veterinary and Animal Science, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Angie Bookout
- Global Obesity and Liver Disease Research, Global Drug Discovery, Novo Nordisk Research Center, Seattle, WA 98109, USA; (A.B.); (C.M.C.)
| | - Marina Kjærgaard Gerstenberg
- Global Obesity and Liver Disease Research, Global Drug Discovery, Novo Nordisk A/S, Novo Park 1, 2670 Måløv, Denmark; (L.T.); (M.K.G.); (R.E.K.)
| | - Carlos M. Castorena
- Global Obesity and Liver Disease Research, Global Drug Discovery, Novo Nordisk Research Center, Seattle, WA 98109, USA; (A.B.); (C.M.C.)
| | - Rune Ehrenreich Kuhre
- Global Obesity and Liver Disease Research, Global Drug Discovery, Novo Nordisk A/S, Novo Park 1, 2670 Måløv, Denmark; (L.T.); (M.K.G.); (R.E.K.)
- Department of Veterinary and Animal Science, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
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Zhang Q, Ye R, Zhang YY, Fan CC, Wang J, Wang S, Chen S, Liu X. Brown Adipose Tissue and Novel Management Strategies for Polycystic Ovary Syndrome Therapy. Front Endocrinol (Lausanne) 2022; 13:847249. [PMID: 35663310 PMCID: PMC9160465 DOI: 10.3389/fendo.2022.847249] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 03/22/2022] [Indexed: 12/24/2022] Open
Abstract
Brown adipose tissue (BAT), a unique tissue, plays a key role in metabolism and energy expenditure through adaptive nonshivering thermogenesis. It has recently become a therapeutic target in the treatment of obesity and metabolic diseases. The thermogenic effect of BAT occurs through uncoupling protein-1 by uncoupling adenosine triphosphate (ATP) synthesis from energy substrate oxidation. The review discusses the recent developments and progress associated with the biology, function, and activation of BAT, with a focus on its therapeutic potential for the treatment of polycystic ovary syndrome (PCOS). The endocrine activity of brown adipocytes affects the energy balance and homeostasis of glucose and lipids, thereby affecting the association of BAT activity and the metabolic profile. PCOS is a complex reproductive and metabolic disorder of reproductive-age women. Functional abnormalities of adipose tissue (AT) have been reported in patients with PCOS. Numerous studies have shown that BAT could regulate the features of PCOS and that increases in BAT mass or activity were effective in the treatment of PCOS through approaches including cold stimulation, BAT transplantation and compound activation in various animal models. Therefore, BAT may be used as a novel management strategy for the patients with PCOS to improve women's health clinically. It is highly important to identify key brown adipokines for the discovery and development of novel candidates to establish an efficacious therapeutic strategy for patients with PCOS in the future.
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Affiliation(s)
- Qiaoli Zhang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Beijing Maternal and Child Health Care Hospital, Capital Medical University, Beijing, China
| | - Rongcai Ye
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Yuan-Yuan Zhang
- Department of Reproductive Regulation (Family Planning), Beijing Obstetrics and Gynecology Hospital, Beijing Maternal and Child Health Care Hospital, Capital Medical University, Beijing, China
| | - Chen-Chen Fan
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Beijing Maternal and Child Health Care Hospital, Capital Medical University, Beijing, China
| | - Jun Wang
- Department of Reproductive Regulation (Family Planning), Beijing Obstetrics and Gynecology Hospital, Beijing Maternal and Child Health Care Hospital, Capital Medical University, Beijing, China
| | - Shuyu Wang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Beijing Maternal and Child Health Care Hospital, Capital Medical University, Beijing, China
- *Correspondence: Suwen Chen, ; Xiaowei Liu, ; Shuyu Wang,
| | - Suwen Chen
- Department of Reproductive Regulation (Family Planning), Beijing Obstetrics and Gynecology Hospital, Beijing Maternal and Child Health Care Hospital, Capital Medical University, Beijing, China
- *Correspondence: Suwen Chen, ; Xiaowei Liu, ; Shuyu Wang,
| | - Xiaowei Liu
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Beijing Maternal and Child Health Care Hospital, Capital Medical University, Beijing, China
- *Correspondence: Suwen Chen, ; Xiaowei Liu, ; Shuyu Wang,
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5
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Bae EJ, Choi WG, Pagire HS, Pagire SH, Parameswaran S, Choi JH, Yoon J, Choi WI, Lee JH, Song JS, Bae MA, Kim M, Jeon JH, Lee IK, Kim H, Ahn JH. Peripheral Selective Oxadiazolylphenyl Alanine Derivatives as Tryptophan Hydroxylase 1 Inhibitors for Obesity and Fatty Liver Disease. J Med Chem 2021; 64:1037-1053. [PMID: 33417443 DOI: 10.1021/acs.jmedchem.0c01560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Tryptophan hydroxylase 1 (TPH1) has been recently suggested as a promising therapeutic target for treating obesity and fatty liver disease. A new series of 1,2,4-oxadiazolylphenyl alanine derivatives were identified as TPH1 inhibitors. Among them, compound 23a was the most active in vitro, with an IC50 (half-maximal inhibitory concentration) value of 42 nM, showed good liver microsomal stability, and showed no significant inhibition of CYP and hERG. Compound 23a inhibited TPH1 in the peripheral tissue with limited BBB penetration. In high-fat diet-fed mice, 23a reduced body weight gain, body fat, and hepatic lipid accumulation. Also, 23a improved glucose intolerance and energy expenditure. Taken together, compound 23a shows promise as a therapeutic agent for the treatment of obesity and fatty liver diseases.
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Affiliation(s)
- Eun Jung Bae
- Department of Chemistry, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea
| | - Won Gun Choi
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Haushabhau S Pagire
- Department of Chemistry, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea
| | - Suvarna H Pagire
- Department of Chemistry, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea
| | - Saravanan Parameswaran
- Department of Chemistry, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea
| | - Jun-Ho Choi
- Department of Chemistry, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea
| | - Jihyeon Yoon
- Department of Chemistry, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea
| | - Won-Il Choi
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Ji Hun Lee
- Bio and Drug Discovery Division, Korea Research Institute of Chemical Technology, Daejeon 34114, Republic of Korea
| | - Jin Sook Song
- Bio and Drug Discovery Division, Korea Research Institute of Chemical Technology, Daejeon 34114, Republic of Korea
| | - Myung Ae Bae
- Bio and Drug Discovery Division, Korea Research Institute of Chemical Technology, Daejeon 34114, Republic of Korea
| | - Mijin Kim
- Research Institute of Aging and Metabolism, Kyungpook National University, Daegu 41404, Republic of Korea
| | - Jae-Han Jeon
- Research Institute of Aging and Metabolism, Kyungpook National University, Daegu 41404, Republic of Korea.,Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
| | - In-Kyu Lee
- Research Institute of Aging and Metabolism, Kyungpook National University, Daegu 41404, Republic of Korea.,Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
| | - Hail Kim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Jin Hee Ahn
- Department of Chemistry, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea
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6
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Engelstoft MS, Lund ML, Grunddal KV, Egerod KL, Osborne-Lawrence S, Poulsen SS, Zigman JM, Schwartz TW. Research Resource: A Chromogranin A Reporter for Serotonin and Histamine Secreting Enteroendocrine Cells. Mol Endocrinol 2015; 29:1658-71. [PMID: 26352512 DOI: 10.1210/me.2015-1106] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Chromogranin A (ChgA) is an acidic protein found in large dense-core secretory vesicles and generally considered to be expressed in all enteroendocrine cells of the gastrointestinal (GI) tract. Here, we characterize a novel reporter mouse for ChgA, ChgA-humanized Renilla reniformis (hr)GFP. The hrGFP reporter was found in the monoamine-storing chromaffin cells of the adrenal medulla, where ChgA was originally discovered. hrGFP also was expressed in enteroendocrine cells throughout the GI tract, faithfully after the expression of ChgA, as characterized by immunohistochemistry and quantitative PCR analysis of fluorescence-activated cell sorting-purified cells, although the expression in the small intestine was weak compared with that of the stomach and colon. In the stomach, hrGFP was highly expressed in almost all histamine-storing enterochromaffin (EC)-like cells, at a lower level in the majority of serotonin-storing EC cells and ghrelin cells, in a small fraction of somatostatin cells, but was absent from gastrin cells. In the small intestine, the hrGFP reporter was selectively, but weakly expressed in EC cells, although not in any peptide-storing enteroendocrine cells. In the colon, hrGFP was exclusively expressed in EC cells but absent from the peptide-storing enteroendocrine cells. In contrast, in the pancreas, hrGFP was expressed in β-cells, α-cells, and a fraction of pancreatic polypeptide cells. It is concluded that ChgA-hrGFP in the GI tract functions as an effective reporter, particularly for the large populations of still poorly characterized monoamine-storing enteroendocrine cells. Furthermore, our findings substantiate the potential function of ChgA as a monoamine-binding protein that facilitates the regulated endocrine secretion of large amounts of monoamines from enteroendocrine cells.
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Affiliation(s)
- Maja S Engelstoft
- Novo Nordisk Foundation Center for Basic Metabolic Research (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Section for Metabolic Receptology, and Laboratory for Molecular Pharmacology (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, and Department of Biomedical Sciences (S.S.P.), Endocrinology Research Section, University of Copenhagen, Copenhagen DK-2200, Denmark; Danish Diabetes Academy (M.S.E.), Odense, Denmark; and Division of Hypothalamic Research (S.O.-L., J.M.Z.), Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Mari L Lund
- Novo Nordisk Foundation Center for Basic Metabolic Research (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Section for Metabolic Receptology, and Laboratory for Molecular Pharmacology (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, and Department of Biomedical Sciences (S.S.P.), Endocrinology Research Section, University of Copenhagen, Copenhagen DK-2200, Denmark; Danish Diabetes Academy (M.S.E.), Odense, Denmark; and Division of Hypothalamic Research (S.O.-L., J.M.Z.), Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Kaare V Grunddal
- Novo Nordisk Foundation Center for Basic Metabolic Research (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Section for Metabolic Receptology, and Laboratory for Molecular Pharmacology (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, and Department of Biomedical Sciences (S.S.P.), Endocrinology Research Section, University of Copenhagen, Copenhagen DK-2200, Denmark; Danish Diabetes Academy (M.S.E.), Odense, Denmark; and Division of Hypothalamic Research (S.O.-L., J.M.Z.), Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Kristoffer L Egerod
- Novo Nordisk Foundation Center for Basic Metabolic Research (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Section for Metabolic Receptology, and Laboratory for Molecular Pharmacology (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, and Department of Biomedical Sciences (S.S.P.), Endocrinology Research Section, University of Copenhagen, Copenhagen DK-2200, Denmark; Danish Diabetes Academy (M.S.E.), Odense, Denmark; and Division of Hypothalamic Research (S.O.-L., J.M.Z.), Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Sherri Osborne-Lawrence
- Novo Nordisk Foundation Center for Basic Metabolic Research (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Section for Metabolic Receptology, and Laboratory for Molecular Pharmacology (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, and Department of Biomedical Sciences (S.S.P.), Endocrinology Research Section, University of Copenhagen, Copenhagen DK-2200, Denmark; Danish Diabetes Academy (M.S.E.), Odense, Denmark; and Division of Hypothalamic Research (S.O.-L., J.M.Z.), Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Steen Seier Poulsen
- Novo Nordisk Foundation Center for Basic Metabolic Research (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Section for Metabolic Receptology, and Laboratory for Molecular Pharmacology (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, and Department of Biomedical Sciences (S.S.P.), Endocrinology Research Section, University of Copenhagen, Copenhagen DK-2200, Denmark; Danish Diabetes Academy (M.S.E.), Odense, Denmark; and Division of Hypothalamic Research (S.O.-L., J.M.Z.), Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Jeffrey M Zigman
- Novo Nordisk Foundation Center for Basic Metabolic Research (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Section for Metabolic Receptology, and Laboratory for Molecular Pharmacology (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, and Department of Biomedical Sciences (S.S.P.), Endocrinology Research Section, University of Copenhagen, Copenhagen DK-2200, Denmark; Danish Diabetes Academy (M.S.E.), Odense, Denmark; and Division of Hypothalamic Research (S.O.-L., J.M.Z.), Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Thue W Schwartz
- Novo Nordisk Foundation Center for Basic Metabolic Research (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Section for Metabolic Receptology, and Laboratory for Molecular Pharmacology (M.S.E., M.L.L., K.V.G., K.L.E., T.W.S.), Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, and Department of Biomedical Sciences (S.S.P.), Endocrinology Research Section, University of Copenhagen, Copenhagen DK-2200, Denmark; Danish Diabetes Academy (M.S.E.), Odense, Denmark; and Division of Hypothalamic Research (S.O.-L., J.M.Z.), Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas 75390
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