Neuroendocrine control of food intake

Role of Cholecystokinin (cck) in Feeding Regulation of Largemouth Bass (Micropterus salmoides): Peptide Activation and Antagonist Inhibition

This study investigated the role of cholecystokinin (cck) in the feeding regulation of largemouth bass (Micropterus salmoides) via peptide activation and antagonist inhibition. The results show that the cck gene was expressed in various tissues, with the highest expression level occurring in the brain. Feeding, continuous feeding, and refeeding after fasting could significantly improve the mRNA levels of cck in the brain. Moreover, the activation of cck via injecting an exogenous CCK peptide could inhibit feed intake by regulating the mRNA levels of anorexigenic and feed-promoting factors in the brain and intestine. Furthermore, the CCK peptide reduced feed intake; however, the presence of an antagonist (Ly225910-CCK1R and devazepide-CCK2R) could reverse this effect through regulating the mRNA levels of anorexigenic and feed-promoting factors in the brain and intestine. Treatment with devazepide + CCK (CCK2R) reversed feed intake more effectively than Ly225910 + CCK (CCK1R) treatment. In summary, cck could regulate the feed intake of largemouth bass through regulating feeding-related genes in the brain and intestine. In addition, cck required binding with the receptor to inhibit feed intake more effectively in largemouth bass, and the binding effect of CCK1R was better than that of CCK2R.

Avoidant restrictive food intake disorder: recent advances in neurobiology and treatment

Avoidant restrictive food intake disorder (ARFID) is an eating disorder characterized by persistent insufficient nutritional and/or energy intake. ARFID, before referred to as "selective eating disorder", was introduced recently in the DSM-5 as a replacement for and expansion of the previous diagnosis. Individuals with ARFID may limit food variety and intake due to avoidance based on the sensory characteristics of the food or related to any adverse consequences of eating without the intention of losing weight and concerns of body image. The limited understanding of avoidant and restrictive eating poses challenges to effective treatment and management, impacting directly on the growth and development of children and adolescents. The ARFID neurobiological concept has not yet been clearly defined to clinical practice for nutritionists, thereby hindering screening and impeding the development of treatment recommendations. This narrative review provide useful practical information to consult the pathophysiology, the neurobiology, the clinical features, the assessment and the treatment for healthcare professionals seeking to enhance their clinical knowledge and management of this disorder.

Hypothalamic syndrome

Hypothalamic syndrome (HS) is a rare disorder caused by disease-related and/or treatment-related injury to the hypothalamus, most commonly associated with rare, non-cancerous parasellar masses, such as craniopharyngiomas, germ cell tumours, gliomas, cysts of Rathke's pouch and Langerhans cell histiocytosis, as well as with genetic neurodevelopmental syndromes, such as Prader-Willi syndrome and septo-optic dysplasia. HS is characterized by intractable weight gain associated with severe morbid obesity, multiple endocrine abnormalities and memory impairment, attention deficit and reduced impulse control as well as increased risk of cardiovascular and metabolic disorders. Currently, there is no cure for this condition but treatments for general obesity are often used in patients with HS, including surgery, medication and counselling. However, these are mostly ineffective and no medications that are specifically approved for the treatment of HS are available. Specific challenges in HS are because the syndrome represents an adverse effect of different diseases, and that diagnostic criteria, aetiology, pathogenesis and management of HS are not completely defined.

A review of the "OMICS" for management of patients with obstructive sleep apnoea

Obstructive sleep apnaea (OSA) syndrome is a condition characterised by the presence of complete or partial collapse of the upper airways during sleep, resulting in fragmentation of sleep associated with rapid episodes of intermittent hypoxia (IH), activation of the sympathetic nervous system and oxidative stress. OSA is associated with a broad spectrum of cardiovascular, metabolic and neurocognitive comorbidities that appear to be particularly evident in obese patients, while affecting both sexes in a different manner and varying in severity according to gender and age. In recent years, studies on OSA have increased considerably, but in clinical practice, it is still a highly underdiagnosed disease. To date, the gold standard for the diagnosis of OSA is nocturnal polysomnography (PSG). However, since it is not well suited for a large number of patients, the Home Sleep Test (HST) is also an accepted diagnostic method. Currently, the major aim of research is to identify non-invasive methods to achieve a highly predictive, non-invasive screening system for these subjects. The most recent reports indicate that research in this field has made significant progress in identifying possible biomarkers in OSA, using -OMIC approaches, particularly in the fields of proteomics and metabolomics. In this review, we analyse these OMIC biomarkers found in the literature.

Effects of apelin on reproductive functions: relationship with feeding behavior and energy metabolism

Apelin is an adipose tissue derived peptidergic hormone. In this study, 40 male Sprague-Dawley rats were used (four groups; n = 10). Apelin-13 at three different dosages (1, 5 and 50 μg/kg) was given intraperitoneally while the control group received vehicle the same route for a period of 14 days. In results, apelin-13 caused significant decreases in serum testosterone, luteinizing hormone and follicle-stimulating hormone levels (p < 0.05). Administration of apelin-13 significantly increased body weights, food intake, serum low-density lipoprotein and total cholesterol levels (p < 0.05), but caused significant decreases in high-density lipoprotein levels (p < 0.05). Serum glucose and triglyceride levels were not significantly altered by apelin-13 administration. Significant decreases in both uncoupling protein (UCP)-1 levels in the white and brown adipose tissues and UCP-3 levels in the biceps muscle (p < 0.05) were noted. The findings of the study suggest that apelin-13 may not only lead to obesity by increasing body weight but also cause infertility by suppressing reproductive hormones.

Transgenic n-3 PUFAs enrichment leads to weight loss via modulating neuropeptides in hypothalamus

Body weight is related to fat mass, which is associated with obesity. Our study explored the effect of fat-1 gene on body weight in fat-1 transgenic mice. In present study, we observed that the weight/length ratio of fat-1 transgenic mice was lower than that of wild-type mice. The serum levels of triglycerides (TG), cholesterol (CT), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c) and blood glucose (BG) in fat-1 transgenic mice were all decreased. The weights of peri-bowels fat, perirenal fat and peri-testicular fat in fat-1 transgenic mice were reduced. We hypothesized that increase of n-3 PUFAs might alter the expression of hypothalamic neuropeptide genes and lead to loss of body weight in fat-1 transgenic mice. Therefore, we measured mRNA levels of appetite neuropeptides, Neuropeptide Y (NPY), Agouti-related peptides (AgRP), Proopiomelanocortin (POMC), Cocaine and amphetamine regulated transcript (CART), ghrelin and nesfatin-1 in hypothalamus by real-time PCR. Compared with wild-type mice, the mRNA levels of CART, POMC and ghrelin were higher, while the mRNA levels of NPY, AgRP and nesfatin-1 were lower in fat-1 transgenic mice. The results indicate that fat-1 gene or n-3 PUFAs participates in regulation of body weight, and the mechanism of this phenomenon involves the expression of appetite neuropeptides and lipoproteins in fat-1 transgenic mice.

Perturbed energy balance and hydration status in ultra-endurance runners during a 24 h ultra-marathon

The present study aimed to assess the adequacy of energy, macronutrients and water intakes of ultra-endurance runners (UER) competing in a 24 h ultra-marathon (distance range: 122-208 km). The ad libitum food and fluid intakes of the UER (n 25) were recorded throughout the competition and analysed using dietary analysis software. Body mass (BM), urinary ketone presence, plasma osmolality (POsmol) and volume change were determined at pre- and post-competition time points. Data were analysed using appropriate t tests, with significance set at P <0·05. The total energy intake and expenditure of the UER were 20 (sd 12) and 55 (sd 11) MJ, respectively (control (CON) (n 17): 12 (sd 1) and 14 (sd 5) MJ, respectively). The protein, carbohydrate and fat intakes of the UER were 1·1 (sd 0·4), 11·3 (sd 7·0) and 1·5 (sd 0·7) g/kg BM, respectively. The rate of carbohydrate intake during the competition was 37 (sd 24) g/h. The total water intake of the UER was 9·1 (sd 4·0) litres (CON: 2·1 (sd 1·0) litres), while the rate of water intake was 378 (sd 164) ml/h. Significant BM loss occurred at pre- to post-competition time points (P =0·001) in the UER (1·6 (sd 2·0) %). No significant changes in POsmol values were observed at pre- (285 (sd 11) mOsmol/kg) to post-competition (287 (sd 10) mOsmol/kg) time points in the UER and were lower than those recorded in the CON group (P <0·05). However, plasma volume (PV) increased at post-competition time points in the UER (10·2 (sd 9·7) %; P <0·001). Urinary ketones were evident in the post-competition samples of 90 % of the UER. Energy deficit was observed in all the UER, with only one UER achieving the benchmark recommendations for carbohydrate intake during endurance exercise. Despite the relatively low water intake rates recorded in the UER, hypohydration does not appear to be an issue, considering increases in PV values observed in the majority (80 %) of the UER. Population-specific dietary recommendations may be beneficial and warranted.

Effect of fish oil intake on glucose levels in rat prefrontal cortex, as measured by microdialysis

Background

Brain glucose sensing may contribute to energy homeostasis control. The prefrontal cortex (PFC) participates in the hedonic component of feeding control. As high-fat diets may disrupt energy homeostasis, we evaluated in male Wistar rats whether intake of high-fat fish-oil diet modified cortical glucose extracellular levels and the feeding induced by intracerebroventricular glucose or PFC glucoprivation.

Methods

Glucose levels in PFC microdialysates were measured before and after a 30-min meal. Food intake was measured in animals receiving intracerebroventricular glucose followed, 30-min. later, by 2-deoxy-D-glucose injected into the PFC.

Results

The fish-oil group showed normal body weight and serum insulin while fat pads weight and glucose levels were increased. Baseline PFC glucose and 30-min. carbohydrates intake were similar between the groups. Feeding-induced PFC glucose levels increased earlier and more pronouncedly in fish-oil than in control rats. Intracerebroventricular glucose inhibited feeding consistently in the control but not in the fish-oil group. Local PFC glucoprivation with 2-DG attenuated glucose-induced hypophagia.

Conclusions

The present experiments have shown that, following food intake, more glucose reached the prefrontal cortex of the rats fed the high-fat fish-oil diet than of the rats fed the control diet. However, when administered directly into the lateral cerebral ventricle, glucose was able to consistently inhibit feeding only in the control rats. The findings indicate that, an impairment of glucose transport into the brain does not contribute to the disturbances induced by the high-fat fish-oil feeding.

Rats allowed to self-select zinc-deficient lard and fish-oil diets did not develop a preference for fish-oil diet

Zinc (Zn)-deficiency causes a reduction in food intake and alters adipose metabolism. The effect of zinc restriction in rats on the selection of fish-oil and lard was studied during a period of reduced appetite. The reduction of appetite was caused by an experimentally induced Zn-deficiency. Four-week-old male rats were divided into three dietary treatment groups: Zn-adequate (ZnA, 30.9 mg Zn/kg), marginal Zn-deficient (ZnM, 5.9 mg Zn/kg) or Zn-deficient (ZnD, 0.9 mg Zn/kg). The three groups were placed on a self-selection regimen of the ZnA-fish-oil diet (ZnA-FD) and the ZnA-lard diet (ZnA-LD), the ZnM-FD and the ZnM-LD or the ZnD-FD and the ZnD-LD, respectively for 24 d. The amount of the FD intake in the ZnD group decreased to 0.5 g/d after day 4-6 of self-selecting on the LD and the FD and no significant increase in the FD intake in the group was observed during the self-selection period. However, after day 7-9 and 13-15, the FD intake of the ZnA and the ZnM groups increased, respectively, and at the end of the self-selection period the ZnM and the ZnA rats consumed about 2.0 g FD/d and 4.5 g FD/d, respectively. The FD intake ratio [FD intake (g)/total intake (g)] in the ZnD rats during the self-selection period was the lowest and that in the ZnA rats was the highest of three groups. In conclusion, we showed that zinc status alters fish-oil and lard selection patterns and ZnD rats did not show a preference for fish-oil.

Postexercise water immersion increases short-term food intake in trained men

PURPOSE

The performance of exercise while immersed in cold water has been shown to influence energy intake in the subsequent meal. In addition, cold water immersion (CWI) itself has been shown to reduce the concentration of the hormone leptin, high concentrations of which signal satiety. Taken together, these findings raise the question of whether the common practice of postexercise CWI by athletes acutely affects energy intake. Hence, this study investigated the acute effect of CWI after exercise on subsequent energy intake and macronutrient preferences as well as the circulating levels of a range of appetite-related hormones.

METHODS

Ten physically active men participated in three randomized, counterbalanced trials consisting of 40 min of treadmill running (70% VO(2peak)), followed by 20 min of CWI (15°C), neutral water immersion (NWI; 33°C), or a resting control with no immersion (CON). Participants were then given a 30-min access to a buffet-type breakfast of precisely known quantity and nutrient composition from which they could consume ad libitum.

RESULTS

Participants consumed significantly more energy after both CWI (mean ± SD = 4893 ± 1554 kJ, P = 0.006) and NWI (5167 ± 1975 kJ, P = 0.010) compared with CON (4089 ± 1585 kJ). However, there was no significant difference in total energy intake between the CWI and the NWI trials (P = 0.595). These changes were associated with a significant interaction effect of time and trial on both leptin (P = 0.045) and active ghrelin (P = 0.046).

CONCLUSION

Postexercise water immersion is associated with higher energy intake in the subsequent meal compared with CON. This is an important consideration for trained men using water immersion as a method of recovery from exercise.

Zinc's role in rat preference for a low-fat diet in a two-choice diet program of low- and high-fat diets

To investigate the change in preference for a low-fat diet (LFD) and a high-fat diet (HFD) under disorders induced by a zinc (Zn)-deficiency, two groups of 4-wk-old male rats were fed a two-choice diet of Zn-deficient (ZnD; 0.75 mg/kg) and Zn-adequate (ZnA; 30.75 mg/kg) LFD and HFD. After 21 d, 10 rats in each of the two groups were sacrificed. The remaining ZnD rats were switched to ZnA diets for 7 d. Intakes of the LFD and the HFD were measured to determine the diet preferences of the ZnD, the ZnA and the Zn-recovered groups. Energy intake of the ZnD group was significantly lower than that of the ZnA group and showed cyclical 3- to 4-d patterns of decrease. In the ZnD group, although the LFD intake decreased parallel to the reduction in the energy intake, the HFD intake did not show the cyclical pattern of decrease. The reduced intake of the LFD in the ZnD rats was accompanied by a low carbohydrate intake and a low plasma insulin concentration. When the ZnD group recovered sufficient amounts of Zn, the energy intake was restored to normal levels and the difference in the LFD intake and the plasma insulin concentration disappeared between the ZnD and the ZnA groups. It was supposed that the specific change in the LFD intake patterns during development and recovery from Zn-deficiency might be related to Zn-mediated changes in impaired synthesis and the release of insulin from the pancreas.

Neuropeptide exocytosis involving synaptotagmin-4 and oxytocin in hypothalamic programming of body weight and energy balance

Hypothalamic neuropeptides play essential roles in regulating energy and body weight balance. Energy imbalance and obesity have been linked to hypothalamic signaling defects in regulating neuropeptide genes; however, it is unknown whether dysregulation of neuropeptide exocytosis could be critically involved. This study discovered that synaptotagmin-4, an atypical modulator of synaptic exocytosis, is expressed most abundantly in oxytocin neurons of the hypothalamus. Synaptotagmin-4 negatively regulates oxytocin exocytosis, and dietary obesity is associated with increased vesicle binding of synaptotagmin-4 and thus enhanced negative regulation of oxytocin release. Overexpressing synaptotagmin-4 in hypothalamic oxytocin neurons and centrally antagonizing oxytocin in mice are similarly obesogenic. Synaptotagmin-4 inhibition prevents against dietary obesity by normalizing oxytocin release and energy balance under chronic nutritional excess. In conclusion, the negative regulation of synaptotagmin-4 on oxytocin release represents a hypothalamic basis of neuropeptide exocytosis in controlling obesity and related diseases.

Acute effect of environmental temperature during exercise on subsequent energy intake in active men

BACKGROUND

The performance of exercise while immersed in cold water has been shown to influence energy intake in the subsequent meal. However, the effect of ambient temperature during land-based exercise is not known.

OBJECTIVES

Our aims were to investigate the effect of exercise performed in the heat on energy intake in the subsequent meal and to determine concentrations of circulating appetite-related hormones.

DESIGN

In a randomized, counterbalanced design, 11 active male participants completed 3 experimental trials in a fasted state: exercise in the heat (36 degrees C), exercise in a neutral temperature (25 degrees C), and a resting control (25 degrees C). The exercise trials consisted of treadmill running for 40 min at 70% VO(2peak). After each trial, participants were presented with a buffet-type breakfast of precisely known quantity and nutrient composition, which they could consume ad libitum.

RESULTS

Energy intake was greater after exercise in the neutral temperature compared with the control (P = 0.021) but was similar between exercise in the heat and the control and between the 2 exercise trials. When accounting for the excess energy expended during exercise, relative energy intake during exercise in the heat was lower than the control (P = 0.002) but was similar between exercise in the neutral temperature and the control and between exercise in the heat and in the neutral temperature. The lower relative energy intake after exercise in the heat was associated with an elevated tympanic temperature and circulating concentrations of peptide YY (P < 0.05).

CONCLUSION

Exercise in a neutral environmental temperature is associated with higher energy intake in the subsequent meal compared with a control, whereas exercise in the heat is not.

The effects of high fat on central appetite genes in Wistar rats: a microarray analysis

BACKGROUND

To evaluate the effects of high fat on central appetite regulatory genes in Wistar rats by microarray.

METHODS

Sixteen male Wistar rats were randomly assigned to control (15% energy from fat) and high-fat (60% energy from fat) diets for 12 weeks. Body weight and food intake were recorded. Plasma leptin, ghrelin and insulin were measured by radioimmunoassay method. The expression of 111 appetite regulatory genes in the hypothalamus was evaluated by microarray and six genes, including leptin receptor, insulin receptor, orexin, NPY, AgRP, MC-4R, were further evaluated by real-time RT-PCR.

RESULTS

Body weight increased significantly in HF group compared with control group, whereas energy intake was similar in the two groups. HF had a time dependent effect on plasma leptin, but insulin and ghrelin level remained stable throughout the study. A positive relation was also found between body weight and plasma leptin (r=0.88, P<0.01). The expression of 27 appetite genes in the hypothalamus was significantly affected by HF diet. However, only the expression of leptin receptor was confirmed lower in HF group than that in control by real-time PCR, which suggested that lower expression of leptin receptor might be another reason for leptin resistance.

CONCLUSIONS

HF diet fed rats demonstrated leptin resistance, which could be targeted for obesity treatment.

Decreased levels of ghrelin, cortisol, and fasting blood sugar, but not n-octanoylated ghrelin, in Japanese schizophrenic inpatients treated with olanzapine

The mechanism by which chronic administration of olanzapine induces a marked weight gain in patients with schizophrenia remains unknown. We examined the influence of long-term treatment with olanzapine on plasma levels of hormones regulating food intake and energy homeostasis in schizophrenia. In this study, olanzapine was administered to 28 Japanese inpatients for 16 weeks after switching from typical antipsychotic drugs or risperidone. At endpoint, no significant changes in body weight or body mass index were found. There was a significant decrease in the plasma levels of ghrelin without any accompanying change in active, n-octanoylated ghrelin. Serum levels of leptin tended to be increased and a significant reduction in plasma cortisol levels was found. In addition, the levels of fasting blood sugar as well as free fatty acid were significantly decreased. Furthermore, we did not confirm any marked weight gain induced by chronic administration of olanzapine as previously reported. The reason for this discrepancy may be due to differences in subjects and treatment settings. Based on these findings, it is unlikely that the decrease in plasma ghrelin levels by chronic administration of olanzapine affects weight gain. Further studies examining the effect of chronic olanzapine administration on weight and energy homeostasis in inpatients are required.

The effect of peripheral administration of zinc on food intake in rats fed Zn-adequate or Zn-deficient diets

Zinc deficiency induces a striking reduction of food intake in animals. To elucidate the mechanisms for this effect, two studies were connectedly conducted to determine the effects of peripheral administration of zinc on food intake in rats fed the zinc-adequate or zinc-deficient diets for a 3-week period. In study 1, two groups of male Sprague-Dawley rats were provided diets made either adequate (ZA; 38.89 mg/kg) or deficient (ZD; 3.30 mg/kg) in zinc. In study 2, after feeding for 3 weeks, both ZA and ZD groups received intraperitoneal (IP) injection of zinc solution with three levels (0.5, 1.0, and 2.0 microg zinc/g body weight, respectively) and cumulative food intake at 0.5, 1, 2, 4, and 24 h, and plasma hormones concentrations were measured. The results in study 1 showed rats fed the ZD diets revealed symptoms of zinc deficiency, such as sparse and coarse hair, poor appetite, susceptibility to surroundings, lethargy, and small movements. Zinc concentrations in serum, femur, and skeletal muscle of rats fed the ZD diets declined by 26.58% (P < 0.01), 27.32% (P < 0.01), and 24.22% (P < 0.05), respectively, as compared with ZA control group. These findings demonstrated that rat models with zinc deficiency and zinc adequacy had been fully established. The results in study 2 showed that IP administration of zinc in both ZA and ZD rats did not influence food intake at each time points (P > 0.05), although zinc deficiency suppressed food intake. Plasma neuropeptide Y (NPY) was higher, but insulin and glucagon were lower in response to zinc deficiency or zinc administration by contrast with their respective controls (P < 0.05). Leptin, T3, and T4 concentrations were uniformly decreased (P < 0.05) in rats fed the ZD diets in contrast to ZA diets; however, no differences (P > 0.05) were observed during zinc injection. Calcitonin gene-related peptide was unaffected (P > 0.05) by either zinc deficiency or zinc administration. The present studies suggested that zinc administration did not affect short-term food intake in rats even in the zinc-deficient ones; the reduced food intake induced by zinc deficiency was probably associated with the depression in thyroid hormones. The results also indicated that NPY and insulin varied conversely during the control of food intake.

Homeobox gene Sax2 deficiency causes an imbalance in energy homeostasis

The brain, in particular the hypothalamus and the brainstem, plays a critical role in the regulation of energy homeostasis by incorporating signals from the periphery and translating them into feeding behavior. Here we show that the homeobox gene Sax2, which is expressed predominantly in the brainstem, in the vicinity of serotonergic neurons, contributes to this physiological balance. Sax2 deficiency results in a decrease of fat and glycogen storage, reduced blood glucose levels, and raised serotonin levels in the hindbrain. Surprisingly, in the brainstem the expression levels of pro-opiomelanocortin and neuropeptide Y were indicative of a fasting condition, opposed to the observed high serotonin levels implying satiation. Furthermore, Sax2-directed lacZ expression reveals a dramatic change of the distribution of Sax2-expressing cells in the null mutant occurring during perinatal development. These data strongly suggest that Sax2 is required for the coordinated crosstalk of factors involved in the maintenance of energy homeostasis.

Changes in body mass index in Canadians over a five-year period: results of a prospective, population-based study

BACKGROUND

The initiation of the Canadian Multicentre Osteoporosis Study in 1996, and subsequent follow-up of the cohort 5 years later, provided longitudinal body mass index (BMI) data for a random sample of Canadians.

METHODS

Height and weight were measured at baseline and 5 years and used to calculate BMI and assign one of six weight categories. Multiple imputation was used to adjust for missing weight at year 5. Data were stratified by age and gender. The proportion of participants moving between categories was generated, and multivariable linear regression was used to identify factors associated with weight change.

RESULTS

Baseline data were available for 8548 participants, year 5 data for 6721, and year 5 weight was imputed for 1827 (17.6%). Mean BMI for every age and gender group exceeded healthy weight guidelines. Most remained within their BMI classification over 5 years, but when change occurred, BMI category was more likely to increase than decrease. Several sociodemographic, lifestyle and clinical characteristics were associated with change.

CONCLUSION

Mean baseline BMI tended to be higher than recommended. Moreover, on average, men under age 45 and women under age 55 were gaining approximately 0.45 kilograms (one pound) per year, which leveled off with increased age and reversed in the oldest age groups. These findings underscore the need for public health efforts aimed at combating obesity.

Ghrelin, the peripheral hunger hormone

In the current review we summarize the available data concerning the gastric hormone ghrelin and its receptor. Ghrelin stimulates short-term food intake and long-term body weight regulation via its adipogenic and diabetogenic effects. Ghrelin stimulates gastric emptying, and these effects could be explored from a therapeutic point of view. Ghrelin levels change profoundly in anorexia, in states of insulin resistance, in obesity, and after bariatric surgery, suggesting that this is an important hormone in body weight regulation.

Gut-brain communication: how does it stand after bariatric surgery?

PURPOSE OF REVIEW

This article aims to critically review the literature, describing the possible implications of different bariatric surgery techniques in gastrointestinal peptides and their relation with the neural paths involved in the central regulation of appetite and satiety: the gut-brain axis.

RECENT FINDINGS

Bariatric surgery operations change orexigenic and anorexigenic gastrointestinal peptide levels. Forty-one studies were analyzed in order to understand the effects of different operations on the behavior of gut peptides (ghrelin, cholecystokinin, peptide YY, glucagon-like peptide-1, gastric inhibitory polypeptide, pancreatic polypeptide). The authors have tried to correlate these findings with weight loss/maintenance via different surgical techniques.

SUMMARY

The present line of research is recent and there is a lack of comparability between studies. There are different design approaches and study protocols, different laboratorial exams. Prospective long-term studies with larger samples are needed to clarify the effects of bariatric operations on the gut-brain axis.

Obestatin acts in brain to inhibit thirst

Derived from the same prohormone, obestatin has been reported to exert effects on food intake that oppose those of ghrelin. The obestatin receptor GPR39 is present in brain and pituitary gland. Since the gene encoding those two peptides is expressed also in those tissues, we examined further the possible actions of obestatin in vivo and in vitro. Intracerebroventricular administration of obestatin inhibited water drinking in ad libitum-fed and -watered rats, and in food-and water-deprived animals. The effects on water drinking preceded and were more pronounced than any effect on food intake, and did not appear to be the result of altered locomotor/behavioral activity. In addition, obestatin inhibited ANG II-induced water drinking in animals provided free access to water and food. Current-clamp recordings from cultured, subfornical organ neurons revealed significant effects of the peptide on membrane potential, suggesting this as a potential site of action. In pituitary cell cultures, log molar concentrations of obestatin ranging from 1.0 pM to 100 nM failed to alter basal growth hormone (GH) secretion. In addition, 100 nM obestatin failed to interfere with the stimulation of GH secretion by GH-releasing hormone or ghrelin and did not alter the inhibition by somatostatin in vitro. We conclude that obestatin does not act in pituitary gland to regulate GH secretion but may act in brain to alter thirst mechanisms. Importantly, in rats the effects of obestatin on food intake may be secondary to an action of the peptide to inhibit water drinking.

The role of neuropeptide Y, orexins, cocaine and amphetamine-related transcript, cholecystokinin, amylin and leptin in the regulation of feeding in fish

In fish, as in all vertebrates, the brain is the primary center of regulation of food intake. Afferent signals continuously inform the central nervous system about changes in energy homeostasis. The brain interprets and integrates these signals and responds with efferent signals that help maintain a constant energy balance. Neuropeptides that originate from the hypothalamus regulate food intake either by stimulating (orexigenic factors) or inhibiting (anorexigenic factors) appetite. Studies using brain or peripheral peptide injections have shown that neuropeptide Y (NPY) and orexins are potent orexigenic factors in fish, whereas cocaine and amphetamine-related transcript (CART) peptides decrease food intake. Complex interactions exist between these central neuropeptide systems. For example, NPY and orexins have synergistic effects on food intake and they are both modulated by CART peptides. These systems are also influenced by endocrine factors from the periphery, including hormones from the gut, such as cholecystokinin (CCK), the pancreatic hormone amylin and the adipocyte hormone leptin. Fasting or ingestion of a meal induces changes in the mRNA expression of NPY, orexins and CART, suggesting that nutritional status modulates the action of these systems. This brief review will focus on our current knowledge on the structure and role of these six appetite-regulating peptides in fish.

Alterations of arcuate nucleus neuropeptidergic development in contactin-deficient mice: comparison with anorexia and food-deprived mice

A mutation in the Contactin-1 gene results in an ataxic and anorectic phenotype that is apparent by postnatal day 10 and lethal by postnatal day 19 [Berglund et al. (1999) Neuron 24, 739-750]. The resemblance of this phenotype with the anorexia (anx/anx) mouse mutation prompted us to investigate the hypothalamic neurochemistry of Contactin knock-out (KO) mice. Contactin was expressed in the hypothalamic neuropil of wild-type (WT) but not Contactin KO mice. In the KO condition, neuropeptide Y (NPY) and agouti-related protein (AgRP) immunoreactivity (IR) accumulated in the somata of arcuate nucleus neurons, whereas IR for these neuropeptides as well as for alpha-melanocyte-stimulating hormone (alpha-MSH) decreased in the corresponding axon projections. These changes in the pattern of neuropeptide expression in the Contactin-deficient hypothalamus were similar but more pronounced than those found in anx/anx mice. Increased levels of NPY and AgRP and decreased concentrations of pro-opiomelanocortin mRNA in arcuate neurons accompanied these changes. In relating these alterations a 24-h food deprivation period, we observed in 3-week-old WT mice an elevation of NPY- and AgRP-IR in the perikarya of arcuate neurons without notable reduction of NPY- or AgRP-IR in nerve fibers, suggesting that the decrease of arcuate projections can be associated with postnatal anorectic phenotype. Our data implicate Contactin in the postnatal development of the NPY/AgRP and alpha-MSH arcuate neurons and suggest that similar to anx/anx mutant mice, compromised orexigenic signaling via NPY/AgRP neurons may contribute to reduced food intake by the Contactin-mutant animals.

Effects of central infusion of ghrelin on food intake and plasma levels of growth hormone, luteinizing hormone, prolactin, and cortisol secretion in sheep

Ghrelin is an endogenous ligand for the GH secretagogue/ghrelin receptor (GHS-R) and stimulates feeding behavior and GH levels in rodents and humans. A preprandial increase in plasma ghrelin levels is seen in sheep on programmed feeding, followed by a postprandial rise in plasma GH levels, but effects on food intake and endocrine function are not defined in this ruminant species. We administered ghrelin to female sheep in various modes and measured effects on voluntary food intake (VFI) and plasma levels of GH, LH, prolactin, and cortisol. Whether administered intracerebroventricularly or iv, ghrelin consistently failed to stimulate VFI. On the other hand, ghrelin invariably increased plasma GH levels and alpha,beta-diaminopropanoic acid-octanoyl3 human ghrelin was more potent than ovine ghrelin. Bolus injection of ghrelin into the third cerebral ventricle reduced plasma LH levels but did not affect levels of prolactin or cortisol. These findings suggested that the preprandial rise in plasma ghrelin that is seen in sheep on programmed feeding does not influence VFI but is likely to be important in the postprandial rise in GH levels. Thus, ghrelin does not appear to be a significant regulator of ingestive behavior in this species of ruminant but acts centrally to indirectly regulate GH and LH secretion.

Therapy Insight: weight-loss surgery and major cardiovascular risk factors

Weight-loss surgery is an effective treatment for severe, medically complicated and refractory obesity. It reverses, eliminates or significantly ameliorates major cardiovascular risk factors related to obesity. In a large proportion of patients, the therapy produces significant weight loss, reduces the risk of disability and premature death, and improves quality of life. Surgical treatment by gastric-restrictive and malabsorptive procedures started several decades ago in the US. Since the 1970s, accrued clinical experience and advances in technology, particularly in minimally invasive surgical approaches, have changed this therapy. Some procedures have evolved, whereas others have become obsolete. Today's weight-loss operations are safe, effective and potentially life-saving options for severely obese cardiology patients. This review describes weight-loss surgery procedures and their effects on cardiovascular risk factors.