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Senol E, Mohammad H. Current perspectives on brain circuits involved in food addiction-like behaviors. J Neural Transm (Vienna) 2024; 131:475-485. [PMID: 38216705 DOI: 10.1007/s00702-023-02732-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/17/2023] [Indexed: 01/14/2024]
Abstract
There is an emerging view that the increased availability of energy-dense foods in our society is contributing to excessive food consumption which could lead to food addiction-like behavior. Particularly, compulsive eating patterns are predominant in people suffering from eating disorders (binge-eating disorder, bulimia and anorexia nervosa) and obesity. Phenotypically, the behavioral pattern exhibits a close resemblance to individuals suffering from other forms of addiction (drug, sex, gambling). Growing body of evidence in neuroscience research is showing that excessive consumption of energy-dense foods alters the brain circuits implicated in reward, decision-making, control, habit formation, and emotions that are central to drug addiction. Here, we review the current understanding of the circuits of food addiction-like behaviors and highlight the future possibility of exploring those circuits to combat obesity and eating disorders.
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Affiliation(s)
- Esra Senol
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Hasan Mohammad
- Centre de Recherche en Biomédicine de Strasbourg (CRBS), L'Institut National de La Santé Et de La Recherche Médicale (Inserm) U1114, University of Strasbourg, Strasbourg, France.
- Department of Biological Sciences, Indian Institute of Science Education and Research, Mohali, Punjab, 140306, India.
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2
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G Anversa R, Campbell EJ, Walker LC, S Ch'ng S, Muthmainah M, S Kremer F, M Guimarães A, O'Shea MJ, He S, Dayas CV, Andrews ZB, Lawrence AJ, Brown RM. A paraventricular thalamus to insular cortex glutamatergic projection gates "emotional" stress-induced binge eating in females. Neuropsychopharmacology 2023; 48:1931-1940. [PMID: 37474763 PMCID: PMC10584903 DOI: 10.1038/s41386-023-01665-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/14/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023]
Abstract
It is well-established that stress and negative affect trigger eating disorder symptoms and that the brains of men and women respond to stress in different ways. Indeed, women suffer disproportionately from emotional or stress-related eating, as well as associated eating disorders such as binge eating disorder. Nevertheless, our understanding of the precise neural circuits driving this maladaptive eating behavior, particularly in women, remains limited. We recently established a clinically relevant model of 'emotional' stress-induced binge eating whereby only female mice display binge eating in response to an acute "emotional" stressor. Here, we combined neuroanatomic, transgenic, immunohistochemical and pathway-specific chemogenetic approaches to investigate whole brain functional architecture associated with stress-induced binge eating in females, focusing on the role of Vglut2 projections from the paraventricular thalamus (PVTVglut2+) to the medial insular cortex in this behavior. Whole brain activation mapping and hierarchical clustering of Euclidean distances revealed distinct patterns of coactivation unique to stress-induced binge eating. At a pathway-specific level, PVTVglut2+ cells projecting to the medial insular cortex were specifically activated in response to stress-induced binge eating. Subsequent chemogenetic inhibition of this pathway suppressed stress-induced binge eating. We have identified a distinct PVTVglut2+ to insular cortex projection as a key driver of "emotional" stress-induced binge eating in female mice, highlighting a novel circuit underpinning this sex-specific behavior.
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Affiliation(s)
- Roberta G Anversa
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, Australia
- The Florey Institute of Neuroscience and Mental Health, Mental Health Division, Parkville, Melbourne, Australia
- The Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, Melbourne, Australia
| | - Erin J Campbell
- The Florey Institute of Neuroscience and Mental Health, Mental Health Division, Parkville, Melbourne, Australia
- The Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, Melbourne, Australia
- School of Biochemical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
| | - Leigh C Walker
- The Florey Institute of Neuroscience and Mental Health, Mental Health Division, Parkville, Melbourne, Australia
- The Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, Melbourne, Australia
| | - Sarah S Ch'ng
- The Florey Institute of Neuroscience and Mental Health, Mental Health Division, Parkville, Melbourne, Australia
| | - Muthmainah Muthmainah
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, Australia
- The Florey Institute of Neuroscience and Mental Health, Mental Health Division, Parkville, Melbourne, Australia
- Department of Anatomy, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Frederico S Kremer
- Laboratório de Bioinformática, Programa de Pós-Graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Federal University of Pelotas, Pelotas, Brazil
| | - Amanda M Guimarães
- Laboratório de Bioinformática, Programa de Pós-Graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Federal University of Pelotas, Pelotas, Brazil
| | - Mia J O'Shea
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, Australia
| | - Suheng He
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, Australia
| | - Christopher V Dayas
- School of Biochemical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
| | - Zane B Andrews
- Biomedicine Discovery Institute and department of Physiology, Monash University, Clayton, Australia
| | - Andrew J Lawrence
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, Australia
- The Florey Institute of Neuroscience and Mental Health, Mental Health Division, Parkville, Melbourne, Australia
| | - Robyn M Brown
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, Australia.
- The Florey Institute of Neuroscience and Mental Health, Mental Health Division, Parkville, Melbourne, Australia.
- The Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, Melbourne, Australia.
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Passeri A, Municchi D, Cavalieri G, Babicola L, Ventura R, Di Segni M. Linking drug and food addiction: an overview of the shared neural circuits and behavioral phenotype. Front Behav Neurosci 2023; 17:1240748. [PMID: 37767338 PMCID: PMC10520727 DOI: 10.3389/fnbeh.2023.1240748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Despite a lack of agreement on its definition and inclusion as a specific diagnosable disturbance, the food addiction construct is supported by several neurobiological and behavioral clinical and preclinical findings. Recognizing food addiction is critical to understanding how and why it manifests. In this overview, we focused on those as follows: 1. the hyperpalatable food effects in food addiction development; 2. specific brain regions involved in both food and drug addiction; and 3. animal models highlighting commonalities between substance use disorders and food addiction. Although results collected through animal studies emerged from protocols differing in several ways, they clearly highlight commonalities in behavioral manifestations and neurobiological alterations between substance use disorders and food addiction characteristics. To develop improved food addiction models, this heterogeneity should be acknowledged and embraced so that research can systematically investigate the role of specific variables in the development of the different behavioral features of addiction-like behavior in preclinical models.
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Affiliation(s)
- Alice Passeri
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Psychology and Center “Daniel Bovet”, Sapienza University, Rome, Italy
| | - Diana Municchi
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Psychology and Center “Daniel Bovet”, Sapienza University, Rome, Italy
| | - Giulia Cavalieri
- Department of Psychology and Center “Daniel Bovet”, Sapienza University, Rome, Italy
| | | | - Rossella Ventura
- Department of Psychology and Center “Daniel Bovet”, Sapienza University, Rome, Italy
- IRCCS San Raffaele, Rome, Italy
| | - Matteo Di Segni
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Psychology and Center “Daniel Bovet”, Sapienza University, Rome, Italy
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Berger G, Corris JD, Fields SE, Hao L, Scarpa LL, Bello NT. Systematic Review of Binge Eating Rodent Models for Developing Novel or Repurposing Existing Pharmacotherapies. Biomolecules 2023; 13:742. [PMID: 37238615 PMCID: PMC10216509 DOI: 10.3390/biom13050742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
Recent advances in developing and screening candidate pharmacotherapies for psychiatric disorders have depended on rodent models. Eating disorders are a set of psychiatric disorders that have traditionally relied on behavioral therapies for effective long-term treatment. However, the clinical use of Lisdexamfatamine for binge eating disorder (BED) has furthered the notion of using pharmacotherapies for treating binge eating pathologies. While there are several binge eating rodent models, there is not a consensus on how to define pharmacological effectiveness within these models. Our purpose is to provide an overview of the potential pharmacotherapies or compounds tested in established rodent models of binge eating behavior. These findings will help provide guidance for determining pharmacological effectiveness for potential novel or repurposed pharmacotherapies.
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Affiliation(s)
- Gregory Berger
- Endocrinology and Animal Biosciences Graduate Program, Department of Animal Sciences, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA
| | - Joshua D. Corris
- Endocrinology and Animal Biosciences Graduate Program, Department of Animal Sciences, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA
| | - Spencer E. Fields
- Department of Animal Sciences, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA
- Nutritional Sciences Graduate Program, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA
| | - Lihong Hao
- Department of Animal Sciences, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA
| | - Lori L. Scarpa
- Department of Animal Sciences, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA
| | - Nicholas T. Bello
- Endocrinology and Animal Biosciences Graduate Program, Department of Animal Sciences, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA
- Rutgers Brain Health Institute, Rutgers University and Rutgers Biomedical and Health Sciences, Piscataway, NJ 08854, USA
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Brown RM, James MH. Binge eating, overeating and food addiction: Approaches for examining food overconsumption in laboratory rodents. Prog Neuropsychopharmacol Biol Psychiatry 2023; 123:110717. [PMID: 36623582 PMCID: PMC10162020 DOI: 10.1016/j.pnpbp.2023.110717] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023]
Abstract
Overeating ranges in severity from casual overindulgence to an overwhelming drive to consume certain foods. At its most extreme, overeating can manifest as clinical diagnoses such as binge eating disorder or bulimia nervosa, yet subclinical forms of overeating such as emotional eating or uncontrolled eating can still have a profoundly negative impact on health and wellbeing. Although rodent models cannot possibly capture the full spectrum of disordered overeating, studies in laboratory rodents have substantially progressed our understanding of the neurobiology of overconsumption. These experimental approaches range from simple food-exposure protocols that promote binge-like eating and the development of obesity, to more complex operant procedures designed to examine distinct 'addiction-like' endophenotypes for food. This review provides an overview of these experimental approaches, with the view to providing a comprehensive resource for preclinical investigators seeking to utilize behavioural models for studying the neural systems involved in food overconsumption.
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Affiliation(s)
- Robyn M Brown
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, VIC, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.
| | - Morgan H James
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, NJ, USA; Brain Health Institute, Rutgers University, NJ, USA.
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Saccaro LF, Rutigliano G, Landi P, Spera M, Kraslavski A, Zappa MA, Mencacci C. Emotional Regulation Underlies Gender Differences in Pathological Eating Behavior Styles of Bariatric Surgery Candidates. WOMEN 2023. [DOI: 10.3390/women3020015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Almost a third of bariatric surgery patients present suboptimal weight loss or important weight regain in the first five postoperative years. While the reasons underlying this are not fully understood, it is known that pathological eating styles (such as emotional or binge eating) can thwart efforts to maintain weight loss. However, detailed characterization and understanding of these eating styles have yet to be achieved. In particular, research on gender differences in pathological eating styles and psychiatric symptoms before bariatric surgery is lacking. To characterize gender differences in eating styles and their association with clinical symptoms, we prospectively enrolled 110 bariatric surgery candidates, collecting eating styles and clinical scores. Women displayed a higher frequency of emotional eating as compared to men (x2 = 9.07, p = 0.003), while men showed a higher frequency of quantitative eating behavioral style (x2 = 4.58, p = 0.044). Binge eating style was associated with higher Difficulties in Emotion Regulation Scale (DERS), Hamilton Depression Scale (HAM-D), and Hamilton Anxiety Scale (HAM-A) scores (p < 0.05). Emotional eating style was associated with higher HAM-D and HAM-A scores (p < 0.05). The present findings highlight the importance of understanding the role of gender differences in emotion regulation processes involved in the development and maintenance of pathological eating styles in bariatric surgery candidates. This paves the way to gender- and symptoms-specific interventions on eating behaviors to improve surgery long-term outcomes.
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Affiliation(s)
- Luigi F. Saccaro
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Campus Biotech, 9 Chemin des Mines, 1202 Geneva, Switzerland
- Department of Psychiatry, Geneva University Hospital, 1205 Geneva, Switzerland
| | - Grazia Rutigliano
- Institute of Clinical Sciences, Imperial College London, MRI Steiner Unit, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK
- Department of Pathology, University of Pisa, via Savi 10, 56126 Pisa, Italy
| | - Paola Landi
- Dipartimento di Salute Mentale e Dipendenze, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
| | - Milena Spera
- Dipartimento di Salute Mentale e Dipendenze, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
| | - Alexandra Kraslavski
- Dipartimento di Salute Mentale e Dipendenze, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
| | - Marco Antonio Zappa
- UOC di Chirurgia Generale, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde 3, 20121 Milano, Italy
| | - Claudio Mencacci
- Dipartimento di Salute Mentale e Dipendenze, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
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Sex-dependent role of orexin deficiency in feeding behavior and affective state of mice following intermittent access to a Western diet - Implications for binge-like eating behavior. Physiol Behav 2023; 260:114069. [PMID: 36572152 DOI: 10.1016/j.physbeh.2022.114069] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/02/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022]
Abstract
Binge eating disorder is a debilitating disease characterized by recurrent episodes of excessive food consumption and associated with psychiatric comorbidities. Despite a growing body of research investigating the neurobiological underpinnings of eating disorders, specific treatments are lacking. Given its fundamental role in feeding behaviors, we investigated the role of the orexin (hypocretin) neuropeptide system in binge-like eating and associated phenotypes. Specifically, we submitted female and male orexin-deficient mice to a paradigm of intermittent access (once weekly for 24 h) to a Western diet (WD) to induce binge-like eating. Additionally, we measured their anxiety-like behavior and plasma corticosterone levels. All mice showed binge-like eating in response to the intermittent WD access, but females did so to a greater extent than males. While orexin deficiency did not affect binge-like eating in this paradigm, we found that female orexin-deficient mice generally weighed more, and they expressed increased hypophagia and stress levels compared to wild-type mice following binge-like eating episodes. These detrimental effects of orexin deficiency were marginal or absent in males. Moreover, male wild-type mice expressed post-binge anxiety, but orexin-deficient mice did not. In conclusion, these results extend our knowledge of orexin's role in dysregulated eating and associated negative affective states, and contribute to the growing body of evidence indicating a sexual dimorphism of the orexin system. Considering that many human disorders, and especially eating disorders, have a strong sex bias, our findings further emphasize the importance of testing both female and male subjects.
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Helman TJ, Headrick JP, Stapelberg NJC, Braidy N. The sex-dependent response to psychosocial stress and ischaemic heart disease. Front Cardiovasc Med 2023; 10:1072042. [PMID: 37153459 PMCID: PMC10160413 DOI: 10.3389/fcvm.2023.1072042] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Stress is an important risk factor for modern chronic diseases, with distinct influences in males and females. The sex specificity of the mammalian stress response contributes to the sex-dependent development and impacts of coronary artery disease (CAD). Compared to men, women appear to have greater susceptibility to chronic forms of psychosocial stress, extending beyond an increased incidence of mood disorders to include a 2- to 4-fold higher risk of stress-dependent myocardial infarction in women, and up to 10-fold higher risk of Takotsubo syndrome-a stress-dependent coronary-myocardial disorder most prevalent in post-menopausal women. Sex differences arise at all levels of the stress response: from initial perception of stress to behavioural, cognitive, and affective responses and longer-term disease outcomes. These fundamental differences involve interactions between chromosomal and gonadal determinants, (mal)adaptive epigenetic modulation across the lifespan (particularly in early life), and the extrinsic influences of socio-cultural, economic, and environmental factors. Pre-clinical investigations of biological mechanisms support distinct early life programming and a heightened corticolimbic-noradrenaline-neuroinflammatory reactivity in females vs. males, among implicated determinants of the chronic stress response. Unravelling the intrinsic molecular, cellular and systems biological basis of these differences, and their interactions with external lifestyle/socio-cultural determinants, can guide preventative and therapeutic strategies to better target coronary heart disease in a tailored sex-specific manner.
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Affiliation(s)
- Tessa J. Helman
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, NSW, Sydney, Australia
- Correspondence: Tessa J. Helman
| | - John P. Headrick
- Schoolof Pharmacy and Medical Sciences, Griffith University, Southport, QLD, Australia
| | | | - Nady Braidy
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, NSW, Sydney, Australia
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Nicolau J, Pujol A, Tofé S, Bonet A, Gil A. SHORT TERM EFFECTS OF SEMAGLUTIDE ON EMOTIONAL EATING AND OTHER ABNORMAL EATING PATTERNS AMONG SUBJECTS LIVING WITH OBESITY. Physiol Behav 2022; 257:113967. [PMID: 36162525 DOI: 10.1016/j.physbeh.2022.113967] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 07/18/2022] [Accepted: 09/07/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Emotional eating (EE) and other abnormal eating patterns are highly prevalent among people living with obesity (PWO). In this sense, semaglutide, by acting on areas of the brain involved in the reward system and emotion regulation, could have the potential to ameliorate these eating patterns. METHOD 69 PWO attending an obesity clinic were evaluated baseline and after 3 months since the beginning of semaglutide. To rule out abnormal EE, the Emotional Eating Questionnaire was administered, and a structured interview was conducted. RESULTS 69 PWO (82.6%♀, 43.7±1years, and 34.3±6kg/m 2) were included. After 3 months of semaglutide, there was a significant reduction in weight (96.1±20.9 vs 91.3±19.7kg; p<0.001) and BMI (34.3±6 vs 32.4±5.6kg/m 2; p<0.0001). The proportion of patients with EE (72.5% vs 11.5%; p<0.001), external eating (27.5% vs 10.1%; p<0.001) cravings (49.3% vs 21.7%; p<0.001) and savory cravings (53.6% vs 14.5%; p<0.001) was significantly reduced after 3 months of semaglutide. Also, the proportion of PWO with regular exercise was increased (15.9% vs 39.1%; p<0.001). However, Logistic regression analysis showed that only sweet cravings at baseline were the only factor associated, although not significant, with a poorer weight loss (p=0.05). DISCUSSION Semaglutide is an effective weight-loss treatment in PWO at short term. Moreover, semaglutide was highly effective in ameliorating EE and other abnormal eating patterns that exert a negative influence on weight.
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Affiliation(s)
- Joana Nicolau
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer. Health Research Institute of the Balearic Islands (IdISBa) .Ctra Manacor km 4, 07198 Palma de Mallorca, Baleares, Spain; Clínica Rotger (Grupo Quirón). Via Roma,3. 07012 Palma de Mallorca, Baleares Spain.
| | - Antelm Pujol
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer. Health Research Institute of the Balearic Islands (IdISBa) .Ctra Manacor km 4, 07198 Palma de Mallorca, Baleares, Spain
| | - Santiago Tofé
- Clínica Juaneda (Grupo Juaneda). Palma de Mallorca; Servicio de Endocrinología y Nutrición. Hospital Universitario Son Espases. Palma de Mallorca
| | - Aina Bonet
- Clínica Rotger (Grupo Quirón). Via Roma,3. 07012 Palma de Mallorca, Baleares Spain
| | - Apolonia Gil
- Clínica Rotger (Grupo Quirón). Via Roma,3. 07012 Palma de Mallorca, Baleares Spain
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A Framework for Developing Translationally Relevant Animal Models of Stress-Induced Changes in Eating Behavior. Biol Psychiatry 2022; 91:888-897. [PMID: 34433512 PMCID: PMC8720907 DOI: 10.1016/j.biopsych.2021.06.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 02/08/2023]
Abstract
Stress often affects eating behaviors, leading to increased eating in some individuals and decreased eating in others. Identifying physiological and psychological factors that determine the direction of eating responses to stress has been a major goal of epidemiological and clinical studies. However, challenges of standardizing the stress exposure in humans hinder efforts to uncover the underlying mechanisms. The issue of what determines the direction of stress-induced feeding responses has not been directly addressed in animal models, but assays that combine stress with a feeding-related task are commonly used as readouts of other behaviors, such as anxiety. Sex, estrous cyclicity, circadian cyclicity, caloric restriction, palatable diets, elevated body weight, and properties of the stressors similarly influence feeding behavior in humans and rodent models. Yet, most rodent studies do not use conditions that are most relevant for studying feeding behavior in humans. This review proposes a conceptual framework for incorporating these influences to develop reproducible and translationally relevant assays to study effects of stress on food intake. Such paradigms have the potential to uncover links between emotional eating and obesity as well as to the etiology of eating disorders.
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Moghimi E, Davis C, Bonder R, Knyahnytska Y, Quilty L. Exploring women's experiences of treatment for binge eating disorder: Methylphenidate vs. cognitive behavioural therapy. Prog Neuropsychopharmacol Biol Psychiatry 2022; 114:110492. [PMID: 34863926 DOI: 10.1016/j.pnpbp.2021.110492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/29/2021] [Accepted: 11/27/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The current qualitative study explored the personal experiences of a sample of women with binge eating disorder (BED). The women were previously enrolled in a 12-week randomized controlled trial comparing pharmacotherapy (methylphenidate [MP]) and cognitive behavioural therapy (CBT). METHODS Semi-structured interviews were conducted with 15 women who completed the trial (8 MP, 7 CBT) to obtain their narrative accounts. Key themes were then identified from transcribed tape recordings, using thematic analysis. RESULTS Participants described self-awareness as bringing greater attention to their binge eating, and to their thoughts and emotions. Furthermore, both groups valued the interpersonal relationships with the clinicians and their ability to create a safe and comforting environment. In the MP group, many participants described the medication as reducing their preoccupation with food, and hence, binge frequency. In CBT, there was a focus on psychoeducation and obtaining a "toolbox" of long-term binge-management skills that could also be used following treatment. In both groups, stress was described as a primary trigger for a binge and/or a cause of relapse. DISCUSSION Although patients reported having a positive experience in the therapies, it is suggested that broader stress regulation skills training would be useful to evaluate further, to bolster relapse prevention skills. These qualitative findings add a much-needed lived-experience perspective on clinical treatments for binge eating. This is especially significant considering that a psychostimulant similar to MP is the only approved pharmacotherapy for BED, and to date, little is known about the patient's subjective experiences when taking this medication.
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Affiliation(s)
- Elnaz Moghimi
- School of Kinesiology and Health Science, Faculty of Health, York University, 4700 Keele St, Toronto, Ontario, Canada.
| | - Caroline Davis
- School of Kinesiology and Health Science, Faculty of Health, York University, 4700 Keele St, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, 1025-1051 Queen St. West, Toronto, Ontario, Canada.
| | - Revi Bonder
- School of Kinesiology and Health Science, Faculty of Health, York University, 4700 Keele St, Toronto, Ontario, Canada
| | - Yuliya Knyahnytska
- Centre for Addiction and Mental Health, 1025-1051 Queen St. West, Toronto, Ontario, Canada
| | - Lena Quilty
- Centre for Addiction and Mental Health, 1025-1051 Queen St. West, Toronto, Ontario, Canada
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Eickelberg V, Lüersen K, Staats S, Rimbach G. Phenotyping of Drosophila Melanogaster-A Nutritional Perspective. Biomolecules 2022; 12:221. [PMID: 35204721 PMCID: PMC8961528 DOI: 10.3390/biom12020221] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/15/2022] [Accepted: 01/20/2022] [Indexed: 02/01/2023] Open
Abstract
The model organism Drosophila melanogaster was increasingly applied in nutrition research in recent years. A range of methods are available for the phenotyping of D. melanogaster, which are outlined in the first part of this review. The methods include determinations of body weight, body composition, food intake, lifespan, locomotor activity, reproductive capacity and stress tolerance. In the second part, the practical application of the phenotyping of flies is demonstrated via a discussion of obese phenotypes in response to high-sugar diet (HSD) and high-fat diet (HFD) feeding. HSD feeding and HFD feeding are dietary interventions that lead to an increase in fat storage and affect carbohydrate-insulin homeostasis, lifespan, locomotor activity, reproductive capacity and stress tolerance. Furthermore, studies regarding the impacts of HSD and HFD on the transcriptome and metabolome of D. melanogaster are important for relating phenotypic changes to underlying molecular mechanisms. Overall, D. melanogaster was demonstrated to be a valuable model organism with which to examine the pathogeneses and underlying molecular mechanisms of common chronic metabolic diseases in a nutritional context.
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Affiliation(s)
- Virginia Eickelberg
- Department of Food Science, Institute of Human Nutrition and Food Science, University of Kiel, Hermann-Rodewald-Strasse 6-8, D-24118 Kiel, Germany; (K.L.); (S.S.); (G.R.)
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Brown RM, Dayas CV, James MH, Smith RJ. New directions in modelling dysregulated reward seeking for food and drugs. Neurosci Biobehav Rev 2022; 132:1037-1048. [PMID: 34736883 PMCID: PMC8816817 DOI: 10.1016/j.neubiorev.2021.10.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 10/08/2021] [Accepted: 10/19/2021] [Indexed: 01/03/2023]
Abstract
Behavioral models are central to behavioral neuroscience. To study the neural mechanisms of maladaptive behaviors (including binge eating and drug addiction), it is essential to develop and utilize appropriate animal models that specifically focus on dysregulated reward seeking. Both food and cocaine are typically consumed in a regulated manner by rodents, motivated by reward and homeostatic mechanisms. However, both food and cocaine seeking can become dysregulated, resulting in binge-like consumption and compulsive patterns of intake. The speakers in this symposium for the 2021 International Behavioral Neuroscience Meeting utilize behavioral models of dysregulated reward-seeking to investigate the neural mechanisms of binge-like consumption, enhanced cue-driven reward seeking, excessive motivation, and continued use despite negative consequences. In this review, we outline examples of maladaptive patterns of intake and explore recent animal models that drive behavior to become dysregulated, including stress exposure and intermittent access to rewards. Lastly, we explore select behavioral and neural mechanisms underlying dysregulated reward-seeking for both food and drugs.
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Affiliation(s)
- Robyn M Brown
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, VIC, 3052, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, 3052, Australia.
| | - Christopher V Dayas
- School of Biomedical Sciences & Pharmacy, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Morgan H James
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, 08854, USA; Brain Health Institute, Rutgers University, Piscataway, NJ, 08854, USA.
| | - Rachel J Smith
- Department of Psychological & Brain Sciences, Institute for Neuroscience, Texas A&M University, College Station, TX, 77843, USA
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14
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Sleep dysregulation in binge eating disorder and "food addiction": the orexin (hypocretin) system as a potential neurobiological link. Neuropsychopharmacology 2021; 46:2051-2061. [PMID: 34145404 PMCID: PMC8505614 DOI: 10.1038/s41386-021-01052-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 12/12/2022]
Abstract
It has been proposed that binge eating reflects a pathological compulsion driven by the "addictive" properties of foods. Proponents of this argument highlight the large degree of phenomenological and diagnostic overlap between binge eating disorder (BED) and substance use disorders (SUDs), including loss of control over how much is consumed and repeated unsuccessful attempts to abstain from consumption, as well as commonalities in brain structures involved in food and drug craving. To date, very little attention has been given to an additional behavioral symptom that BED shares with SUDs-sleep dysregulation-and the extent to which this may contribute to the pathophysiology of BED. Here, we review studies examining sleep outcomes in patients with BED, which collectively point to a heightened incidence of sleep abnormalities in BED. We identify the orexin (hypocretin) system as a potential neurobiological link between compulsive eating and sleep dysregulation in BED, and provide a comprehensive update on the evidence linking this system to these processes. Finally, drawing on evidence from the SUD literature indicating that the orexin system exhibits significant plasticity in response to drugs of abuse, we hypothesize that chronic palatable food consumption likewise increases orexin system activity, resulting in dysregulated sleep/wake patterns. Poor sleep, in turn, is predicted to exacerbate binge eating, contributing to a cycle of uncontrolled food consumption. By extension, we suggest that pharmacotherapies normalizing orexin signaling, which are currently being trialed for the treatment of SUDs, might also have utility in the clinical management of BED.
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15
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Mikhail ME, Anaya C, Culbert KM, Sisk CL, Johnson A, Klump KL. Gonadal Hormone Influences on Sex Differences in Binge Eating Across Development. Curr Psychiatry Rep 2021; 23:74. [PMID: 34613500 PMCID: PMC8576863 DOI: 10.1007/s11920-021-01287-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Binge eating is a transdiagnostic symptom that disproportionately affects females. Sexually dimorphic gonadal hormones (e.g., estradiol, testosterone) substantially impact eating behavior and may contribute to sex differences in binge eating. We examine recent evidence for the role of gonadal hormones in binge eating risk across development. RECENT FINDINGS Both organizational (long-lasting impact on the central nervous system (CNS)) and activational (transient influences on the CNS) hormone effects may contribute to sex differences in binge eating. Gonadal hormones also impact within-sex variability in binge eating, with higher estradiol levels in females and higher testosterone levels in males protective across development. Emerging evidence suggests that the impact of gonadal hormones may be greatest for people with other risk factors, including genetic, temperamental (e.g., high negative affect), and psychosocial (e.g., exposure to weight-based teasing) risk. Gonadal hormones contribute to sex differences and within-sex variability in binge eating across development.
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Affiliation(s)
- Megan E. Mikhail
- Department of Psychology, Michigan State University, 316 Physics Rd., Room 107B, East Lansing, MI, 48824-1116, USA
| | - Carolina Anaya
- Department of Psychology, Michigan State University, 316 Physics Rd., Room 107B, East Lansing, MI, 48824-1116, USA
| | - Kristen M. Culbert
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Cheryl L. Sisk
- Neuroscience Program, Michigan State University, East Lansing, MI, USA
| | - Alexander Johnson
- Neuroscience Program, Michigan State University, East Lansing, MI, USA
| | - Kelly L. Klump
- Department of Psychology, Michigan State University, 316 Physics Rd., Room 107B, East Lansing, MI, 48824-1116, USA,Corresponding author:
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16
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A review of sex differences in the mechanisms and drivers of overeating. Front Neuroendocrinol 2021; 63:100941. [PMID: 34454955 DOI: 10.1016/j.yfrne.2021.100941] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/23/2021] [Accepted: 08/17/2021] [Indexed: 12/16/2022]
Abstract
Disordered eating is often associated with marked psychological and emotional distress, and severe adverse impact on quality of life. Several factors can influence eating behavior and drive food consumption in excess of energy requirements for homeostasis. It is well established that stress and negative affect contribute to the aetiology of eating disorders and weight gain, and there is substantial evidence suggesting sex differences in sub-clinical and clinical types of overeating. This review will examine how negative affect and stress shape eating behaviors, and how the relationship between the physiological, endocrine, and neural responses to stress and eating behaviors differs between men and women. We will examine several drivers of overeating and explore possible mechanisms underlying sex differences in eating behavior.
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17
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Guerrero-Hreins E, Goldstone AP, Brown RM, Sumithran P. The therapeutic potential of GLP-1 analogues for stress-related eating and role of GLP-1 in stress, emotion and mood: a review. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110303. [PMID: 33741445 DOI: 10.1016/j.pnpbp.2021.110303] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/19/2021] [Accepted: 03/09/2021] [Indexed: 01/11/2023]
Abstract
Stress and low mood are powerful triggers for compulsive overeating, a maladaptive form of eating leading to negative physical and mental health consequences. Stress-vulnerable individuals, such as people with obesity, are particularly prone to overconsumption of high energy foods and may use it as a coping mechanism for general life stressors. Recent advances in the treatment of obesity and related co-morbidities have focused on the therapeutic potential of anorexigenic gut hormones, such as glucagon-like peptide 1 (GLP-1), which acts both peripherally and centrally to reduce energy intake. Besides its appetite suppressing effect, GLP-1 acts on areas of the brain involved in stress response and emotion regulation. However, the role of GLP-1 in emotion and stress regulation, and whether it is a viable treatment for stress-induced compulsive overeating, has yet to be established. A thorough review of the pre-clinical literature measuring markers of stress, anxiety and mood after GLP-1 exposure points to potential divergent effects based on temporality. Specifically, acute GLP-1 injection consistently stimulates the physiological stress response in rodents whereas long-term exposure indicates anxiolytic and anti-depressive benefits. However, the limited clinical evidence is not as clear cut. While prolonged GLP-1 analogue treatment in people with type 2 diabetes improved measures of mood and general psychological wellbeing, the mechanisms underlying this may be confounded by associated weight loss and improved blood glucose control. There is a paucity of longitudinal clinical literature on mechanistic pathways by which stress influences eating behavior and how centrally-acting gut hormones such as GLP-1, can modify these. (250).
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Affiliation(s)
- Eva Guerrero-Hreins
- The Florey Institute of Neuroscience and Mental Health, Mental Health Theme, Parkville, Melbourne, Australia; The Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, Melbourne, Australia; PsychoNeuroEndocrinology Research Group, Centre for Neuropsychopharmacology, Division of Psychiatry, and Computational, Cognitive and Clinical Neuroimaging Laboratory, Department of Brain Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Anthony P Goldstone
- PsychoNeuroEndocrinology Research Group, Centre for Neuropsychopharmacology, Division of Psychiatry, and Computational, Cognitive and Clinical Neuroimaging Laboratory, Department of Brain Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Robyn M Brown
- The Florey Institute of Neuroscience and Mental Health, Mental Health Theme, Parkville, Melbourne, Australia; The Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, Melbourne, Australia
| | - Priya Sumithran
- Department of Medicine (St Vincent's), University of Melbourne, Victoria, Australia; Dept. of Endocrinology, Austin Health, Victoria, Australia.
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Hildebrandt BA, Ahmari SE. Breaking It Down: Investigation of Binge Eating Components in Animal Models to Enhance Translation. Front Psychiatry 2021; 12:728535. [PMID: 34484010 PMCID: PMC8414642 DOI: 10.3389/fpsyt.2021.728535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/19/2021] [Indexed: 12/28/2022] Open
Abstract
Binge eating (BE) is a core eating disorder behavior that is present across nearly all eating disorder diagnoses (e. g., bulimia nervosa, binge eating disorder, anorexia nervosa binge/purge subtype), and is also widely present in the general population. Despite the prevalence of BE, limited treatment options exist and there are often high rates of relapse after treatment. There is evidence showing that genetic factors contribute to the heritability of BE and support for biological contributions to BE. However, more work is needed to fully understand neurobiological mechanisms underlying BE. One approach to target this problem is to separate BE into its distinct clinical components that can be more easily modeled using pre-clinical approaches. To date, a variety of animal models for BE have been used in pre-clinical studies; but there have been challenges translating this work to human BE. Here, we review these pre-clinical approaches by breaking them down into three clinically-significant component parts (1) consumption of a large amount of food; (2) food consumption within a short period of time; and (3) loss of control over eating. We propose that this rubric identifies the most frequently used and effective ways to model components of BE behavior using pre-clinical approaches with the strongest clinical relevance. Finally, we discuss how current pre-clinical models have been integrated with techniques using targeted neurobiological approaches and propose ways to improve translation of pre-clinical work to human investigations of BE that could enhance our understanding of BE behavior.
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Affiliation(s)
- Britny A Hildebrandt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Susanne E Ahmari
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States
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Bourdier L, Fatseas M, Maria AS, Carre A, Berthoz S. The Psycho-Affective Roots of Obesity: Results from a French Study in the General Population. Nutrients 2020; 12:nu12102962. [PMID: 32998238 PMCID: PMC7650670 DOI: 10.3390/nu12102962] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/20/2020] [Accepted: 09/24/2020] [Indexed: 12/20/2022] Open
Abstract
The aim of the study was to examine the extent to which obese people differ in their emotionally driven and addictive-like eating behaviors from normal-weight and overweight people. A total of 1142 participants were recruited from a general population, by a web-based cross-sectional survey assessing anxiety/depression (Hospital Anxiety and Depression Scale), emotional eating (Emotional Appetite Questionnaire), food addiction (modified Yale Food Addiction Scale), and intuitive eating (Intuitive Eating Scale-2). The statistical design was based on analyses of (co)variance, correlograms, and mediations. A set of Body Mass Index (BMI) group comparisons showed that obese people reported higher levels of depression and emotional eating and that they experienced more severe and frequent food addiction symptoms than overweight and normal-weight people. Associations between anxiety, depression, food addiction symptoms’ count, and the difficulties to rely on hunger and satiety cues were found across all weight classes, suggesting that addictive-like eating may represent a unique phenotype of problematic eating behavior that is not synonymous with high BMI or obesity. Conversely, the interrelation between anxiety/depression, emotional eating, and the difficulties to rely on hunger and satiety cues was found only among obese participants, and negative emotional eating mediated the association between depression and anxiety and the difficulties to rely on hunger and satiety cues. This study emphasizes the necessity to develop more comprehensive approaches integrating emotional dysregulation and addictive-like eating behaviors to improve weight management and quality of life of obese people.
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Affiliation(s)
- Lena Bourdier
- Addictology Department, University Hospital of Bordeaux, 33000 Bordeaux, France;
- Correspondence:
| | - Melina Fatseas
- Addictology Department, University Hospital of Bordeaux, 33000 Bordeaux, France;
- CNRS, EPHE, INCIA, UMR 5287, Université de Bordeaux, F-33000 Bordeaux, France;
| | - Anne-Solène Maria
- Private Practice, Stimulus Consulting Ltd., Coastal Road, Cascavelle 90203, Mauritius;
- UVSQ, CESP, INSERM, Université Paris-Sud and Université Paris Descartes, 75014 Paris, France
| | - Arnaud Carre
- LIP/PC2S, Grenoble Alpes University and Savoie Mont Blanc University, F-38000 Grenoble, France;
| | - Sylvie Berthoz
- CNRS, EPHE, INCIA, UMR 5287, Université de Bordeaux, F-33000 Bordeaux, France;
- Department of Psychiatry for Adolescents and Young Adults, Institut Mutualiste Montsouris, 75014 Paris, France
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Pan MH, Zhu SR, Duan WJ, Ma XH, Luo X, Liu B, Kurihara H, Li YF, Chen JX, He RR. "Shanghuo" increases disease susceptibility: Modern significance of an old TCM theory. JOURNAL OF ETHNOPHARMACOLOGY 2019; 250:112491. [PMID: 31863858 DOI: 10.1016/j.jep.2019.112491] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 02/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE "Shanghuo", a concept based on Traditional Chinese Medicine (TCM) theory, describes a status of Yin-Yang imbalance when Yang overwhelms Yin. The imbalance of Yin-Yang resembles the breaking of homeostasis and manifests by the impaired physiological functions, which leads to the onset, recurrence, and progression of diseases. Since ancient times, Chinese Materia Medica (CMM), such as herbal tea, has been applied as a treatment for "Shanghuo". AIM OF THE STUDY This review is aimed to describe the origin of "Shanghuo" from the Yin-Yang theory in TCM, as well as explore the relevance and correlations between "Shanghuo" and diseases susceptibility from the perspective of modern medicine. We also propose several strategies from CMM to improve the status of "Shanghuo" for the purpose of treating diseases. METHODS Systematic research of articles with keywords including Shanghuo, Yin-Yang, emotional stress and disease susceptibility was done by using the literature databases (Web of Science, Google Scholar, PubMed, CNKI). Related books, PhD and master's dissertations were also researched. Full scientific plant names were validated by "The Plant List" (www.theplantlist.org). RESULTS To date, a large number of publications have reported research on sub-health status, but studies about the theory or intervention of "Shanghuo" are rarely found. The articles we reviewed indicate that accumulated emotional stress is critical for the cause of "Shanghuo". As a status similar to sub-health, "Shanghuo" is also manifested by impaired physiological functions and decreased nonspecific resistance, which increase susceptibility to various diseases. What's more, some studies highlight the importance of TCM treatment towards "Shanghuo" in maintaining normal physiological functions, such as immunity, lipid metabolism and ROS clearance. CONCLUSIONS Researches on "Shanghuo" and its mechanism are every rare currently and are in need of investigation in the future. Studies on disease susceptibility recently are mostly about susceptible genes that relate to a few parts of people, however, for most of the people, accumulated emotional stress or other stressors is accountable for the susceptibility of diseases. Given that emotional stress plays an important factor in the causation of "Shanghuo", we reviewed the articles about this relevance and discussed the connection of "Shanghuo" with disease susceptibility in a novel perspective. In addition, we have reviewed the disease susceptibility model of restraint stress from its biochemical manifestation to application in CMM assessment. Although it would be a breakthrough in evaluating CMM efficacy of attenuating disease-susceptibility, understanding the comprehensive theory and establishing more models of "Shanghuo" would be required in further investigation.
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Affiliation(s)
- Ming-Hai Pan
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, Jinan University, Guangzhou, 510632, China; Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China; International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), College of Pharmacy, Jinan University, Guangzhou, 510632, China
| | - Si-Rui Zhu
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, Jinan University, Guangzhou, 510632, China; Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China; International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), College of Pharmacy, Jinan University, Guangzhou, 510632, China; School of Pharmaceutical Sciences, Sun Yat-sen University, Guangdong, Guangzhou, 510006, China
| | - Wen-Jun Duan
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, Jinan University, Guangzhou, 510632, China; Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China; International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), College of Pharmacy, Jinan University, Guangzhou, 510632, China
| | - Xiao-Hui Ma
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, Jinan University, Guangzhou, 510632, China; Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China; International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), College of Pharmacy, Jinan University, Guangzhou, 510632, China
| | - Xiang Luo
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, Jinan University, Guangzhou, 510632, China; Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China; International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), College of Pharmacy, Jinan University, Guangzhou, 510632, China
| | - Bo Liu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, And Collaborative Innovation Center for Biotherapy, Chengdu, 610041, China
| | - Hiroshi Kurihara
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, Jinan University, Guangzhou, 510632, China; Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China; International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), College of Pharmacy, Jinan University, Guangzhou, 510632, China
| | - Yi-Fang Li
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, Jinan University, Guangzhou, 510632, China; Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China; International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), College of Pharmacy, Jinan University, Guangzhou, 510632, China.
| | - Jia-Xu Chen
- College of Chinese Medicine, Jinan University, Guangzhou, 510632, China.
| | - Rong-Rong He
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, Jinan University, Guangzhou, 510632, China; Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China; International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), College of Pharmacy, Jinan University, Guangzhou, 510632, China.
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