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Síndrome de Prader-Willi: avanzando paso a paso. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Caixàs A. Prader-Willi syndrome: Making progress, one step at a time. ENDOCRINOL DIAB NUTR 2022; 69:1-3. [PMID: 35232554 DOI: 10.1016/j.endien.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Assumpta Caixàs
- Servicio de Endocrinología y Nutrición, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT), Departament Medicina Universitat Autònoma de Barcelona, Sabadell, Spain.
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Hunger and Satiety Peptides: Is There a Pattern to Classify Patients with Prader-Willi Syndrome? J Clin Med 2021; 10:jcm10215170. [PMID: 34768690 PMCID: PMC8585040 DOI: 10.3390/jcm10215170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022] Open
Abstract
Hyperphagia is one of the main problems of patients with Prader-Willi syndrome (PWS) to cope with everyday life. The underlying mechanisms are not yet well understood. Gut-brain hormones are an interrelated network that may be at least partially involved. We aimed to study the hormonal profile of PWS patients in comparison with obese and healthy controls. Thirty adult PWS patients (15 men; age 27.5 ± 8.02 years; BMI 32.4 ± 8.14 kg/m2), 30 obese and 30 healthy controls were studied before and after eating a hypercaloric liquid diet. Plasma brain-derived neurotrophic factor (BDNF), leptin, total and active ghrelin, peptide YY (PYY), pancreatic polypeptide (PP), Glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and amylin were determined at times 0′, 30′, 60′ and 120′. Cluster analysis was used. When considering all peptides together, two clusters were established according to fasting hormonal standardized concentrations. Cluster 1 encompassed most of obese (25/30) and healthy controls (28/30). By contrast, the majority of patients with PWS were located in Cluster 2 (23/27) and presented a similar fasting profile with hyperghrelinemia, high levels of leptin, PYY, GIP and GLP-1, compared to Cluster 1; that may reflect a dysfunction of these hunger/satiety hormones. When peptide behavior over the time was considered, PP concentrations were not sustained postprandially from 60 min onwards in Cluster 2. BDNF and amylin did not help to differentiate the two clusters. Thus, cluster analysis could be a good tool to distinguish and characterize the differences in hormone responses between PWS and obese or healthy controls.
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Vlaardingerbroek H, van den Akker ELT, Hokken-Koelega ACS. Appetite- and weight-inducing and -inhibiting neuroendocrine factors in Prader-Willi syndrome, Bardet-Biedl syndrome and craniopharyngioma versus anorexia nervosa. Endocr Connect 2021; 10:R175-R188. [PMID: 33884958 PMCID: PMC8183618 DOI: 10.1530/ec-21-0111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 04/22/2021] [Indexed: 12/15/2022]
Abstract
Obesity is reaching an epidemic state and has a major impact on health and economy. In most cases, obesity is caused by lifestyle factors. However, the risk of becoming obese differs highly between people. Individual's differences in lifestyle, genetic, and neuroendocrine factors play a role in satiety, hunger and regulation of body weight. In a small percentage of children and adults with obesity, an underlying hormonal or genetic cause can be found. The aim of this review is to present and compare data on the extreme ends of the obesity and undernutrition spectrum in patients with Prader-Willi syndrome (PWS), Bardet-Biedl syndrome (BBS), acquired hypothalamic obesity in craniopharyngioma patients, and anorexia nervosa. This may give more insight into the role of neuroendocrine factors and might give direction for future research in conditions of severe obesity and underweight.
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Affiliation(s)
- H Vlaardingerbroek
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center-Sophia Children’s Hospital, Rotterdam, The Netherlands
- Willem-Alexander Children’s Hospital, Department of Pediatrics, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Correspondence should be addressed to H Vlaardingerbroek:
| | - E L T van den Akker
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center-Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - A C S Hokken-Koelega
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center-Sophia Children’s Hospital, Rotterdam, The Netherlands
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"A LEAP 2 conclusions? Targeting the ghrelin system to treat obesity and diabetes". Mol Metab 2020; 46:101128. [PMID: 33246141 PMCID: PMC8085568 DOI: 10.1016/j.molmet.2020.101128] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 11/15/2020] [Accepted: 11/20/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The hormone ghrelin stimulates food intake, promotes adiposity, increases body weight, and elevates blood glucose. Consequently, alterations in plasma ghrelin levels and the functioning of other components of the broader ghrelin system have been proposed as potential contributors to obesity and diabetes. Furthermore, targeting the ghrelin system has been proposed as a novel therapeutic strategy for obesity and diabetes. SCOPE OF REVIEW The current review focuses on the potential for targeting ghrelin and other proteins comprising the ghrelin system as a treatment for obesity and diabetes. The main components of the ghrelin system are introduced. Data supporting a role for the endogenous ghrelin system in the development of obesity and diabetes along with data that seemingly refute such a role are outlined. An argument for further research into the development of ghrelin system-targeted therapeutic agents is delineated. Also, an evidence-based discussion of potential factors and contexts that might influence the efficacy of this class of therapeutics is provided. MAJOR CONCLUSIONS It would not be a "leap to" conclusions to suggest that agents which target the ghrelin system - including those that lower acyl-ghrelin levels, raise LEAP2 levels, block GHSR activity, and/or raise desacyl-ghrelin signaling - could represent efficacious novel treatments for obesity and diabetes.
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Guinovart M, Coronas R, Caixàs A. Psychopathological disorders in Prader-Willi syndrome. ACTA ACUST UNITED AC 2019; 66:579-587. [PMID: 31006652 DOI: 10.1016/j.endinu.2019.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/27/2019] [Accepted: 03/02/2019] [Indexed: 01/07/2023]
Abstract
Prader-Willi syndrome is a genetic disorder caused by chromosomal changes in segment 15q11-q13 including cognitive, mental, and behavioral symptoms, as well as a specific physical phenotype. Both the most common psychopathological changes (intellectual disability, obsessions, impulsivity, autism spectrum disorders, self-injuries) and the main psychiatric comorbidities (affective disorders, psychosis, obsessive-compulsive disorder, autism spectrum disorder) are characterized by a great heterogeneity, which warrants the need for better identification of their frequency and clinical signs. In addition to its effects on body compositionand hypotony, growth hormone has been shown to be useful for regulating patient behavior, and psychoactive drugs are also an option. Other alternatives have shown promising results in experimental trials. Adequate understanding of the psychopathology associated to Prader-Willi syndrome would allow for improving clinical approach, symptom identification, detection of comorbidities, and administration of more effective treatments, leading to better clinical outcomes.
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Affiliation(s)
- Martí Guinovart
- Servicio de Salud Mental, Hospital Universitari Parc Taulí, Universidad Autónoma de Barcelona, Sabadell (Barcelona), España
| | - Ramón Coronas
- Servicio de Salud Mental, Hospital Universitari Parc Taulí, Universidad Autónoma de Barcelona, Sabadell (Barcelona), España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
| | - Assumpta Caixàs
- Servicio de Endocrinología y Nutrición, Hospital Universitari Parc Taulí, Universidad Autónoma de Barcelona, Sabadell (Barcelona), España.
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7
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Rodriguez JA, Bruggeman EC, Mani BK, Osborne-Lawrence S, Lord CC, Roseman HF, Viroslav HL, Vijayaraghavan P, Metzger NP, Gupta D, Shankar K, Pietra C, Liu C, Zigman JM. Ghrelin Receptor Agonist Rescues Excess Neonatal Mortality in a Prader-Willi Syndrome Mouse Model. Endocrinology 2018; 159:4006-4022. [PMID: 30380028 PMCID: PMC6260060 DOI: 10.1210/en.2018-00801] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/24/2018] [Indexed: 12/18/2022]
Abstract
In the current study, we sought to determine the significance of the ghrelin system in Prader-Willi Syndrome (PWS). PWS is characterized by hypotonia and difficulty feeding in neonates and hyperphagia and obesity beginning later in childhood. Other features include low GH, neonatal hypoglycemia, hypogonadism, and accelerated mortality. Although the hyperphagia and obesity in PWS have been attributed to elevated levels of the orexigenic hormone ghrelin, this link has never been firmly established, nor have ghrelin's potentially protective actions to increase GH secretion, blood glucose, and survival been investigated in a PWS context. In the current study, we show that placing Snord116del mice modeling PWS on ghrelin-deficient or ghrelin receptor [GH secretagogue receptor (GHSR)]-deficient backgrounds does not impact their characteristically reduced body weight, lower plasma IGF-1, delayed sexual maturation, or increased mortality in the period prior to weaning. However, blood glucose was further reduced in male Snord116del pups on a ghrelin-deficient background, and percentage body weight gain and percentage fat mass were further reduced in male Snord116del pups on a GHSR-deficient background. Strikingly, 2 weeks of daily administration of the GHSR agonist HM01 to Snord116del neonates markedly improved survival, resulting in a nearly complete rescue of the excess mortality owing to loss of the paternal Snord116 gene. These data support further exploration of the therapeutic potential of GHSR agonist administration in limiting PWS mortality, especially during the period characterized by failure to thrive.
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Affiliation(s)
- Juan A Rodriguez
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Emily C Bruggeman
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Bharath K Mani
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Sherri Osborne-Lawrence
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Caleb C Lord
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Henry F Roseman
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Hannah L Viroslav
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Prasanna Vijayaraghavan
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Nathan P Metzger
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Deepali Gupta
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Kripa Shankar
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | | | - Chen Liu
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
- Department of Neuroscience, UT Southwestern Medical Center, Dallas, Texas
| | - Jeffrey M Zigman
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
- Division of Endocrinology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas
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8
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Rigamonti AE, Bini S, Piscitelli F, Lauritano A, Di Marzo V, Vanetti C, Agosti F, De Col A, Lucchetti E, Grugni G, Sartorio A. Hedonic eating in Prader-Willi syndrome is associated with blunted PYY secretion. Food Nutr Res 2017; 61:1297553. [PMID: 28659728 PMCID: PMC5475322 DOI: 10.1080/16546628.2017.1297553] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 02/13/2017] [Indexed: 11/14/2022] Open
Abstract
Hedonic and homeostatic hunger represent two different forms of eating: just for pleasure or following energy deprivation, respectively. Consumption of food for pleasure was reported to be associated with increased circulating levels of both the orexigenic peptide ghrelin and some specific endocannabinoids in normal-weight subjects and patients with morbid obesity. To date, the effects of palatable food on these mediators in Prader–Willi syndrome (PWS) are still unknown. To explore the role of some gastrointestinal orexigenic and anorexigenic peptides and endocannabinoids (and some related congeners) in chocolate consumption, we measured changes in circulating levels of ghrelin, cholecystokinin (CCK), peptide YY (PYY), anandamide (AEA), 2-arachidonoyl-glycerol (2-AG), palmitoylethanolamide (PEA) and oleoylethanolamide (OEA) in eight satiated adult PWS patients after consumption of chocolate and, on a separate day, of a non-palatable isocaloric food with the same macronutrient composition. Evaluation of hunger and satiety was also performed by visual analogic scale. The anticipatory phase and the consumption of food for pleasure were associated with decreased circulating levels of PYY. An increase in PEA levels was also observed. By contrast, circulating levels of ghrelin, CCK, AEA, 2-AG and OEA did not differ before and after the exposure/ingestion of either chocolate or non-palatable foods. Hunger and satiety were similar in the hedonic and non-palatable sessions. In conclusion, when motivation to eat is promoted by highly palatable foods, a depressed post-prandial PYY secretion is observed in PWS. Although preliminary, these findings seem to hypothesize a possible role of PYY agonists in the management of PWS patients. Abbreviations: AEA, Anandamide; 2-AG, 2-arachidonoyl-glycerol; CB1, cannabinoid receptor type 1; OEA, oleoylethanolamide; PEA, palmitoylethanolamide; PWS: Prader-Willi syndrome; VAS, visual analog scales
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Affiliation(s)
- A E Rigamonti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - S Bini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - F Piscitelli
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry, Consiglio Nazionale delle Ricerche, Pozzuoli, Italy
| | - A Lauritano
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry, Consiglio Nazionale delle Ricerche, Pozzuoli, Italy
| | - V Di Marzo
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry, Consiglio Nazionale delle Ricerche, Pozzuoli, Italy
| | - C Vanetti
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - F Agosti
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, Milan and Piancavallo (VB), Italy
| | - A De Col
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, Milan and Piancavallo (VB), Italy
| | - E Lucchetti
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, Milan and Piancavallo (VB), Italy
| | - G Grugni
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, Milan and Piancavallo (VB), Italy.,Division of Auxology, Istituto Auxologico Italiano, IRCCS, Piancavallo (VB), Italy
| | - A Sartorio
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, Milan and Piancavallo (VB), Italy.,Division of Auxology, Istituto Auxologico Italiano, IRCCS, Piancavallo (VB), Italy
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9
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Bueno M, Esteba-Castillo S, Novell R, Giménez-Palop O, Coronas R, Gabau E, Corripio R, Baena N, Viñas-Jornet M, Guitart M, Torrents-Rodas D, Deus J, Pujol J, Rigla M, Caixàs A. Lack of Postprandial Peak in Brain-Derived Neurotrophic Factor in Adults with Prader-Willi Syndrome. PLoS One 2016; 11:e0163468. [PMID: 27685845 PMCID: PMC5042477 DOI: 10.1371/journal.pone.0163468] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 09/08/2016] [Indexed: 02/06/2023] Open
Abstract
Context Prader-Willi syndrome (PWS) is characterized by severe hyperphagia. Brain-derived neurotrophic factor (BDNF) and leptin are reciprocally involved in energy homeostasis. Objectives To analyze the role of BDNF and leptin in satiety in genetic subtypes of PWS. Design Experimental study. Setting University hospital. Subjects 90 adults: 30 PWS patients; 30 age-sex-BMI-matched obese controls; and 30 age-sex-matched lean controls. Interventions Subjects ingested a liquid meal after fasting ≥10 hours. Main Outcome Measures Leptin and BDNF levels in plasma extracted before ingestion and 30’, 60’, and 120’ after ingestion. Hunger, measured on a 100-point visual analogue scale before ingestion and 60’ and 120’ after ingestion. Results Fasting BDNF levels were lower in PWS than in controls (p = 0.05). Postprandially, PWS patients showed only a truncated early peak in BDNF, and their BDNF levels at 60' and 120' were lower compared with lean controls (p<0.05). Leptin was higher in PWS patients than in controls at all time points (p<0.001). PWS patients were hungrier than controls before and after eating. The probability of being hungry was associated with baseline BDNF levels: every 50-unit increment in BDNF decreased the odds of being hungry by 22% (OR: 0.78, 95%CI: 0.65–0.94). In uniparental disomy, the odds of being hungry decreased by 66% (OR: 0.34, 90%CI: 0.13–0.9). Postprandial leptin patterns did no differ among genetic subtypes. Conclusions Low baseline BDNF levels and lack of postprandial peak may contribute to persistent hunger after meals. Uniparental disomy is the genetic subtype of PWS least affected by these factors.
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Affiliation(s)
- Marta Bueno
- Department of Endocrinology and Nutrition, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Susanna Esteba-Castillo
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Ramon Novell
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Olga Giménez-Palop
- Department of Endocrinology and Nutrition, Sabadell University Hospital, Corporació Sanitària Parc Taulí, Sabadell, Spain, Autonomous University of Barcelona, Bellaterra, Spain
| | - Ramon Coronas
- Mental Health Center, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Elisabeth Gabau
- Pediatric Endocrinology Unit, Sabadell University Hospital, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Raquel Corripio
- Pediatric Endocrinology Unit, Sabadell University Hospital, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Neus Baena
- Genetics Laboratory, UDIAT, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Marina Viñas-Jornet
- Genetics Laboratory, UDIAT, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Míriam Guitart
- Genetics Laboratory, UDIAT, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - David Torrents-Rodas
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Joan Deus
- Department of Clinical and Health Psychology, Autonomous University of Barcelona, Bellaterra, Spain
- MRI Research Unit, Department of Radiology, CIBERSAM G21, Hospital del Mar, Barcelona, Spain
- Guttmann Neurorehabilitation Institute, Barcelona, Spain, Autonomous University of Barcelona, Bellaterra, Spain
| | - Jesús Pujol
- MRI Research Unit, Department of Radiology, CIBERSAM G21, Hospital del Mar, Barcelona, Spain
| | - Mercedes Rigla
- Department of Endocrinology and Nutrition, Sabadell University Hospital, Corporació Sanitària Parc Taulí, Sabadell, Spain, Autonomous University of Barcelona, Bellaterra, Spain
| | - Assumpta Caixàs
- Department of Endocrinology and Nutrition, Sabadell University Hospital, Corporació Sanitària Parc Taulí, Sabadell, Spain, Autonomous University of Barcelona, Bellaterra, Spain
- * E-mail:
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10
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Kuppens RJ, Delhanty PJD, Huisman TM, van der Lely AJ, Hokken-Koelega ACS. The Authors' Reply: Acylated and unacylated ghrelin during OGTT in Prader-Willi syndrome, a rebuttal to the conclusions by Kuppens et al. Clin Endocrinol (Oxf) 2016; 85:323-4. [PMID: 27144882 DOI: 10.1111/cen.13091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R J Kuppens
- Dutch Growth Research Foundation, Rotterdam, The Netherlands. ,
- Erasmus University Medical Center-Sophia Children's Hospital, Department of Pediatrics, Subdivision of Endocrinology, Rotterdam, The Netherlands. ,
| | - P J D Delhanty
- Erasmus University Medical Center, Department of Internal Medicine, Rotterdam, The Netherlands
| | - T M Huisman
- Erasmus University Medical Center, Department of Internal Medicine, Rotterdam, The Netherlands
| | - A J van der Lely
- Erasmus University Medical Center, Department of Internal Medicine, Rotterdam, The Netherlands
| | - A C S Hokken-Koelega
- Dutch Growth Research Foundation, Rotterdam, The Netherlands
- Erasmus University Medical Center-Sophia Children's Hospital, Department of Pediatrics, Subdivision of Endocrinology, Rotterdam, The Netherlands
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11
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Allas S, Abribat T. Acylated and unacylated ghrelin during OGTT in Prader-Willi syndrome: a rebuttal to the conclusions by Kuppens et al. Clin Endocrinol (Oxf) 2016; 85:322-3. [PMID: 27037909 DOI: 10.1111/cen.13072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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12
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Gumus Balikcioglu P, Balikcioglu M, Muehlbauer MJ, Purnell JQ, Broadhurst D, Freemark M, Haqq AM. Macronutrient Regulation of Ghrelin and Peptide YY in Pediatric Obesity and Prader-Willi Syndrome. J Clin Endocrinol Metab 2015; 100:3822-31. [PMID: 26259133 PMCID: PMC5399503 DOI: 10.1210/jc.2015-2503] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The roles of macronutrients and GH in the regulation of food intake in pediatric obesity and Prader-Willi Syndrome (PWS) are poorly understood. OBJECTIVE We compared effects of high-carbohydrate (HC) and high-fat (HF) meals and GH therapy on ghrelin, insulin, peptide YY (PYY), and insulin sensitivity in children with PWS and body mass index (BMI) -matched obese controls (OCs). METHODS In a randomized, crossover study, 14 PWS (median, 11.35 y; BMI z score [BMI-z], 2.15) and 14 OCs (median, 11.97 y; BMI-z, 2.35) received isocaloric breakfast meals (HC or HF) on separate days. Blood samples were drawn at baseline and every 30 minutes for 4 hours. Mixed linear models were adjusted for age, sex, and BMI-z. RESULTS Relative to OCs, children with PWS had lower fasting insulin and higher fasting ghrelin and ghrelin/PYY. Ghrelin levels were higher in PWS across all postprandial time points (P < .0001). Carbohydrate was more potent than fat in suppressing ghrelin levels in PWS (P = .028); HC and HF were equipotent in OCs but less potent than in PWS (P = .011). The increase in PYY following HF was attenuated in PWS (P = .037); thus, postprandial ghrelin/PYY remained higher throughout. A lesser increase in insulin and lesser decrease in ghrelin were observed in GH-treated PWS patients than in untreated patients; PYY responses were comparable. CONCLUSION Children with PWS have fasting and postprandial hyperghrelinemia and an attenuated PYY response to fat, yielding a high ghrelin/PYY ratio. GH therapy in PWS is associated with increased insulin sensitivity and lesser postprandial suppression of ghrelin. The ratio Ghrelin/PYY may be a novel marker of orexigenic drive.
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Affiliation(s)
- Pinar Gumus Balikcioglu
- Division of Pediatric Endocrinology and Diabetes (P.G.B., M.F.), Duke University Medical Center, Durham, North Carolina 27710; Advanced Analytics (M.B.), SAS Institute Inc., Cary, North Carolina 27513; Duke Molecular Physiology Institute (M.J.M., M.F.), Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina 27710; Knight Cardiovascular Institute (J.Q.P.), Oregon Health & Science University, Portland, Oregon 97239; and Department of Medicine (D.B.) and Division of Pediatric Endocrinology and Diabetes (A.M.H.), University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - Metin Balikcioglu
- Division of Pediatric Endocrinology and Diabetes (P.G.B., M.F.), Duke University Medical Center, Durham, North Carolina 27710; Advanced Analytics (M.B.), SAS Institute Inc., Cary, North Carolina 27513; Duke Molecular Physiology Institute (M.J.M., M.F.), Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina 27710; Knight Cardiovascular Institute (J.Q.P.), Oregon Health & Science University, Portland, Oregon 97239; and Department of Medicine (D.B.) and Division of Pediatric Endocrinology and Diabetes (A.M.H.), University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - Michael J Muehlbauer
- Division of Pediatric Endocrinology and Diabetes (P.G.B., M.F.), Duke University Medical Center, Durham, North Carolina 27710; Advanced Analytics (M.B.), SAS Institute Inc., Cary, North Carolina 27513; Duke Molecular Physiology Institute (M.J.M., M.F.), Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina 27710; Knight Cardiovascular Institute (J.Q.P.), Oregon Health & Science University, Portland, Oregon 97239; and Department of Medicine (D.B.) and Division of Pediatric Endocrinology and Diabetes (A.M.H.), University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - Jonathan Q Purnell
- Division of Pediatric Endocrinology and Diabetes (P.G.B., M.F.), Duke University Medical Center, Durham, North Carolina 27710; Advanced Analytics (M.B.), SAS Institute Inc., Cary, North Carolina 27513; Duke Molecular Physiology Institute (M.J.M., M.F.), Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina 27710; Knight Cardiovascular Institute (J.Q.P.), Oregon Health & Science University, Portland, Oregon 97239; and Department of Medicine (D.B.) and Division of Pediatric Endocrinology and Diabetes (A.M.H.), University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - David Broadhurst
- Division of Pediatric Endocrinology and Diabetes (P.G.B., M.F.), Duke University Medical Center, Durham, North Carolina 27710; Advanced Analytics (M.B.), SAS Institute Inc., Cary, North Carolina 27513; Duke Molecular Physiology Institute (M.J.M., M.F.), Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina 27710; Knight Cardiovascular Institute (J.Q.P.), Oregon Health & Science University, Portland, Oregon 97239; and Department of Medicine (D.B.) and Division of Pediatric Endocrinology and Diabetes (A.M.H.), University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - Michael Freemark
- Division of Pediatric Endocrinology and Diabetes (P.G.B., M.F.), Duke University Medical Center, Durham, North Carolina 27710; Advanced Analytics (M.B.), SAS Institute Inc., Cary, North Carolina 27513; Duke Molecular Physiology Institute (M.J.M., M.F.), Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina 27710; Knight Cardiovascular Institute (J.Q.P.), Oregon Health & Science University, Portland, Oregon 97239; and Department of Medicine (D.B.) and Division of Pediatric Endocrinology and Diabetes (A.M.H.), University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - Andrea M Haqq
- Division of Pediatric Endocrinology and Diabetes (P.G.B., M.F.), Duke University Medical Center, Durham, North Carolina 27710; Advanced Analytics (M.B.), SAS Institute Inc., Cary, North Carolina 27513; Duke Molecular Physiology Institute (M.J.M., M.F.), Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina 27710; Knight Cardiovascular Institute (J.Q.P.), Oregon Health & Science University, Portland, Oregon 97239; and Department of Medicine (D.B.) and Division of Pediatric Endocrinology and Diabetes (A.M.H.), University of Alberta, Edmonton, AB T6G 2R3 Canada
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Tang J, Lin J. Relationship between ghrelin and gastrointestinal diseases. Shijie Huaren Xiaohua Zazhi 2014; 22:5447-5453. [DOI: 10.11569/wcjd.v22.i35.5447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Ghrelin is a newly found 28-amino acid brain-gut peptide, which is mainly secreted by the gastric mucosa. It has two forms, acyl-ghrelin and des-acyl ghrelin, and the former is the major active form. Ghrelin is an endogenous ligand for the growth hormone secretagogue receptor and plays an important role in regulating food intake, gastric acid secretion, gastrointestinal motility, gastric mucosa protection, and inhibition of inflammatory reaction in paracrine, autocrine and endocrine manners. Recent studies have found that ghrelin levels are abnormal in a variety of gastrointestinal diseases, such as Helicobacter pylori infection, peptic ulcer, functional dyspepsia, inflammatory bowel disease, pancreatitis, tumors and so on, suggesting that ghrelin may be involved in the pathogenesis of these diseases. Ghrelin may become an index for disease diagnosis and prognosis evaluation and a new target for treatment of gastrointestinal diseases.
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Rigamonti AE, Bini S, Grugni G, Agosti F, De Col A, Mallone M, Cella SG, Sartorio A. Unexpectedly increased anorexigenic postprandial responses of PYY and GLP-1 to fast ice cream consumption in adult patients with Prader-Willi syndrome. Clin Endocrinol (Oxf) 2014; 81:542-50. [PMID: 24372155 DOI: 10.1111/cen.12395] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 11/23/2013] [Accepted: 12/19/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The effect of eating rate on the release of anorexigenic gut peptides in Prader-Willi syndrome (PWS), a neurogenetic disorder clinically characterized by hyperphagia and excessive obesity, has not been investigated so far. DESIGN AND PATIENTS Postprandial PYY and GLP-1 levels to fast (5 min) and slow (30 min) ice cream consumption were measured in PWS adult patients and age-matched patients with simple obesity and normal-weighted subjects. Visual analog scales (VASs) were used to evaluate the subjective feelings of hunger and satiety. RESULTS Fast ice cream consumption stimulated GLP-1 release in normal subjects, a greater increase being observed with slow feeding. Fast or slow feeding did not change circulating levels of GLP-1 in obese patients, while, unexpectedly, fast feeding (but not slow feeding) stimulated GLP-1 release in PWS patients. Plasma PYY concentrations increased in all groups, irrespective of the eating rate. Slow feeding was more effective in stimulating PYY release in normal subjects, while fast feeding was more effective in PWS patients. Slow feeding evoked a lower hunger and higher satiety compared with fast feeding in normal subjects, this finding being not evident in obese patients. Unexpectedly, fast feeding evoked a lower hunger and higher satiety in PWS patients in comparison with slow feeding. CONCLUSIONS Fast feeding leads to higher concentrations of anorexigenic gut peptides and favours satiety in PWS adult patients, this pattern being not evident in age-matched patients with simple obesity, thus suggesting the existence of a different pathophysiological substrate in these two clinical conditions.
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Affiliation(s)
- A E Rigamonti
- Department of Clinical Sciences and Community, Università degli Studi di Milano, Milan, Italy
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15
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Bueno Díez M, Caixàs Pedragós A. Prader-Willi syndrome and hyperphagia: a challenge to investigate. ACTA ACUST UNITED AC 2014; 61:121-2. [PMID: 24602488 DOI: 10.1016/j.endonu.2014.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 02/11/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Marta Bueno Díez
- Servicio de Endocrinología y Nutrición, Hospital Universitari Arnau de Vilanova, Lleida, España.
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16
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Delporte C. Structure and physiological actions of ghrelin. SCIENTIFICA 2013; 2013:518909. [PMID: 24381790 PMCID: PMC3863518 DOI: 10.1155/2013/518909] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 11/10/2013] [Indexed: 05/30/2023]
Abstract
Ghrelin is a gastric peptide hormone, discovered as being the endogenous ligand of growth hormone secretagogue receptor. Ghrelin is a 28 amino acid peptide presenting a unique n-octanoylation modification on its serine in position 3, catalyzed by ghrelin O-acyl transferase. Ghrelin is mainly produced by a subset of stomach cells and also by the hypothalamus, the pituitary, and other tissues. Transcriptional, translational, and posttranslational processes generate ghrelin and ghrelin-related peptides. Homo- and heterodimers of growth hormone secretagogue receptor, and as yet unidentified receptors, are assumed to mediate the biological effects of acyl ghrelin and desacyl ghrelin, respectively. Ghrelin exerts wide physiological actions throughout the body, including growth hormone secretion, appetite and food intake, gastric secretion and gastrointestinal motility, glucose homeostasis, cardiovascular functions, anti-inflammatory functions, reproductive functions, and bone formation. This review focuses on presenting the current understanding of ghrelin and growth hormone secretagogue receptor biology, as well as the main physiological effects of ghrelin.
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Affiliation(s)
- Christine Delporte
- Laboratory of Pathophysiological and Nutritional Biochemistry, Université Libre de Bruxelles, 808 Route de Lennik, Bat G/E-CP611, 1070 Brussels, Belgium
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Bereket A, Kiess W, Lustig RH, Muller HL, Goldstone AP, Weiss R, Yavuz Y, Hochberg Z. Hypothalamic obesity in children. Obes Rev 2012; 13:780-98. [PMID: 22577758 DOI: 10.1111/j.1467-789x.2012.01004.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Hypothalamic obesity is an intractable form of obesity syndrome that was initially described in patients with hypothalamic tumours and surgical damage. However, this definition is now expanded to include obesity developing after a variety of insults, including intracranial infections, infiltrations, trauma, vascular problems and hydrocephalus, in addition to acquired or congenital functional defects in central energy homeostasis in children with the so-called common obesity. The pathogenetic mechanisms underlying hypothalamic obesity are complex and multifactorial. Weight gain results from damage to the ventromedial hypothalamus, which leads, variously, to hyperphagia, a low-resting metabolic rate; autonomic imbalance; growth hormone-, gonadotropins and thyroid-stimulating hormone deficiency; hypomobility; and insomnia. Hypothalamic obesity did not receive enough attention, as evidenced by rarity of studies in this group of patients. A satellite symposium was held during the European Congress of Obesity in May 2011, in Istanbul, Turkey, to discuss recent developments and concepts regarding pathophysiology and management of hypothalamic obesity in children. An international group of leading researchers presented certain aspects of the problem. This paper summarizes the highlights of this symposium. Understanding the central role of the hypothalamus in the regulation of feeding and energy metabolism will help us gain insights into the pathogenesis and management of common obesity.
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Affiliation(s)
- A Bereket
- Department of Pediatrics, Marmara University, Istanbul, Turkey.
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Giménez-Palop O, Coronas R, Cobo J, Gallart L, Barbero JD, Parra I, Fusté G, Vendrell J, Bueno M, González-Clemente JM, Caixàs A. Fasting plasma peptide YY concentrations are increased in patients with major depression who associate weight loss. J Endocrinol Invest 2012; 35:645-8. [PMID: 22183081 DOI: 10.3275/8180] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Many patients with major depression refer a decreased appetite and weight loss among their symptoms. Peptide YY (PYY) and ghrelin belong to the family of peptides of the gut-brain axis implicated in the regulation of appetite and energy metabolism. PYY stimulates a powerful central satiety response and ghrelin increases food intake and weight gain. Brain-derived neurotrophic factor (BDNF) also contributes to the central control of food intake as an anorexigenic factor. AIM To study fasting plasma total and acylated ghrelin, plasma PYY and serum BDNF levels in patients with major depression with weight loss as one of their symptoms and compare them with matched healthy controls. SUBJECTS AND METHODS Fifteen adult patients, 9 male and 6 female, with recent diagnosis of major depression, and 16 healthy adult subjects, matched by age and anthropometric parameters were studied. All depressed patients referred weight loss and were not under antidepressant therapy. Fasting total PYY, total ghrelin and acylated ghrelin and BDNF were determined. RESULTS Fasting total PYY was higher in patients than controls (2.01±0.09 vs 1.29±0.16 pmol/l). There were no differences in fasting total ghrelin, acylated ghrelin or BDNF levels. CONCLUSIONS Major depressed patients, with weight loss at diagnosis, showed higher fasting plasma PYY levels that could contribute to their reduced appetite.
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Affiliation(s)
- O Giménez-Palop
- Diabetes, Endocrinology and Nutrition Department, Sabadell Hospital, Sabadell (Barcelona), Spain.
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Cardona Cano S, Merkestein M, Skibicka KP, Dickson SL, Adan RAH. Role of ghrelin in the pathophysiology of eating disorders: implications for pharmacotherapy. CNS Drugs 2012; 26:281-96. [PMID: 22452525 DOI: 10.2165/11599890-000000000-00000] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Ghrelin is the only known circulating orexigenic hormone. It increases food intake by interacting with hypothalamic and brainstem circuits involved in energy balance, as well as reward-related brain areas. A heightened gut-brain ghrelin axis is an emerging feature of certain eating disorders such as anorexia nervosa and Prader-Willi syndrome. In common obesity, ghrelin levels are lowered, whereas post-meal ghrelin levels remain higher than in lean individuals. Agents that interfere with ghrelin signalling have therapeutic potential for eating disorders, including obesity. However, most of these drugs are only in the preclinical phase of development. Data obtained so far suggest that ghrelin agonists may have potential in the treatment of anorexia nervosa, while ghrelin antagonists seem promising for other eating disorders such as obesity and Prader-Willi syndrome. However, large clinical trials are needed to evaluate the efficacy and safety of these drugs.
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Abstract
OBJECTIVE Prader-Willi syndrome (PWS) is a genetic neurodevelopmental disorder with several nutritional phases during childhood proceeding from poor feeding, through normal eating without and with obesity, to hyperphagia and life-threatening obesity, with variable ages of onset. We investigated whether differences in appetite hormones may explain the development of abnormal eating behaviour in young children with PWS. SUBJECTS In this cross-sectional study, children with PWS (n=42) and controls (n=9) aged 7 months-5 years were recruited. Mothers were interviewed regarding eating behaviour, and body mass index (BMI) was calculated. Fasting plasma samples were assayed for insulin, leptin, glucose, peptide YY (PYY), ghrelin and pancreatic polypeptide (PP). RESULTS There was no significant relationship between eating behaviour in PWS subjects and the levels of any hormones or insulin resistance, independent of age. Fasting plasma leptin levels were significantly higher (mean ± s.d.: 22.6 ± 12.5 vs 1.97 ± 0.79 ng ml(-1), P=0.005), and PP levels were significantly lower (22.6 ± 12.5 vs 69.8 ± 43.8 pmol l(-1), P<0.001) in the PWS group compared with the controls, and this was independent of age, BMI, insulin resistance or IGF-1 levels. However, there was no significant difference in plasma insulin, insulin resistance or ghrelin levels between groups, though PYY declined more rapidly with age but not BMI in PWS subjects. CONCLUSION Even under the age of 5 years, PWS is associated with low levels of anorexigenic PP, as in older children and adults. Hyperghrelinaemia or hypoinsulinaemia was not seen in these young children with PWS. Change in these appetite hormones was not associated with the timing of the transition to the characteristic hyperphagic phase. However, abnormal and/or delayed development or sensitivity of the effector pathways of these appetitive hormones (for example, parasympathetic and central nervous system) may interact with low PP levels, and later hyperghrelinaemia or hypoinsulinaemia, to contribute to hyperphagia in PWS.
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Abstract
Ghrelin is a brain-gut peptide that was discovered through reverse pharmacology and was first isolated from extracts of porcine stomach. Ghrelin binds to growth hormone secretagogue receptor (GHS-R) and is acylated on its serine 3 residue by ghrelin O-acyltransferase (GOAT). Several important biological functions of ghrelin have been identified, which include its growth hormone-releasing and appetite-inducing effects. Ghrelin exerts its central orexigenic effect mainly by acting on the hypothalamic arcuate nucleus via the activation of the GHS-R. Peripherally ghrelin has multiple metabolic effects which include promoting gluconeogenesis and fat deposition. These effects together with the increased food intake lead to an overall body weight gain. AMP-activated protein kinase, which is a key enzyme in energy homeostasis, has been shown to mediate the central and peripheral metabolic effects of ghrelin. The hypothalamic fatty acid pathway, hypothalamic mitochondrial respiration and uncoupling protein 2 have all been shown to act as the downstream targets of AMPK in mediating the orexigenic effects of ghrelin. Abnormal levels of ghrelin are associated with several metabolic conditions such as obesity, type 2 diabetes, Prader-Willi syndrome and anorexia nervosa. The ghrelin/GOAT/GHS-R system is now recognised as a potential target for the development of anti-obesity treatment.
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Affiliation(s)
- Chung Thong Lim
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, UK.
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Álvarez-Castro P, Sangiao-Alvarellos S, Brandón-Sandá I, Cordido F. [Endocrine function in obesity]. ACTA ACUST UNITED AC 2011; 58:422-32. [PMID: 21824829 DOI: 10.1016/j.endonu.2011.05.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 05/28/2011] [Accepted: 05/31/2011] [Indexed: 12/28/2022]
Abstract
Obesity is associated to significant disturbances in endocrine function. Hyper insulinemia and insulin resistance are the best known changes in obesity, but their mechanisms and clinical significance are not clearly established. Adipose tissue is considered to be a hormone-secreting endocrine organ; and increased leptin secretion from the adipocyte, a satiety signal, is a well-established endocrine change in obesity. In obesity there is a decreased GH secretion. Impairment of somatotropic function in obesity is functional and may be reversed in certain circumstances. The pathophysiological mechanism responsible for low GH secretion in obesity is probably multifactorial. There are many data suggesting that a chronic state of somatostatin hypersecretion results in inhibition of GH release. Increased FFA levels, as well as a deficient ghrelin secretion, probably contribute to the impaired GH secretion. In women, abdominal obesity is associated to hyperandrogenism and low sex hormone-binding globulin levels. Obese men, particularly those with morbid obesity, have decreased testosterone and gonadotropin levels. Obesity is associated to an increased cortisol production rate, which is compensated for by a higher cortisol clearance, resulting in plasma free cortisol levels that do not change when body weight increases. Ghrelin is the only known circulating orexigenic factor, and has been found to be decreased in obese people. In obesity there is also a trend to increased TSH and free T3 levels.
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Purtell L, Sze L, Loughnan G, Smith E, Herzog H, Sainsbury A, Steinbeck K, Campbell LV, Viardot A. In adults with Prader-Willi syndrome, elevated ghrelin levels are more consistent with hyperphagia than high PYY and GLP-1 levels. Neuropeptides 2011; 45:301-7. [PMID: 21722955 DOI: 10.1016/j.npep.2011.06.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Revised: 05/17/2011] [Accepted: 06/01/2011] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Prader-Willi syndrome (PWS) is a leading genetic cause of obesity, characterized by hyperphagia, endocrine and developmental disorders. It is suggested that the intense hyperphagia could stem, in part, from impaired gut hormone signaling. Previous studies produced conflicting results, being confounded by differences in body composition between PWS and control subjects. DESIGN Fasting and postprandial gut hormone responses were investigated in a cross-sectional cohort study including 10 adult PWS, 12 obese subjects matched for percentage body fat and central abdominal fat, and 10 healthy normal weight subjects. METHODS PYY[total], PYY[3-36], GLP-1[active] and ghrelin[total] were measured by ELISA or radioimmunoassay. Body composition was assessed by dual energy X-ray absorptiometry. Visual analog scales were used to assess hunger and satiety. RESULTS In contrast to lean subjects (p<0.05), PWS and obese subjects were similarly insulin resistant and had similar insulin levels. Ghrelin[total] levels were significantly higher in PWS compared to obese subjects before and during the meal (p<0.05). PYY[3-36] meal responses were higher in PWS than in lean subjects (p=0.01), but not significantly different to obese (p=0.08), with an additional non-significant trend in PYY[total] levels. There were no significant differences in self-reported satiety between groups, however PWS subjects reported more hunger throughout (p=0.003), and exhibited a markedly reduced meal-induced suppression of hunger (p=0.01) compared to lean or obese subjects. CONCLUSIONS Compared to adiposity-matched control subjects, hyperphagia in PWS is not related to a lower postprandial GLP-1 or PYY response. Elevated ghrelin levels in PWS are consistent with increased hunger and are unrelated to insulin levels.
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Affiliation(s)
- Louise Purtell
- Diabetes & Obesity Research Program, Garvan Institute of Medical Research, Sydney-Darlinghurst, Australia.
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Scerif M, Goldstone AP, Korbonits M. Ghrelin in obesity and endocrine diseases. Mol Cell Endocrinol 2011; 340:15-25. [PMID: 21345363 DOI: 10.1016/j.mce.2011.02.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2011] [Accepted: 02/14/2011] [Indexed: 01/27/2023]
Abstract
Ghrelin shows orexigenic effect through its action on the hypothalamic appetite-regulating pathways, while in the periphery ghrelin increases adipose tissue accumulation and has a diabetogenic effect on the liver and pancreas. Adenosine monophosphate-activated protein kinase (AMPK) has been suggested as one of the mediators of ghrelin's effects. Plasma ghrelin levels are dependent on body mass index as well as food intake patterns. Ghrelin levels are in general reduced in obese individuals and in subjects with insulin resistance. In contrast to other forms of obesity, patients with Prader-Willi syndrome (PWS) display high levels of ghrelin, reduced visceral adiposity and relative hypoinsulinemia. Relationships between obesity and common genomic variants of GHRL and GHS-R genes have been studied. Ghrelin may have a role in the weight-reducing effect of bariatric surgery; however, this is a much debated issue. Altered ghrelin levels have also been observed in Cushing's syndrome and thyroid disease probably due to the secondary insulin resistance in these subjects.
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Affiliation(s)
- Miski Scerif
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Bartness TJ, Keen-Rhinehart E, Dailey MJ, Teubner BJ. Neural and hormonal control of food hoarding. Am J Physiol Regul Integr Comp Physiol 2011; 301:R641-55. [PMID: 21653877 DOI: 10.1152/ajpregu.00137.2011] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Many animals hoard food, including humans, but despite its pervasiveness, little is known about the physiological mechanisms underlying this appetitive behavior. We summarize studies of food hoarding in humans and rodents with an emphasis on mechanistic laboratory studies of species where this behavior importantly impacts their energy balance (hamsters), but include laboratory rat studies although their wild counterparts do not hoard food. The photoperiod and cold can affect food hoarding, but food availability is the most significant environmental factor affecting food hoarding. Food-deprived/restricted hamsters and humans exhibit large increases in food hoarding compared with their fed counterparts, both doing so without overeating. Some of the peripheral and central peptides involved in food intake also affect food hoarding, although many have not been tested. Ad libitum-fed hamsters given systemic injections of ghrelin, the peripheral orexigenic hormone that increases with fasting, mimics food deprivation-induced increases in food hoarding. Neuropeptide Y or agouti-related protein, brain peptides stimulated by ghrelin, given centrally to ad libitum-fed hamsters, duplicates the early and prolonged postfood deprivation increases in food hoarding, whereas central melanocortin receptor agonism tends to inhibit food deprivation and ghrelin stimulation of hoarding. Central or peripheral leptin injection or peripheral cholecystokinin-33, known satiety peptides, inhibit food hoarding. Food hoarding markedly increases with pregnancy and lactation. Because fasted and/or obese humans hoard more food in general, and more high-density/high-fat foods specifically, than nonfasted and/or nonobese humans, understanding the mechanisms underlying food hoarding could provide another target for behavioral/pharmacological approaches to curb obesity.
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Affiliation(s)
- Timothy J Bartness
- Department of Biology, Neurobiology and Behavior Program, Georgia State University, Atlanta, Georgia, USA
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Scerif M, Goldstone AP, Korbonits M. WITHDRAWN: Ghrelin in obesity and endocrine diseases. Mol Cell Endocrinol 2011:S0303-7207(11)00157-2. [PMID: 21489902 DOI: 10.1016/j.mce.2011.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 02/22/2011] [Indexed: 10/18/2022]
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published, doi:10.1016/j.mce.2011.02.011. The duplicate article has therefore been withdrawn.
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Affiliation(s)
- Miski Scerif
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
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Meta-analysis of the relationship between obestatin and ghrelin levels and the ghrelin/obestatin ratio with respect to obesity. Am J Med Sci 2011; 341:48-55. [PMID: 21139496 DOI: 10.1097/maj.0b013e3181ec41ed] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The association between gastrointestinal hormones, obestatin and ghrelin, and obesity are controversial. Here, the authors summarize results of published works in this field by using meta-analysis. METHODS Studies that evaluated these hormones and were published before December 2009 were collected from PubMed, HighWire Press and ProQuest Health and Medical Complete. Software Review Manager 4.2 was used (Cochrane Collaboration, Oxford, England). Differences between obese and normal weight (NW) groups were compared using fixed or random effects models based on heterogeneity. RESULTS In obestatin group, 9 studies with 566 participants were included and had significant heterogeneity (I² = 98.6%, P < 0.01). Obestatin of NW groups was 64.19 pg/mL [95% confidence interval (CI) = 36.11-92.26, P < 0.01] higher than those of obese groups. In total ghrelin group, 21 studies with 1187 participants were included and had significant heterogeneity (I² = 97.9%, P < 0.01). Total ghrelin of NW groups was 145.53 pg/mL (95%CI = 109.59-181.47, P < 0.01) higher than those of obese groups. In active ghrelin group, 6 studies with 265 participants were included and had significant heterogeneity (I² = 98.10%, P < 0.01). Active ghrelin in NW groups was 53.22 pg/mL (95%CI = 25.92-80.53, P < 0.01) higher than those of obese groups. In ghrelin/obestatin group, 5 studies with 259 participants were included and had significant heterogeneity (I² = 94.2, P < 0.01). The ratios in NW groups were 2.49 pg/mL (95%CI = 0.03-4.9, P = 0.05) higher than those of obese groups but without significance. CONCLUSIONS Obestatin, total and active ghrelin in NW groups were significantly higher than those of obese groups. Ghrelin/obestatin ratios in NW groups were also higher but without significance.
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De Vriese C, Perret J, Delporte C. Focus on the short- and long-term effects of ghrelin on energy homeostasis. Nutrition 2010; 26:579-84. [DOI: 10.1016/j.nut.2009.09.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Accepted: 09/17/2009] [Indexed: 02/06/2023]
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Chen CY, Asakawa A, Fujimiya M, Lee SD, Inui A. Ghrelin gene products and the regulation of food intake and gut motility. Pharmacol Rev 2010; 61:430-81. [PMID: 20038570 DOI: 10.1124/pr.109.001958] [Citation(s) in RCA: 161] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
A breakthrough using "reverse pharmacology" identified and characterized acyl ghrelin from the stomach as the endogenous cognate ligand for the growth hormone (GH) secretagogue receptor (GHS-R) 1a. The unique post-translational modification of O-n-octanoylation at serine 3 is the first in peptide discovery history and is essential for GH-releasing ability. Des-acyl ghrelin, lacking O-n-octanoylation at serine 3, is also produced in the stomach and remains the major molecular form secreted into the circulation. The third ghrelin gene product, obestatin, a novel 23-amino acid peptide identified from rat stomach, was found by comparative genomic analysis. Three ghrelin gene products actively participate in modulating appetite, adipogenesis, gut motility, glucose metabolism, cell proliferation, immune, sleep, memory, anxiety, cognition, and stress. Knockdown or knockout of acyl ghrelin and/or GHS-R1a, and overexpression of des-acyl ghrelin show benefits in the therapy of obesity and metabolic syndrome. By contrast, agonism of acyl ghrelin and/or GHS-R1a could combat human anorexia-cachexia, including anorexia nervosa, chronic heart failure, chronic obstructive pulmonary disease, liver cirrhosis, chronic kidney disease, burn, and postsurgery recovery, as well as restore gut dysmotility, such as diabetic or neurogenic gastroparesis, and postoperative ileus. The ghrelin acyl-modifying enzyme, ghrelin O-Acyltransferase (GOAT), which attaches octanoate to serine-3 of ghrelin, has been identified and characterized also from the stomach. To date, ghrelin is the only protein to be octanylated, and inhibition of GOAT may have effects only on the stomach and is unlikely to affect the synthesis of other proteins. GOAT may provide a critical molecular target in developing novel therapeutics for obesity and type 2 diabetes.
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Affiliation(s)
- Chih-Yen Chen
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Japan
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Prodam F, Bellone S, Grugni G, Crinò A, Ragusa L, Franzese A, Di Battista E, Corrias A, Walker G, Rapa A, Aimaretti G, Bona G. Influence of age, gender, and glucose tolerance on fasting and fed acylated ghrelin in Prader Willi syndrome. Clin Nutr 2009; 28:94-9. [PMID: 19150743 DOI: 10.1016/j.clnu.2008.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 11/14/2008] [Accepted: 12/07/2008] [Indexed: 01/12/2023]
Abstract
BACKGROUND & AIMS Prader Willi syndrome (PWS) is a genetic syndrome characterized by hyperphagia, morbid obesity, relative hypoinsulinemia and normal insulin sensitivity. PWS presents higher total (TG) and acylated ghrelin (AG) levels. The cause of this increase as well as the modulation of ghrelin secretion in fasting and feeding in relation to other metabolic parameters and glucose tolerance in PWS is largely unknown. METHODS We studied TG and AG at fasting in PWS children (14) and adults (18). We also studied TG and AG response to a mixed standardized light breakfast (SLB) in PWS adults without (AD-GT) and with glucose intolerance (AD-GI) at OGTT. RESULTS TG and AG were higher in children than in adults (p<0.05). AG was higher in adult males (p<0.001). Fasting AG and AG/TG ratio were lower in AD-GI than in AD-GT (p<0.05). TG, but not AG, decreased in AD-GT (p<0.006), whereas AG, but not TG, increased in AD-GI (p<0.03) post-SLB. Fasting TG and AG were negatively predicted by fasting insulin (p<0.05). Post-SLB AG was positively predicted by glucose during OGTT (p<0.04). CONCLUSIONS Fasting and post-meal AG levels are influenced by glucose tolerance in PWS, suggesting that AG derangement might have a role in the development of glucose intolerance.
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Affiliation(s)
- Flavia Prodam
- Division of Paediatrics, Department of Medical Science, University of Piemonte Orientale, Novara, Italy.
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Giménez Palop O, Caixàs A. Péptido YY: una nueva estrategia para el tratamiento de la obesidad. ACTA ACUST UNITED AC 2009; 56:1-3. [DOI: 10.1016/s1575-0922(09)70186-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2008] [Accepted: 09/29/2008] [Indexed: 11/28/2022]
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Penín M, Perez Fontán M, Garcia Buela J, Luisa Isidro M, Martinez T, Outeiriño E, Rodriguez-Carmona A, Sangiao-Alvarellos S, Vidal O, Cordido F. Respuesta secretora de PYY1-36 y PYY3-36 en sujetos normales tras la ingesta de una comida mixta. ACTA ACUST UNITED AC 2008; 55:333-9. [DOI: 10.1016/s1575-0922(08)72793-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2008] [Accepted: 06/20/2008] [Indexed: 12/22/2022]
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Bibliography. Current world literature. Growth and development. Curr Opin Endocrinol Diabetes Obes 2008; 15:79-101. [PMID: 18185067 DOI: 10.1097/med.0b013e3282f4f084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Haqq AM, Muehlbauer M, Svetkey LP, Newgard CB, Purnell JQ, Grambow SC, Freemark MS. Altered distribution of adiponectin isoforms in children with Prader-Willi syndrome (PWS): association with insulin sensitivity and circulating satiety peptide hormones. Clin Endocrinol (Oxf) 2007; 67:944-51. [PMID: 17666087 PMCID: PMC2605973 DOI: 10.1111/j.1365-2265.2007.02991.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Prader-Willi syndrome (PWS) is a genetic syndrome characterized by relative hypoinsulinaemia and normal or increased insulin sensitivity despite profound obesity. We hypothesized that this increased insulin sensitivity is mediated by increased levels of total and high molecular weight adiponectin and associated with changes in levels of satiety hormones. DESIGN, PATIENTS AND MEASUREMENTS We measured total adiponectin and its isoforms [high molecular weight (HMW), middle molecular weight (MMW) and low molecular weight (LMW) adiponectin] and satiety hormones in 14 children with PWS [median age 11.35 years, body mass index (BMI) Z-score 2.15] and 14 BMI-matched controls (median age 11.97 years, BMI Z-score 2.34). RESULTS Despite comparable BMI Z-scores and leptin levels, the PWS children exhibited lower fasting insulin and HOMA-IR (homeostasis model assessment of insulin resistance) scores compared to obese controls. For any given BMI Z-score, the PWS children showed higher concentrations of fasting total and HMW adiponectin and higher HMW/total adiponectin ratios. The HMW/total adioponectin ratio was preserved in children with PWS at high degrees of obesity. In PWS children, fasting plasma total adiponectin, HMW adiponectin and HMW/total adiponectin ratio correlated negatively with age (P < 0.05), HOMA-IR (P < 0.01), BMI Z-score (P < 0.05), insulin (P < 0.01) and leptin (P < 0.05). In addition to higher fasting ghrelin concentrations, the PWS children showed significantly higher fasting levels of total peptide YY (PYY) and gastric inhibitory polypeptide (GIP) compared to obese controls. CONCLUSIONS Relative to controls of similar age and BMI Z-score, the PWS children had significantly higher levels of total and HMW adiponectin, and increased ratios of HMW/total adiponectin. These findings may explain in part the heightened insulin sensitivity of PWS children relative to BMI-matched controls.
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Affiliation(s)
- Andrea M Haqq
- Department of Pediatrics, Division of Pediatric Endocrinology, Duke University Medical Center, Durham, NC 27710, USA.
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Abstract
PURPOSE OF REVIEW The purpose of this review is to provide updated information on the role of ghrelin in food intake and energy homeostasis, and on its mechanism of action. Moreover, the potential of ghrelin as a target for drugs to treat cachexia and obesity will be discussed. RECENT FINDINGS Whereas the effects of ghrelin in the regulation of appetite, food intake and energy homeostasis have been fairly well documented, the pathways responsible for the effects of ghrelin are now increasingly being understood. As a consequence, clinical applications of ghrelin are now being developed. SUMMARY Ghrelin is an endogenous orexigenic peptide recently discovered in the stomach. Ghrelin is involved in short-term regulation of food intake since its plasma levels increase before meals and decrease strongly postprandially. Ghrelin is also involved in long-term body-weight regulation by inducing adiposity. Ghrelin might be useful for cachexia and obesity treatment.
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Affiliation(s)
- Carine De Vriese
- Laboratory of Biological Chemistry and Nutrition, Université Libre de Bruxelles, Brussels, Belgium
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