Current and future drug targets in weight management

Obesity will continue to be one of the leading causes of chronic disease unless the ongoing rise in the prevalence of this condition is reversed. Accumulating morbidity figures and a shortage of effective drugs have generated substantial research activity with several molecular targets being investigated. However, pharmacological modulation of body weight is extremely complex, since it is essentially a battle against one of the strongest human instincts and highly efficient mechanisms of energy uptake and storage. This review provides an overview of the different molecular strategies intended to lower body weight or adipose tissue mass. Weight-loss drugs in development include molecules intended to reduce the absorption of lipids from the GI tract, various ways to limit food intake, and compounds that increase energy expenditure or reduce adipose tissue size. A number of new preparations, including combinations of the existing drugs topiramate plus phentermine, bupropion plus naltrexone, and the selective 5-HT(2C) agonist lorcaserin have recently been filed for approval. Behind these leading candidates are several other potentially promising compounds and combinations currently undergoing phase II and III testing. Some interesting targets further on the horizon are also discussed.

Oxytocinergic Cells of the Hypothalamic Paraventricular Nucleus Are Involved in Food Entrainment

When food is presented at a specific time of day subjects develop intense locomotor behavior before food presentation, termed food anticipatory activity (FAA). Metabolic and hormonal parameters, as well as neural structures also shift their rhythm according to mealtime. Food-entrained activity rhythms are thought to be driven by a distributed system of central and peripheral oscillators sensitive to food cues, but it is not well understood how they are organized for the expression of FAA. The hormone Oxytocin plays an important role in food intake, satiety and homeostatic glucose metabolism and although it is recognized that food is the main cue for food entrainment this hormone has not been implicated in FAA. Here we investigated the activity of oxytocinergic (OTergic) cells of the hypothalamus in relation to the timing of feeding in rabbit pups, a natural model of food entrainment. We found that OTergic cells of the supraoptic nucleus and the main body of the paraventricular nucleus (PVN) are activated after feeding which suggests that OT may be an entraining signal for food synchronization. Moreover, a detailed analysis of the PVN revealed that OTergic cells of the caudal PVN and a subpopulation in the dorsal part of the main body of this nucleus shows activation before the time of food but not 12 h later. Moreover this pattern persists in fasted subjects at the time of the previous scheduled time of nursing. The fact that those OTergic cells of the dorsal and caudal part of the PVN contain preautonomic cells that project to the adrenal, pancreas and liver perhaps may be related to the physiological changes in preparation for food ingestion, and synchronization of peripheral oscillators, which remains to be determined; perhaps they play a main role in the central oscillatory mechanism of FAA as their activity persists in fasted subjects at the time of the next feeding time.

Joint Microbiota Activity and Dietary Assessment through Urinary Biomarkers by LC-MS/MS

Accurate dietary assessment in nutritional research is a huge challenge, but essential. Due to the subjective nature of self-reporting methods, the development of analytical methods for food intake and microbiota biomarkers determination is needed. This work presents an ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS) method for the quantification and semi quantification of 20 and 201 food intake biomarkers (BFIs), respectively, as well as 7 microbiota biomarkers applied to 208 urine samples from lactating mothers (M) (N = 59). Dietary intake was assessed through a 24 h dietary recall (R24h). BFI analysis identified three distinct clusters among samples: samples from clusters 1 and 3 presented higher concentrations of most biomarkers than those from cluster 2, with dairy products and milk biomarkers being more concentrated in cluster 1, and seeds, garlic and onion in cluster 3. Significant correlations were observed between three BFIs (fruits, meat, and fish) and R24h data (r > 0.2, p-values < 0.01, Spearman correlation). Microbiota activity biomarkers were simultaneously evaluated and the subgroup patterns detected were compared to clusters from dietary assessment. These results evidence the feasibility, usefulness, and complementary nature of the determination of BFIs, R24h, and microbiota activity biomarkers in observational nutrition cohort studies.