Appetite Regulation Flashcards

1
Q

What is an orexigen?

A

A substance that increases food intake (appetite sitmulant)

  • can be hormones or drugs
  • unwanted side effect of medication (increase weight gain)
  • desirable outcome of medical therapy
  • activates specific neurological pathways to increase hunger/food intake
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2
Q

What is anorexigen?

A

Substance which inhibits food intake (appetite inhibiting)

  • hormones or drugs
  • activates specifical neuronal pathway altering eating behaviour
  • no current drugs target this pathway
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3
Q

How is food broken down in the GI tract?

A
Mastication
Stomach Acid
Proteases
Rhythmic gastric 
contractions
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4
Q

Where do ingested nutrients pass?

A

Into the duodenum where there are bile acids and pancreatic enzymes

  • sensed by receptors in the GI tract
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5
Q

What are the properties of enteroendocrine cells?

A
  • specialised cell found in the duodenum downwards
  • sense the luminal environment
  • pyramidal shape allowing them to be projected out into the lumen detecting environment when nutrients enter the gut
  • Top luminal part ‘tastes’ the nutrient environment
  • Basal part contains vessels for endocrine hormone release
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6
Q

How do enteroendocrine cells release signalling molecules/hormones?

A
  • nutrients activate to their complementary specific GPCR on apical side of enteroendocrine cells activating them
  • this results in vesicular release of hormones on the basal side of the enteroendocrine cells
  • Hormones bind to vagal afferents (neuronal endings next to endocrine cells) of the extrinsic nervous system of the gut
  • excitation of the nerve causes hormone release
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7
Q

What do vagal afferents outside of the enteroendocrine cells respond to?

A

Nutrients, pH and osmolality

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8
Q

What types of receptors are on vagal afferents?

A
  • chemoreceptors detecting released hormones

- mechanoreceptors stimulated by stretch (gastric distension and meal size)

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9
Q

What is the nervous system of the gut?

A
  • intrinsic neural system (enteric)
  • extrinsic neural system (gut connecting with the CNS mediated by the vagus)
  • pelvis and splanchnic nerves in the distal GI
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10
Q

What is the vagus connected to?

A

The arcuate nucleus in the hypothalamus

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11
Q

What does the arcuate nucleus contain?

A

connects NTS, dorsal motor nucleus of the vagus nerve, area prostrema

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12
Q

What is leptin?

A

Circulating satiety factor
Adipokine - made by adipose tissue
LT response
Secretion related to time

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13
Q

What is the function of leptin

A
  • Anorexigenic - inhibits food intake/appetite inhibiting
  • Inhibits NPY/AgRP neurones and activates POMC/CART neurones
  • Increases bp, regulates thyroid hormone synthesis, reduces insulin secretion, increases heart rate, regulates bone mass, regulates menstrual cycle, regulates appetite/metabolism/energy, activates immune cells
  • increases when there is increased body fat = obese individuals are leptin resistant
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14
Q

What is CKK?

A

Cholecystokinin

Synthesised in the duodenum

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15
Q

What is the function of CKK?

A

Released in response to fat and protein
Slows gastric emptying, releases bile and pancreatic enzymes
Activates vagus leading to satiety
If levels are too high it creates nausea and taste aversion

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16
Q

What is PYY?

A

Peptide YY
Released by L cells in the GI tract
Released in response to high fat and protein

17
Q

What is the function of PYY?

A

Inhibits NPY neurones and activates POMC neurones
Leads to satiety
Reduced food intake
LT body weight regulator
Acts on Y receptors in peripheral, vagal and central mechanisms
If too high creates nausea

18
Q

What is the function of insulin on appetite?

A

Acute satiety signal

Inhibits NPY/AgRP neurones and activates CART/aMSH

19
Q

What is the function of GLP-1?

A
Glucagon like peptide -1
most powerful incretin
Released in response to food intake
Lowers blood glucose and food intake
Reduced in obese subjects
20
Q

What is the function of oxontymodulin?

A

Decreases plasma ghrelin levels and energy expenditure
Is an anorectic peptide product of peproglucagon
Effective weight loss

21
Q

What is the function of PP?

A

Pancreatic polypeptide
Released on food intake
Decreases appetite
LT energy balance

22
Q

Which peptides are arexorgenic?

A
Leptin
CKK
PYY
Insulin
GLP-1
PP
Oxontymodulin
alpha-MSH
CART
Corticotropin-releasing hormone
23
Q

Which peptides are orexigenic?

A
Ghrelin
NPY
AgRP
Orexins
Galanin
Melanin-conc. hormone
24
Q

What is ghrelin

A

Major orexigenic hormone (hunger hormone)
made in the stomach
Circulating so acts directly in hypothalamus via vagus and on brainstem receptors
Infuse ghrelin used for anorexia/cachexia to increase food intake
Inhibited by food intake
Suppressed in proportion to calorie ingestion

25
Q

What is the function of ghrelin?

A

ST = meal initiator = hunger
LT if chronically administered = hyperphagia, malignant ghrelinoma, preserved obesity
Effects: glucose homeostasis, gut motility, pancreas function, inflammation

26
Q

What are the 2 neuroendocrine functions of the hypothalamus?

A
  • direct neuronal connection to anterior pituitary

- hypophyseal portal system

27
Q

What role does the hypothalamus have in metabolism?

A

Regulates metabolic rate as influences pituitary function, feeding, stress response, water balance, sleep-wake cycle and thermoregulation

28
Q

What are the neuroendocrine neurones in the hypothalamus?

A
  • orexigens -> NPY and agouti-related peptide
  • anorexigens -> CART and POMC

reciprocally inhibit each other
signals from the plasma control their activity

29
Q

What is the central orexigenic pathway?

A

NPY and AgRP neurones are in the arcuate nucleus
Get activated by ghrelin
Release NPY which activates Y1 receptors
Activates 2nd order neurones increasing food intake and inhibiting POMC/CART neurones

30
Q

What is AgRP an example of?

A

Melanocortin receptor antagonist

31
Q

What is the central anorexigenic pathway?

A

POMC/CART activated by insulin and leptin
Releases melanocortins
This decreases food intake

32
Q

What is the main melanocortin?

A

alpha-melanocyte stimulating hormone
activates 2nd order neurones (MCR4 receptors)
inhibits NYY/AgRP neurones (MCR3 receptors)

33
Q

What is the role of malonyl-CoA?

A
  • Appetite controller
  • Inhibits lipolysis (carnitine shuttle) at high levels
  • When we are not hungry malonyl-CoA levels increased in cytoplasm for FA synthesis
    & hypothalamus senses high levels and so turns down AgRP and NPY to decrease appetite
  • When hungry less malonyl-CoA in cytoplasm so no FA synthesis, sensed by hypothalamus and AgRP and NPY increased
34
Q

What is the role of cannabinoids?

A

Increase appetite and consumption of food = high expression of CB1 receptor in the hypothalamus