The hypothalamus and the regulation of energy homeostasis: lifting the lid on a black box

Abstract

The hypothalamus is the focus of many peripheral signals and neural pathways that control energy homeostasis and body weight. Emphasis has moved away from anatomical concepts of ‘feeding’ and ‘satiety’ centres to the specific neurotransmitters that modulate feeding behaviour and energy expenditure. We have chosen three examples to illustrate the physiological roles of hypothalamic neurotransmitters and their potential as targets for the development of new drugs to treat obesity and other nutritional disorders. Neuropeptide Y (NPY) is expressed by neurones of the hypothalamic arcuate nucleus (ARC) that project to important appetite-regulating nuclei, including the paraventricular nucleus (PVN). NPY injected into the PVN is the most potent central appetite stimulant known, and also inhibits thermogenesis; repeated administration rapidly induces obesity. The ARC NPY neurones are stimulated by starvation, probably mediated by falls in circulating leptin and insulin (which both inhibit these neurones), and contribute to the increased hunger in this and other conditions of energy deficit. They therefore act homeostatically to correct negative energy balance. ARC NPY neurones also mediate hyperphagia and obesity in the ob/ob and db/db mice and fa/fa rat, in which leptin inhibition is lost through mutations affecting leptin or its receptor. Antagonists of the Y5 receptor (currently thought to be the NPY ‘feeding’ receptor) have anti-obesity effects. Melanocortin-4 receptors (MC4-R) are expressed in various hypothalamic regions, including the ventromedial nucleus and ARC. Activation of MC4-R by agonists such as α-melanocyte-stimulating hormone (a cleavage product of pro-opiomelanocortin which is expressed in ARC neurones) inhibits feeding and causes weight loss. Conversely, MC4-R antagonists such as ‘agouti’ protein and agouti gene-related peptide (AGRP) stimulate feeding and cause obesity. Ectopic expression of agouti in the hypothalamus leads to obesity in the AVY mouse, while AGRP is co-expressed by NPY neurones in the ARC. Synthetic MC4-R agonists may ultimately find use as anti-obesity drugs in human subjects Orexins-A and -B, derived from prepro-orexin, are expressed in specific neurones of the lateral hypothalamic area (LHA). Orexin-A injected centrally stimulates eating and prepro-orexin mRNA is up regulated by fasting and hypoglycaemia. The LHA is important in receiving sensory signals from the gut and liver, and in sensing glucose, and orexin neurones may be involved in stimulating feeding in response to falls in plasma glucose.

A possible role of neuropeptide Y, agouti-related protein and leptin receptor isoforms in hypothalamic programming by perinatal feeding in the rat

“…Among the anorexigenic signals studied here, we only found an increase in the mRNA content of CART in the ARC, with no changes in the PVN or LH. CART mRNA expression in the ARC is stimulated by leptin [3,4,53,54] and SL rats are hyperleptinaemic. In this case, our result could suggest that OB-Rb is regulated in a neuronal specific form in the ARC of obese animals, and that the described down-regulation shown in this work occurs specifically in the medial part of the caudal ARC where AgRP/NPY neurons are located [55], but it does not occur in the lateral ARC, where CART neurons are located.…”

Forebrain oscillators ticking with different clock hands

“…In the Arc, a region implicated in the regulation of energy metabolism and food intake (Williams et al, 2000), this feature was confirmed under HF only (Supplemental Fig. 1), suggesting that PERs may not be implicated in the Arc functioning under ad libitum conditions.…”

The Neuroanatomical Axis for Control of Energy Balance

“…The site of action for the potent intake effects of central MC-R stimulation has been framed exclusively in hypothalamic terms (e.g., 108,200). Yet the MC4-R, the melanocortin receptor most frequently associated with the intake actions of the central melanocortin system, has its highest density in the DVC (127), and the NTS is one of the two structures in the brain containing POMC neurons.…”