Gardiner J V, Jayasena C N, Bloom S R
Department of Investigative Medicine, Imperial College Faculty of Medicine, Hammersmith Hospital, Imperial College, London, UK.
J Neuroendocrinol. 2008 Jun;20(6):834-41. doi: 10.1111/j.1365-2826.2008.01729.x.
The increasing prevalence of obesity and the associated morbidity and mortality has resulted in a major research effort to identify mechanisms that regulate appetite. It is well established that the hypothalamus and brain stem are major sites in the central nervous system (CNS) that regulate appetite. Until recently the missing element has been how information regarding food intake and energy stores is communicated to the CNS. Gut hormones have recently been found to be an important element in this regulation, communicating information regarding food intake to the CNS. Several gut hormones have been found to exert anorectic effects. These include members of the Pancreatic Polypeptide (PP)-fold family, namely PP itself and also peptide tyrosine-tyrosine (PYY), the first gut hormone shown to have appetite-inhibiting properties. The other main class of anorectic gut hormones are those derived by proteolytic processing from proglucagon, most importantly glucagon-like peptide-1 (GLP-1) and oxyntomodulin. All of these are currently being investigated as the basis of treatments to prevent the development of obesity. So far the only gastrointestinal hormone demonstrated to stimulate appetite is ghrelin. Potential sites and mechanisms of action and therapeutic use of these gastrointestinal hormones are discussed.
肥胖症患病率的不断上升以及与之相关的发病率和死亡率，促使人们开展了大量研究工作来确定调节食欲的机制。下丘脑和脑干是中枢神经系统（CNS）中调节食欲的主要部位，这一点已得到充分证实。直到最近，关于食物摄入和能量储备的信息是如何传递到中枢神经系统的这一缺失环节才被发现。肠道激素最近被发现是这种调节中的一个重要因素，它将有关食物摄入的信息传递到中枢神经系统。已发现几种肠道激素具有抑制食欲的作用。这些激素包括胰多肽（PP）折叠家族的成员，即PP本身以及肽YY（PYY），PYY是第一种被证明具有抑制食欲特性的肠道激素。另一类主要的抑制食欲的肠道激素是由胰高血糖素原经蛋白水解加工衍生而来的激素，其中最重要的是胰高血糖素样肽-1（GLP-1）和胃泌酸调节素。目前所有这些激素都在作为预防肥胖症发展的治疗基础进行研究。到目前为止，唯一被证明能刺激食欲的胃肠激素是胃饥饿素。本文讨论了这些胃肠激素的潜在作用部位、作用机制及治疗用途。
