Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Ross 618, 720 Rutland Ave., Baltimore, MD 21205, United States.
Physiol Behav. 2011 Nov 30;105(1):77-81. doi: 10.1016/j.physbeh.2011.02.005. Epub 2011 Feb 17.
Peptidergic and neural signals arising from the presence of food in the gastrointestinal track provide feedback signals to the brain about the nature and quantity of consumed nutrients. Peptide secreting cells are differentially distributed along the gastrointestinal tract. How ingested nutrients activate or inhibit peptide secretion is complex and depends upon local, hormonal and neural mechanisms. The mode of action of the various peptides is equally complex involving endocrine, paracrine and neurocrine signaling. The success of bariatric surgical approaches to obesity treatment is secondary to alterations in gastrointestinal feedback signaling and roles of increased secretion of lower gut peptides such as peptide YY (PYY) and glucagon like peptide 1 (GLP-1) in mediating the superior effects of Roux-en-Y gastric bypass (RYGB) surgery are becoming evident. Direct nutrient delivery to jejunal sites that models the site of gastric-jejunal anastamosis in RYGB is especially effective at inhibiting food intake. Such infusions also stimulate the release of lower gut peptides suggesting a role for increased gut peptide signaling in sustaining such feeding inhibitions. Thus, gut peptides are clear targets for future obesity therapeutic developments.
胃肠道中存在食物所产生的肽类和神经信号向大脑提供有关所消耗营养物质的性质和数量的反馈信号。肽分泌细胞沿胃肠道呈差异分布。摄入的营养物质如何激活或抑制肽分泌是复杂的，取决于局部、激素和神经机制。各种肽的作用方式同样复杂，涉及内分泌、旁分泌和神经内分泌信号。减重手术治疗肥胖症的成功主要归因于胃肠道反馈信号的改变，以及下消化道肽如肽 YY（PYY）和胰高血糖素样肽 1（GLP-1）分泌增加在介导 Roux-en-Y 胃旁路（RYGB）手术的优越效果中的作用变得明显。直接向空肠部位输送营养物质，模拟 RYGB 中胃-空肠吻合部位，特别有效地抑制食物摄入。这种输注还刺激下消化道肽的释放，提示增加肠道肽信号在维持这种进食抑制中的作用。因此，肠道肽是未来肥胖症治疗开发的明确靶点。
