de Lima-Júnior José Carlos, Velloso Lício A, Geloneze Bruno
Laboratory of Cell Signaling, Department of Internal Medicine, University of Campinas-UNICAMP, Campinas, Brazil.
Curr Atheroscler Rep. 2015 Oct;17(10):57. doi: 10.1007/s11883-015-0536-3.
Obesity is a highly prevalent disease in the world and with a major impact on global health. While genetic components are also involved in its pathogenesis, in recent years, it has shown a critical role of the innate and adaptive immune cell response in many tissues triggered by excess of nutrients such as lipids and glucose. Free fatty acids and other nutrient-related signals induce damage such as insulin resistance in the peripheral tissues but also in the brain. Specifically in the hypothalamus, these metabolic signals can trigger significant changes in the control of energy balance. Recent studies have shown that saturated fat disrupts melanocortin signaling of hypothalamic neuronal subgroups pivotal to energy control. Bariatric surgery is a treatment option for obesity when other tools have failed, because it is more effective than pharmacotherapy concerning of weight loss itself and in improvement of obesity-related comorbidities. Here, we review the mechanisms by which Roux-en Y gastric bypass (RYGB) can change peripheral signals that modulate melanocortin circuits involved in the regulation of energy balance.
肥胖是一种在全球高度流行的疾病，对全球健康有着重大影响。虽然遗传因素也参与其发病机制，但近年来，研究表明，在由脂质和葡萄糖等营养物质过剩引发的许多组织中，先天性和适应性免疫细胞反应发挥着关键作用。游离脂肪酸和其他与营养相关的信号不仅会在周围组织，还会在大脑中引发诸如胰岛素抵抗等损伤。特别是在下丘脑，这些代谢信号会引发能量平衡控制方面的显著变化。最近的研究表明，饱和脂肪会破坏对能量控制至关重要的下丘脑神经元亚群的黑皮质素信号传导。当其他治疗手段无效时，减肥手术是治疗肥胖的一种选择，因为就减肥本身以及改善肥胖相关合并症而言，它比药物治疗更有效。在此，我们综述了Roux-en Y胃旁路术（RYGB）改变外周信号的机制，这些外周信号可调节参与能量平衡调节的黑皮质素回路。
