Laboratory of Biomedical Sciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA.
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Int J Obes (Lond). 2018 Jun;42(6):1101-1111. doi: 10.1038/s41366-018-0086-1. Epub 2018 May 24.
The nervous system both monitors and modulates body metabolism to maintain homoeostasis. In disease states such as obesity and diabetes, the neurometabolic interface is dysfunctional and contributes to clinical illness. The vagus nerve, in particular, with both sensory and motor fibres, provides an anatomical substrate for this interface. Its sensory fibres contain receptors for important circulating metabolic mediators, including leptin and cholecystokinin, and provide real-time information about these mediators to the central nervous system. In turn, efferent fibres within the vagus nerve participate in a brain-gut axis to regulate metabolism. In this review, we describe these vagus nerve-mediated metabolic pathways and recent clinical trials of vagus nerve stimulation for the management of obesity. These early studies suggest that neuromodulation approaches that employ electricity to tune neurometabolic circuits may represent a new tool in the clinical armamentarium directed against obesity.
神经系统既能监测又能调节身体代谢以维持内稳态。在肥胖症和糖尿病等疾病状态下，神经代谢界面功能失调，导致临床疾病。迷走神经，特别是具有感觉和运动纤维的迷走神经，为这种界面提供了解剖学基础。其感觉纤维包含对重要循环代谢介质的受体，包括瘦素和胆囊收缩素，并向中枢神经系统提供有关这些介质的实时信息。反过来，迷走神经内的传出纤维参与大脑-肠道轴以调节代谢。在这篇综述中，我们描述了这些迷走神经介导的代谢途径以及最近迷走神经刺激治疗肥胖症的临床试验。这些早期研究表明，采用电来调整神经代谢回路的神经调节方法可能是针对肥胖症的临床武器库中的一种新工具。
