From the Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, and the Program in Neuroscience, Harvard Medical School - both in Boston.
N Engl J Med. 2019 Jan 31;380(5):459-471. doi: 10.1056/NEJMra1812053.
Well-being requires the maintenance of energy stores, water, and sodium within permissive zones. The brain, as ringleader, orchestrates their homeostatic control. It senses disturbances, decides what needs to be done next, and then restores balance by altering physiological processes and ingestive drives (i.e., hunger, thirst, and salt appetite). But how the brain orchestrates this control has been unknown until recently — largely because we have lacked the ability to elucidate and then probe the underlying neuronal “wiring diagrams.” This has changed with the advent of new, transformative neuroscientific tools. When targeted to specific neurons, these tools make it possible to selectively map a neuron’s connections, measure its responses to various homeostatic challenges, and experimentally manipulate its activity. This review examines these approaches and then highlights how they are advancing, and in some cases profoundly changing, our understanding of energy, water, and salt homeostasis and the linked ingestive drives.
幸福感需要将能量储存、水和钠维持在可允许的范围内。大脑作为指挥者,协调着它们的体内平衡控制。它感知干扰,决定下一步需要做什么,然后通过改变生理过程和摄食驱动(即饥饿、口渴和盐食欲)来恢复平衡。但是,大脑如何协调这种控制直到最近才为人所知——主要是因为我们缺乏阐明和探测潜在神经元“布线图”的能力。随着新型变革性神经科学工具的出现,这种情况发生了变化。当针对特定神经元时,这些工具使选择性映射神经元的连接、测量其对各种体内平衡挑战的反应以及实验性地操纵其活性成为可能。本综述探讨了这些方法,然后强调了它们如何正在推进并在某些情况下深刻改变我们对能量、水和盐的体内平衡以及相关摄食驱动的理解。