Schnabl Katharina, Li Yongguo, U-Din Mueez, Klingenspor Martin
Chair for Molecular Nutritional Medicine, TUM School of Life Sciences, Technical University of Munich, Freising, Germany.
EKFZ-Else Kröner Fresenius Center for Nutritional Medicine, Technical University of Munich, Freising, Germany.
Endocrinology. 2021 Sep 1;162(9). doi: 10.1210/endocr/bqab113.
The obesity pandemic requires effective preventative and therapeutic intervention strategies. Successful and sustained obesity treatment is currently limited to bariatric surgery. Modulating the release of gut hormones is considered promising to mimic bariatric surgery with its beneficial effects on food intake, body weight, and blood glucose levels. The gut peptide secretin was the first molecule to be termed a hormone; nevertheless, only recently has it been established as a legitimate anorexigenic peptide. In contrast to gut hormones that crosstalk with the brain either directly or by afferent neuronal projections, secretin mediates meal-associated brown fat thermogenesis to induce meal termination, thereby qualifying this physiological mechanism as an attractive, peripheral target for the treatment of obesity. In this perspective, it is of pivotal interest to deepen our as yet superficial knowledge on the physiological roles of secretin as well as meal-associated thermogenesis in energy balance and body weight regulation. Of note, the emerging differences between meal-associated thermogenesis and cold-induced thermogenesis must be taken into account. In fact, there is no correlation between these 2 entities. In addition, the investigation of potential effects of secretin in hedonic-driven food intake, bariatric surgery and chronic treatment using suitable application strategies to overcome pharmacokinetic limitations will provide further insight into its potential to influence energy balance. The aim of this article is to review the facts on secretin's metabolic effects, address prevailing gaps in our knowledge, and provide an overview on the opportunities and challenges of the therapeutic potential of secretin in body weight control.
肥胖症大流行需要有效的预防和治疗干预策略。目前,成功且持续的肥胖症治疗仅限于减肥手术。调节肠道激素的释放被认为有望模拟减肥手术,对食物摄入、体重和血糖水平产生有益影响。肠道肽促胰液素是第一个被称为激素的分子;然而,直到最近它才被确认为一种合理的厌食肽。与通过直接或传入神经投射与大脑进行相互作用的肠道激素不同,促胰液素介导与进食相关的棕色脂肪产热以诱导进食终止,从而使这种生理机制成为治疗肥胖症的一个有吸引力的外周靶点。从这个角度来看,加深我们对促胰液素的生理作用以及与进食相关的产热在能量平衡和体重调节方面的认识至关重要,目前这些认识还很肤浅。值得注意的是,必须考虑与进食相关的产热和冷诱导产热之间新出现的差异。事实上,这两种情况之间没有关联。此外,通过合适的应用策略研究促胰液素在享乐驱动的食物摄入、减肥手术和长期治疗中的潜在作用,以克服药代动力学限制,将进一步深入了解其影响能量平衡的潜力。本文的目的是回顾促胰液素代谢作用的相关事实,填补我们现有知识中的主要空白,并概述促胰液素在体重控制方面治疗潜力的机遇与挑战。