Borner Tito, Pataro Allison M, De Jonghe Bart C
Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Neurogastroenterol Motil. 2025 Mar;37(3):e14886. doi: 10.1111/nmo.14886. Epub 2024 Aug 6.
BACKGROUND: Nausea and emesis are ubiquitously reported medical conditions and often present as treatment side effects along with polymorbidities contributing to detrimental life-threatening outcomes, such as poor nutrition, lower quality of life, and unfavorable patient prognosis. Growth differentiation factor 15 (GDF15) is a stress response cytokine secreted by a wide variety of cell types in response to a broad range of stressors. Circulating GDF15 levels are elevated in a range of medical conditions characterized by cachexia and malaise. In recent years, GDF15 has gained scientific and translational prominence with the discovery that its receptor, GDNF family receptor α-like (GFRAL), is expressed exclusively in the hindbrain. GFRAL activation may results in profound anorexia and body weight loss, effects which have attracted interest for the pharmacological treatment of obesity. PURPOSE: This review highlights compelling emerging evidence indicating that GDF15 causes anorexia through the induction of nausea, emesis, and food aversions, which encourage a perspective on GDF15 system function in physiology and behavior beyond homeostatic energy regulation contexts. This highlights the potential role of GDF15 in the central mediation of nausea and emesis following a variety of physiological, and pathophysiological conditions such as chemotherapy-induced emesis, hyperemesis gravidarum, and cyclic vomiting syndrome.
背景:恶心和呕吐是普遍报道的医学病症,常作为治疗副作用出现,同时多种疾病会导致危及生命的有害后果,如营养不良、生活质量下降和患者预后不良。生长分化因子15(GDF15)是一种应激反应细胞因子,由多种细胞类型在应对多种应激源时分泌。在一系列以恶病质和不适为特征的医学病症中,循环GDF15水平会升高。近年来,随着其受体GDNF家族受体α样蛋白(GFRAL)仅在后脑表达这一发现,GDF15在科学和转化研究方面受到了广泛关注。GFRAL激活可能导致严重的厌食和体重减轻,这些作用引起了人们对肥胖药物治疗的兴趣。 目的:本综述重点介绍了引人注目的新证据,表明GDF15通过引发恶心、呕吐和食物厌恶来导致厌食,这促使人们从超出稳态能量调节范围的角度看待GDF15系统在生理和行为中的功能。这突出了GDF15在多种生理和病理生理状况(如化疗引起的呕吐、妊娠剧吐和周期性呕吐综合征)后恶心和呕吐的中枢调节中的潜在作用。
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