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      Leptin’s hunger-suppressing effects are mediated by the hypothalamic–pituitary–adrenocortical axis in rodents

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          Significance

          Low levels of leptin, a hormone secreted by adipocytes that signals the body as to the availability of fuel stores, are known to increase food intake. Here, we demonstrate a mechanism by which low leptin stimulates food intake in rodents: Under conditions of hypoleptinemia, stress hormone (glucocorticoid) production is increased, and in turn stimulates AgRP neurons to promote appetite.

          Abstract

          Leptin informs the brain about sufficiency of fuel stores. When insufficient, leptin levels fall, triggering compensatory increases in appetite. Falling leptin is first sensed by hypothalamic neurons, which then initiate adaptive responses. With regard to hunger, it is thought that leptin-sensing neurons work entirely via circuits within the central nervous system (CNS). Very unexpectedly, however, we now show this is not the case. Instead, stimulation of hunger requires an intervening endocrine step, namely activation of the hypothalamic–pituitary–adrenocortical (HPA) axis. Increased corticosterone then activates AgRP neurons to fully increase hunger. Importantly, this is true for 2 forms of low leptin-induced hunger, fasting and poorly controlled type 1 diabetes. Hypoglycemia, which also stimulates hunger by activating CNS neurons, albeit independently of leptin, similarly recruits and requires this pathway by which HPA axis activity stimulates AgRP neurons. Thus, HPA axis regulation of AgRP neurons is a previously underappreciated step in homeostatic regulation of hunger.

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          Most cited references84

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          A mutation in the human leptin receptor gene causes obesity and pituitary dysfunction.

          The adipocyte-specific hormone leptin, the product of the obese (ob) gene, regulates adipose-tissue mass through hypothalamic effects on satiety and energy expenditure. Leptin acts through the leptin receptor, a single-transmembrane-domain receptor of the cytokine-receptor family. In rodents, homozygous mutations in genes encoding leptin or the leptin receptor cause early-onset morbid obesity, hyperphagia and reduced energy expenditure. These rodents also show hypercortisolaemia, alterations in glucose homeostasis, dyslipidaemia, and infertility due to hypogonadotropic hypogonadisms. In humans, leptin deficiency due to a mutation in the leptin gene is associated with early-onset obesity. Here we describe a homozygous mutation in the human leptin receptor gene that results in a truncated leptin receptor lacking both the transmembrane and the intracellular domains. In addition to their early-onset morbid obesity, patients homozygous for this mutation have no pubertal development and their secretion of growth hormone and thyrotropin is reduced. These results indicate that leptin is an important physiological regulator of several endocrine functions in humans.
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            Leptin.

            The discovery of the adipose-derived hormone leptin has generated enormous interest in the interaction between peripheral signals and brain targets involved in the regulation of feeding and energy balance. Plasma leptin levels correlate with fat stores and respond to changes in energy balance. It was initially proposed that leptin serves a primary role as an anti-obesity hormone, but this role is commonly thwarted by leptin resistance. Leptin also serves as a mediator of the adaptation to fasting, and this role may be the primary function for which the molecule evolved. There is increasing evidence that leptin has systemic effects apart from those related to energy homeostasis, including regulation of neuroendocrine and immune function and a role in development.
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              Agouti-related peptide-expressing neurons are mandatory for feeding.

              Multiple hormones controlling energy homeostasis regulate the expression of neuropeptide Y (NPY) and agouti-related peptide (AgRP) in the arcuate nucleus of the hypothalamus. Nevertheless, inactivation of the genes encoding NPY and/or AgRP has no impact on food intake in mice. Here we demonstrate that induced selective ablation of AgRP-expressing neurons in adult mice results in acute reduction of feeding, demonstrating direct evidence for a critical role of these neurons in the regulation of energy homeostasis.
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                Author and article information

                Journal
                Proc Natl Acad Sci U S A
                Proc. Natl. Acad. Sci. U.S.A
                pnas
                pnas
                PNAS
                Proceedings of the National Academy of Sciences of the United States of America
                National Academy of Sciences
                0027-8424
                1091-6490
                2 July 2019
                18 June 2019
                18 June 2019
                : 116
                : 27
                : 13670-13679
                Affiliations
                [1] aDepartment of Internal Medicine, Yale University School of Medicine , New Haven, CT 06520;
                [2] bDepartment of Cellular and Molecular Physiology, Yale University School of Medicine , New Haven, CT 06520;
                [3] cDivision of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center , Harvard Medical School, Boston, MA 02215;
                [4] dProgram in Neuroscience, Harvard Medical School , Boston, MA 02215
                Author notes
                2To whom correspondence may be addressed. Email: blowell@ 123456bidmc.harvard.edu or gerald.shulman@ 123456yale.edu .

                Contributed by Gerald I. Shulman, May 20, 2019 (sent for review February 4, 2019; reviewed by Roger D. Cone and Richard D. Palmiter)

                Author contributions: R.J.P., J.M.R., A.M.D., B.B.L., and G.I.S. designed research; R.J.P., J.M.R., A.M.D., J.C.M., A.R.-C., H.K., C.W., and J.D.S. performed research; R.J.P., J.M.R., A.M.D., J.C.M., A.R.-C., H.K., C.W., J.D.S., B.B.L., and G.I.S. analyzed data; and R.J.P., J.M.R., A.M.D., B.B.L., and G.I.S. wrote the paper.

                Reviewers: R.D.C., University of Michigan; and R.D.P., University of Washington.

                1R.J.P., J.M.R., and A.M.D. contributed equally to this work.

                Author information
                http://orcid.org/0000-0002-5409-7771
                Article
                201901795
                10.1073/pnas.1901795116
                6613139
                31213533
                7b4ca0d0-f15f-40ff-93da-9c930516e097
                Copyright © 2019 the Author(s). Published by PNAS.

                This open access article is distributed under Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND).

                History
                Page count
                Pages: 10
                Funding
                Funded by: HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 100000062
                Award ID: R01 DK-113984
                Award Recipient : Rachel J Perry Award Recipient : Jon Resch Award Recipient : Bradford B Lowell Award Recipient : Gerald I Shulman
                Funded by: HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 100000062
                Award ID: P30 DK-059635
                Award Recipient : Rachel J Perry Award Recipient : Jon Resch Award Recipient : Bradford B Lowell Award Recipient : Gerald I Shulman
                Funded by: HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 100000062
                Award ID: T32 DK-007058
                Award Recipient : Rachel J Perry Award Recipient : Jon Resch Award Recipient : Bradford B Lowell Award Recipient : Gerald I Shulman
                Funded by: HHS | NIH | National Cancer Institute (NCI) 100000054
                Award ID: K99/R00 CA-215315
                Award Recipient : Rachel J Perry
                Funded by: HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 100000062
                Award ID: R01 NS-087568
                Award Recipient : Rachel J Perry Award Recipient : Jon Resch Award Recipient : Bradford B Lowell Award Recipient : Gerald I Shulman
                Funded by: HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 100000062
                Award ID: UL1TR000142
                Award Recipient : Rachel J Perry Award Recipient : Jon Resch Award Recipient : Bradford B Lowell Award Recipient : Gerald I Shulman
                Funded by: HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 100000062
                Award ID: T32 DK-007058
                Award Recipient : Rachel J Perry Award Recipient : Jon Resch Award Recipient : Bradford B Lowell Award Recipient : Gerald I Shulman
                Funded by: HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 100000062
                Award ID: R01 DK-075632
                Award Recipient : Rachel J Perry Award Recipient : Jon Resch Award Recipient : Bradford B Lowell Award Recipient : Gerald I Shulman
                Funded by: HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 100000062
                Award ID: R01 DK-089044
                Award Recipient : Rachel J Perry Award Recipient : Jon Resch Award Recipient : Bradford B Lowell Award Recipient : Gerald I Shulman
                Funded by: HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 100000062
                Award ID: R01 DK-096010
                Award Recipient : Rachel J Perry Award Recipient : Jon Resch Award Recipient : Bradford B Lowell Award Recipient : Gerald I Shulman
                Funded by: HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 100000062
                Award ID: R01 DK-111401
                Award Recipient : Rachel J Perry Award Recipient : Jon Resch Award Recipient : Bradford B Lowell Award Recipient : Gerald I Shulman
                Funded by: HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 100000062
                Award ID: P30 DK-046200
                Award Recipient : Rachel J Perry Award Recipient : Jon Resch Award Recipient : Bradford B Lowell Award Recipient : Gerald I Shulman
                Funded by: HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 100000062
                Award ID: P30 DK-057521
                Award Recipient : Rachel J Perry Award Recipient : Jon Resch Award Recipient : Bradford B Lowell Award Recipient : Gerald I Shulman
                Categories
                PNAS Plus
                Biological Sciences
                Neuroscience
                PNAS Plus

                leptin,food intake,corticosterone,obesity,agrp neurons
                leptin, food intake, corticosterone, obesity, agrp neurons

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