Liraglutide is a glucagon-like peptide-1 (GLP-1) analog marketed for the treatment of type 2 diabetes. Besides lowering blood glucose, liraglutide also reduces body weight. It is not fully understood ...how liraglutide induces weight loss or to what degree liraglutide acts directly in the brain. Here, we determined that liraglutide does not activate GLP-1-producing neurons in the hindbrain, and liraglutide-dependent body weight reduction in rats was independent of GLP-1 receptors (GLP-1Rs) in the vagus nerve, area postrema, and paraventricular nucleus. Peripheral injection of fluorescently labeled liraglutide in mice revealed the presence of the drug in the circumventricular organs. Moreover, labeled liraglutide bound neurons within the arcuate nucleus (ARC) and other discrete sites in the hypothalamus. GLP-1R was necessary for liraglutide uptake in the brain, as liraglutide binding was not seen in Glp1r(-/-) mice. In the ARC, liraglutide was internalized in neurons expressing proopiomelanocortin (POMC) and cocaine- and amphetamine-regulated transcript (CART). Electrophysiological measurements of murine brain slices revealed that GLP-1 directly stimulates POMC/CART neurons and indirectly inhibits neurotransmission in neurons expressing neuropeptide Y (NPY) and agouti-related peptide (AgRP) via GABA-dependent signaling. Collectively, our findings indicate that the GLP-1R on POMC/CART-expressing ARC neurons likely mediates liraglutide-induced weight loss.
Background: The development of effective anti-obesity therapeutics relies heavily on the ability to target CNS signaling mechanisms critically involved in the homeostatic control of body weight. To ...get insight into neurocircuits recruited by anti-obesity drug treatment, the present study aimed to determine whole-brain activation signatures of six different weight-lowering drug classes with documented efficacy in humans.
Methods: Chow-fed mice received a single dose of lorcaserin (7 mg/kg, i.p.), rimonabant (10 mg/kg, i.p.), bromocriptine (D2 receptor agonist, 10 mg/kg, i.p.), sibutramine (10 mg/kg, p.o.), semaglutide (0.04 mg/kg, s.c.) or setmelanotide (4 mg/kg, s.c.). Brains were sampled two hours post-dosing, immunolabelled using c-Fos expression as a proxy for neuronal stimulation. Cleared whole-brains were imaged using light sheet fluorescence microscopy-deep learning pipeline enabling fully automated 3D mapping and quantitation of brain activation patterns at single-cell resolution.
Results: The whole-brain analysis comprised 308 atlas-defined mouse brain areas. To enable fast and efficient data mining, an open-access web-based 3D imaging data viewer (NeuroPedia.dk) was developed. All weight-lowering drugs demonstrated brain-wide responses with notable similarities in c-Fos expression signatures. Overlapping c-Fos responses were detected in discrete homeostatic and non-homeostatic feeding centres located in the dorsal vagal complex and hypothalamus with concurrent activation of several limbic structures as well as the dopaminergic system.
Conclusion: We pinpoint several overlapping brain activation signatures of various weight-lowering drugs. This shared feature suggests that weight-lowering drugs stimulate distinct homeostatic and non-homeostatic feeding centres. Future centrally acting anti-obesity compounds may be specifically designed to target key components of this neurocircuitry framework to provide more effective and sustained weight loss in obese patients.
Disclosure
L.S.Dalboege: Employee; Gubra aps. J.Hecksher-sørensen: Employee; Gubra ApS. M.Tozzi: None. C.G.Salinas: Employee; Gubra. T.Porsgaard: Employee; Gubra. D.D.Thorbek: Employee; Gubra APS. J.L.Skytte: Employee; Gubra ApS. U.Roostalu: Employee; Gubra. H.H.Hansen: None. J.Perens: Employee; Gubra ApS.
Background
GTP cyclohydrolase 1 (GTP-CH1), the rate-limiting enzyme in the synthesis of tetrahydrobiopterin (BH4), encoded by the GCH1 gene, has been implicated in the development and maintenance of ...inflammatory pain in rats. In humans, homozygous carriers of a “pain-protective” (PP) haplotype of the GCH1 gene have been identified exhibiting lower pain sensitivity, but only following pain sensitisation. Ex vivo, the PP GCH1 haplotype is associated with decreased induction of GCH1 after stimulation, whereas the baseline BH4 production is not affected. Contrary, loss of function mutations in the GCH1 gene results in decreased basal GCH1 expression, and is associated with DOPA-responsive dystonia (DRD). So far it is unknown if such mutations affect acute and inflammatory pain.
Results
In the current study, we examined the involvement of the GCH1 gene in pain models using the hyperphenylalaninemia 1 (hph-1) mouse, a genetic model for DRD, with only 10% basal GTP-CH1 activity compared to wild type mice. The study included assays for determination of acute nociception as well as models for pain after sensitisation. Pain behavioural analysis of the hph-1 mice showed reduced pain-like responses following intraplantar injection of CFA, formalin and capsaicin; whereas decreased basal level of GTP-CH1 activity had no influence in naïve hph-1 mice on acute mechanical and heat pain thresholds. Moreover, the hph-1 mice showed no signs of motor impairment or dystonia-like symptoms.
Conclusions
In this study, we demonstrate novel evidence that genetic mutations in the GCH1 gene modulate pain-like hypersensitivity. Together, the present data suggest that BH4 is not important for basal heat and mechanical pain, but they support the hypothesis that BH4 plays a role in inflammation-induced hypersensitivity. Our studies suggest that the BH4 pathway could be a therapeutic target for the treatment of inflammatory pain conditions. Moreover, the hph-1 mice provide a valid model to study the consequence of congenital deficiency of GCH1 in painful conditions.
Amylin and Adrenomedullin both belong to the calcitonin peptide family. While amylin plays an important role in maintaining glucose and energy homeostasis, adrenomedullin is primarily known for its ...beneficial vasoactive effects.
We hypothesize that combining the glucoregulatory and anti-obesity properties of amylin with the cardioprotective effects of adrenomedullin could be an effective treatment strategy to address type 2 diabetes, obesity and cardiovascular diseases in one molecule. Here we report the design and receptor potencies of unimolecular peptide agonists with dual activity at the amylin and adrenomedullin receptors.
Using solid-phase peptide synthesis, an array of hybrid peptides was rationally designed by substituting amino acids essential for amylin activity into the native adrenomedullin sequence. The pharmacokinetic profile was optimized by lipidation with a C20 diacid. Functional activities of the analogues were measured using a cAMP accumulation assay in cells overexpressing the human amylin receptor subtype 3 (hAMY3-R) or human adrenomedullin receptor subtype 1 (hAM1-R).
All analogues were full agonists on both receptors. hAMY3R potencies were comparable to human native amylin, whereas hAM1-R potencies ranged from equipotent to 100-fold less potent compared to human native adrenomedullin.
In summary, we have synthesized novel hybrid amylin-adrenomedullin peptide agonists with dual activity at the hAMY3R and hAM1-R. Ongoing studies address in vivo efficacy and potency of amylin-adrenomedullin dual agonists in rodent models of obesity and diabetes.
Disclosure
L.S. Dalboege: None. P. Magotti: None. N. Buch-Månson: None. E.M. Bech: None. L.N. Fink: Employee; Self; Gubra. Stock/Shareholder; Self; Novo Nordisk A/S. S.L. Pedersen: None. K. Fosgerau: Stock/Shareholder; Self; Gubra.
Roux-en-Y gastric bypass (RYGB) leads to a rapid remission of type 2 diabetes mellitus (T2DM), but the underlying mode of action remains incompletely understood. L-cell derived gut hormones such as ...glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) are thought to play a central role in the anti-diabetic effects of RYGB; therefore, an improved understanding of intestinal endocrine L-cell adaptability is considered pivotal.
The full rostrocaudal extension of the gut was analyzed in rats after RYGB and in sham-operated controls ad libitum fed or food restricted to match the body weight of RYGB rats. Total number of L-cells, as well as regional numbers, densities and mucosa volumes were quantified using stereological methods. Preproglucagon and PYY mRNA transcripts were quantified by qPCR to reflect the total and relative hormone production capacity of the L-cells.
RYGB surgery induced hypertrophy of the gut mucosa in the food exposed regions of the small intestine coupled with a doubling in the total number of L-cells. No changes in L-cell density were observed in any region regardless of surgery or food restriction. The total gene expression capacity of the entire gut revealed a near 200% increase in both PYY and preproglucagon mRNA levels in RYGB rats associated with both increased L-cell number as well as region-specific increased transcription per cell.
Collectively, these findings indicate that RYGB in rats is associated with gut hypertrophy, an increase in L-cell number, but not density, and increased PYY and preproglucagon gene expression. This could explain the enhanced gut hormone dynamics seen after RYGB.
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