Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated-...
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![Page 1: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/1.jpg)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
SEGNALI ANORESSIGENI SEGNALI ANORESSIGENI
![Page 2: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/2.jpg)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
SEGNALI ANORESSIGENI SEGNALI ANORESSIGENI
![Page 3: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/3.jpg)
![Page 4: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/4.jpg)
Leptina
• Citochina
• mRNA espresso a livello del tessuto adiposo e di altri tessuti
• Livelli circolanti associati all’entità della massa adiposa
• Livelli circolanti aumentano dopo il pasto e si riducono nel digiuno prolungato
![Page 5: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/5.jpg)
Fattori che regolano la secrezione di leptina
• Stimolanti– Massa adiposa
– Dimensione adipociti
– Iperalimentazione
– Insulina
– Acidi grassi
– Glucocorticoidi
– TNF-IL1
• Stimolanti– Massa adiposa
– Dimensione adipociti
– Iperalimentazione
– Insulina
– Acidi grassi
– Glucocorticoidi
– TNF-IL1
• Inibenti– Digiuno
– Freddo
– Esercizio fisico intenso
– Androgeni
– Ipertono simpatico
– Catecolamine
– Ormone della crescita
• Inibenti– Digiuno
– Freddo
– Esercizio fisico intenso
– Androgeni
– Ipertono simpatico
– Catecolamine
– Ormone della crescita
![Page 6: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/6.jpg)
Azioni della leptina
• Riduce l’introito di cibo
• Aumenta il dispendio energetico
• Regola l’attività tiroidea
• Facilita l’ematopoiesi
• Regola il sistema riproduttivo e immunologico
• Regola la formazione dell’osso
![Page 7: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/7.jpg)
ARC(Nucleo Arcuato )
POMC cellsMSH
AgRP
NPY
Leptina
PVN(Nucleo
Paraventricolare )
ß-endorfine
MC3MC4
• Digiuno• Grelina• Steroidi (Test, Estr, Cort)• Ritmo circadiano
CB-1
LH - Ipotalamo laterale
CB-1
MCH
• Digiuno • EC• NPY
• CART• GLP1
![Page 8: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/8.jpg)
VMH ARCARCNPY
AgRTCARTPOMC
IPOTALAMO
LEPTINA
SNS
Formazioneosso
Dispendio energetico
Introito calorico
??
?
![Page 9: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/9.jpg)
-25
-20
-15
-10
-5
0
fisiologica leptina insulina leptina + insulina
Modificazioni del peso corporeo nelle 24 ore a seguito di i.c.v.
Air et al, 2002
Pes
o co
rpor
eo (
g)
*
**
*
![Page 10: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/10.jpg)
Night Eating Syndrome
• Alterazione del ritmo circadiano della leptina
• Alterazione del ritmo circadiano della melatonina
• Aumento della produzione del cortisolo
• Bassi livelli di serotonina
• Alterazione del ritmo circadiano della leptina
• Alterazione del ritmo circadiano della melatonina
• Aumento della produzione del cortisolo
• Bassi livelli di serotonina
![Page 11: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/11.jpg)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
SEGNALI ANORESSIGENI SEGNALI ANORESSIGENI
![Page 12: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/12.jpg)
ARC(Nucleo Arcuato )
POMC cellsMSH
AgRP
NPY
Leptina
PVN(Nucleo
Paraventricolare )
ß-endorfine
MC3MC4
• Digiuno• Grelina• Steroidi (Test, Estr, Cort)• Ritmo circadiano
CB-1
LH - Ipotalamo laterale
CB-1
MCH
• Digiuno • EC• NPY
• CART• GLP1
![Page 13: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/13.jpg)
Livelli di GLP-1 nell’obesità e nell’anoressia
2,6
1,6 1,7
0
0,5
1
1,5
2
2,5
3
Controlli Obese Anoressiche
Tomazik et al, 2002
GP
L-1
pm
ol/l
![Page 14: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/14.jpg)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
SEGNALI ANORESSIGENI SEGNALI ANORESSIGENI
![Page 15: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/15.jpg)
Segnali periferici Segnali periferici afferenti afferenti al SNC al fine di al SNC al fine di regolare regolare il consumo di il consumo di cibocibo
![Page 16: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/16.jpg)
Correlazione tra livelli plasmatici di Peptide YY Correlazione tra livelli plasmatici di Peptide YY (PYY) e Body-Mass Index. (PYY) e Body-Mass Index.
Batterham et al, 2003
![Page 17: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/17.jpg)
Batterham et al, 2003
Caloric Intake by Obese and Lean Subjects after Infusion of Peptide YY3–36 (PYY) or
Saline.
Obese Lean
24-H
r C
alor
ic I
nta
ke
(Kca
l)
0
500
1000
1500
2000
2500
3000
3500
4000
* **
![Page 18: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/18.jpg)
Livelli plasmatici di grelina durante e dopo Livelli plasmatici di grelina durante e dopo infusione di Peptide YY3–36 (PYY). infusione di Peptide YY3–36 (PYY).
Batterham et al, 2003
![Page 19: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/19.jpg)
ARC(Nucleo Arcuato )
POMC cellsMSH
AgRP
NPY
Leptina
PVN(Nucleo
Paraventricolare )
ß-endorfine
MC3MC4
• Digiuno• Ritmo circadiano• Steroidi (Test, Estr, Cort)• Grelina
CB-1
LH - Ipotalamo laterale
CB-1
MCH
• Digiuno • EC• NPY
• CART• GLP1
PYY
![Page 20: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/20.jpg)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
SEGNALI ANORESSIGENI SEGNALI ANORESSIGENI
![Page 21: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/21.jpg)
Colecistochinina (CCK)
• Prodotta dall’intestino tenue, su stimolo AA e lipidico
• Attiva i segnali di sazietà (inibisce la produzione di -endorfine?)
• Riduce la motilità gastrica• Attiva la contrazione della colecisti• Attiva la secrezione pancreatica• Aumenta la motilità del colon• Favorisce la memoria (del cibo?)
![Page 22: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/22.jpg)
CCKCCKBULIMIA
MEMORIASAZIETA’
Motilità colon
Contrazione colecisti HCl
motilità gastrica
Secrezione pancreas
AA+lipidi++
++
++++
++
++
--++
--
![Page 23: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/23.jpg)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
SEGNALI ANORESSIGENI SEGNALI ANORESSIGENI
![Page 24: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/24.jpg)
CART (g)CART (g)0
0,5
1
1,5
2
2,5
3
3,5
4
4,5
0 1 2
EFFETTO DI i.c.v. DI CART IN RATTI NON-DIGIUNI, DURANTE LA PRIMA ORA DOPO L’INIEZIONE
Nature, 393, 7 May 1998
* p < 0.05*
*
Con
sum
o d
i cib
o (g
ram
s)
![Page 25: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/25.jpg)
0
100
200
300
400
500
ARC
(fisiol)
ARC
(leptina)
DMHARC
(pair-fed)
DMH DMH(fisiol) (leptina)(pair-fed)
Den
sità
(%
) co
nfro
nta
ta a
i con
trol
li
* p < 0.05
*
*
Nature, 393, 7 May 1998
LA LEPTINA INDUCE L’EXPRESSIONE DEL GENE DEL CART SIA NELL’ARC CHE NEL DMH
![Page 26: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/26.jpg)
ARC(Nucleo Arcuato )
POMC cellsMSH
AgRP
NPY
Leptina
PVN(Nucleo
Paraventricolare )
ß-endorfine
MC3MC4
• Digiuno• Ritmo circadiano• Steroidi (Test, Estr, Cort)• Grelina
CB-1
LH - Ipotalamo laterale
CB-1
MCH
• Digiuno • EC• NPY
• CART• GLP1
PYY CCK
![Page 27: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/27.jpg)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
• Leptina• Insulina• GPL-1• Peptide YY (PYY)• CCK (Colecistochinina)• CART (cocaine -anphetamine-regulated-
transcript)
• Pro-opiomelacortina (POMC)• -MSH (Melanocyte Stimulating Hormone)
SEGNALI ANORESSIGENI SEGNALI ANORESSIGENI
![Page 28: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/28.jpg)
ARC(Nucleo Arcuato )
POMC cellsMSH
AgRP
NPY
Leptina
PVN(Nucleo
Paraventricolare )
ß-endorfine
MC3MC4
CB-1
LH - Ipotalamo laterale
CB-1
MCH
• Digiuno • EC• NPY
• CART• GLP1• Digiuno
• Ritmo circadiano• Steroidi (Test, Estr, Cort)• GrelinaPYY CCK
![Page 29: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/29.jpg)
0
0,1
0,2
0,3
0,4
0,5
0,6
0,7
0,8
Magri Obesi
* p < 0.05
*
Korner et al,1999
LIVELLI DI POMC-mRNA NEL MBH DI RATTI ZUCKER
PO
MC
mR
NA
(p
g/g
RN
A)
![Page 30: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/30.jpg)
0
1
2
3
4
5
6
7
8
LeanObese
-MSH -MSH
*
*
ng/
mg
pro
tein
POMC-DERIVED PEPTIDE LEVELS FROM HYPOPTHALAMUS OF LEAN AND OBESE ZUCKER RATS
* p < 0.05
Korner et al,1999
![Page 31: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/31.jpg)
0
0,2
0,4
0,6
0,8
1
1,2
1,4
Control 1 hr 3 hrs
EFFECT OF i.c.v. LEPTIN INJECTION ON POMC GENE EXPRESSION IN HYPOPTHALAMUS OF LEAN ZUCKER RATS
* p < 0.05
*P
OM
C m
RN
A
Korner et al,1999
![Page 32: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/32.jpg)
0
20
40
60
80
100
120
140
FED SALINE FASTEDSALINE
FASTEDINSULIN
Exp
ress
ion
(%
of
fed
)
CENTRAL ADMINISTRATION OF INSULIN INCREASES EXPRESSION OF POMC RELATIVE TO FASTING
Benoit et al, 2002
*
P < 0.01
![Page 33: Leptina Insulina GPL-1 Peptide YY (PYY) CCK (Colecistochinina) CART (cocaine -anphetamine-regulated- transcript) Pro-opiomelacortina (POMC) -MSH (Melanocyte.](https://reader036.fdocuments.us/reader036/viewer/2022062300/5542eb57497959361e8c17af/html5/thumbnails/33.jpg)
MICE LACKING THE MC4-R ARE HYPERPHAGIC
Dai
ly F
ood
con
sum
pti
on(g
r./d
ay)
00
11
22
33
44
MC4-R+/+ MC4-R-/-MC4-R+/+ MC4-R-/-
55
66
C57BL/6C57BL/6 AyAy
** **
Cell, VOL 88, 131-141, 1997
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DOMINANT AND RECESSIVE INHERITANCE OF MORBID OBESITY ASSOCIATED WITH MELANOCORTIN 4 RECEPTOR DEFICIENCY I. Sadaf Farooqi, Giles S.H. Yeo, Julia M. Keogh, Shiva Aminian, Susan A. Jebb, Gary Butler, Tim Cheetham, and Stephen O’Rahilly
J. Clin. Invest. 2000 106: 271-279.
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ARC(Nucleo Arcuato )
POMC cellsMSH
AgRP
NPY
Leptina
PVN(Nucleo
Paraventricolare )
ß-endorfine
MC3MC4
• CART• GLP1
CB-1
LH - Ipotalamo laterale VMH - Ipotalamo Ventromediale
MC4
CRH
CB-1
MCH
• EC• NPY
CCK
LeptinaCCK-A
• Digiuno• Ritmo circadiano• Steroidi (Test, Estr, Cort)• GrelinaPYY