Laparoscopic Sleeve Gastrectomy is a Safe and Effective Bariatric Procedure for the Lower BMI (35.0–43.0 kg/m2) Population

# The Author(s) 2010. This article is published with open access at Springerlink.com Background The laparoscopic vertical sleeve gastrectomy (LSG) is derived from the biliopancreatic diversion with duodenal switch operation (Marceau et al., Obes Surg 3:29

Ghrelin Indirectly Activates Hypophysiotropic CRF Neurons in Rodents

Ghrelin is a stomach-derived hormone that regulates food intake and neuroendocrine function by acting on its receptor, GHSR (Growth Hormone Secretagogue Receptor). Recent evidence indicates that a key function of ghrelin is to signal stress to the brain. It has been suggested that one of the potential stress-related ghrelin targets is the CRF (Corticotropin-Releasing Factor)-producing neurons of the hypothalamic paraventricular nucleus, which secrete the CRF neuropeptide into the median eminence and activate the hypothalamic-pituitary-adrenal axis. However, the neural circuits that mediate the ghrelin-induced activation of this neuroendocrine axis are mostly uncharacterized. In the current study, we characterized in vivo the mechanism by which ghrelin activates the hypophysiotropic CRF neurons in mice. We found that peripheral or intra-cerebro-ventricular administration of ghrelin strongly activates c-fos – a marker of cellular activation – in CRF-producing neurons. Also, ghrelin activates CRF gene expression in the paraventricular nucleus of the hypothalamus and the hypothalamic-pituitary-adrenal axis at peripheral level. Ghrelin administration directly into the paraventricular nucleus of the hypothalamus also induces c-fos within the CRF-producing neurons and the hypothalamic-pituitary-adrenal axis, without any significant effect on the food intake. Interestingly, dual-label immunohistochemical analysis and ghrelin binding studies failed to show GHSR expression in CRF neurons. Thus, we conclude that ghrelin activates hypophysiotropic CRF neurons, albeit indirectly

Ablations of Ghrelin and Ghrelin Receptor Exhibit Differential Metabolic Phenotypes and Thermogenic Capacity during Aging

mice are adaptive. mice.Our data therefore suggest that GHS-R ablation activates adaptive thermogenic function(s) in BAT and increases EE, thereby enabling the retention of a lean phenotype. This is the first direct evidence that the ghrelin signaling pathway regulates fat-burning BAT to affect energy balance during aging. This regulation is likely mediated through an as-yet-unidentified new ligand of GHS-R

Leptina, ghrelina e exercício físico

A obesidade é atualmente um problema de saúde pública que provoca sérias conseqüências sociais, físicas e psicológicas. A etiologia da obesidade não é de fácil identificação, uma vez que a mesma é caracterizada como doença multifatorial de complexa interação entre fatores comportamentais, culturais, genéticos, fisiológicos e psicológicos. Recentes avanços na área de endocrinologia e metabolismo mostram que, diferentemente do que se acreditava há alguns anos, o adipócito sintetiza e libera diversas substâncias, não sendo apenas uma célula armazenadora de energia. Entre as substâncias liberadas pelo adipócito incluem-se a adiponectina, o fator de necrose tumoral-alfa, a interleucina-6 e a leptina. Especificamente, a leptina desempenha importante papel no controle da ingestão alimentar e no controle do peso corporal em mamíferos. Além disso, o hormônio ghrelina, recentemente descoberto, também parece influenciar o metabolismo energético e a obesidade. As alterações que o exercício físico provoca na fisiologia endócrino-metabólica podem contribuir sobremaneira para a prática clínica. Assim, essa revisão abordará os conhecimentos mais recentes sobre a leptina, a ghrelina e o papel dos diferentes tipos de exercício físico sobre estes hormônios. Os trabalhos mostram que a relação entre o exercício físico e a concentração plasmática desses peptídeos ainda não está clara. As razões para isso poderiam ser devidas aos diferentes protocolos de treinamento físico empregados nos estudos. Além disso, diferenças genéticas também podem explicar as discrepâncias entre os resultados obtidos em seres humanos, pois a existência de polimorfismo em alguns genes pode acarretar respostas celulares diferentes frente ao exercício físico.Obesity is a major public health problem in the Western world resulting in serious social, physical and psychological damages. The genesis of obesity is complex involving a variety of factors such as genetic, psychological, metabolic and environmental factors. Progress in endocrinology and metabolism show that adipocyte is considered now as an endocrine tissue producing several substance including adiponectin, tumor necrosis factor-alpha, interleukin-6 and leptin. Specifically, leptin is the main peptide produced by the adipocyte and its serum concentration represents an important peripheral signal in the regulation of food intake and energy expenditure in mammals. In addition to leptin, a new peptide was discovered recently named ghrelin. Ghrelin, a peptide hormone identified in the stomach, is directly involved with the regulation of energy balance and obesity. Physical exercise has been used as a non-pharmacological tool in management of body weight and the effect of physical activity on weight control is an important issue for clinical studies in endocrinology field. Thus, this review will attempt to update the knowledge of leptin and ghrelin on the body weight regulation and the effect of exercise training on these peptide concentrations. It can be concluded that the relationship between physical exercise and the plasma concentration of these peptides is not clear. The reasons for that could be related to the differences in duration, intensity and frequency of the training program employed in each study. Indeed, most of the studies have not analyzed the intensity of training program by either plasma lactate concentration or maximum oxygen consumption. on the other hand, genetic basis could also explain the discrepancies found in some studies, since it has been shown that polymorphism for a variety of genes might be an important factor to determine the differences of cellular response to physical training.Universidade Estadual Paulista Instituto de Biociências Departamento de Educação FísicaUniversidade Estadual Paulista Instituto de Biociências Departamento de Educação Físic

Current management of the gastrointestinal complications of systemic sclerosis.

Systemic sclerosis is a multisystem autoimmune disorder that involves the gastrointestinal tract in more than 90% of patients. This involvement can extend from the mouth to the anus, with the oesophagus and anorectum most frequently affected. Gut complications result in a plethora of presentations that impair oral intake and faecal continence and, consequently, have an adverse effect on patient quality of life, resulting in referral to gastroenterologists. The cornerstones of gastrointestinal symptom management are to optimize symptom relief and monitor for complications, in particular anaemia and malabsorption. Early intervention in patients who develop these complications is critical to minimize disease progression and improve prognosis. In the future, enhanced therapeutic strategies should be developed, based on an ever-improving understanding of the intestinal pathophysiology of systemic sclerosis. This Review describes the most commonly occurring clinical scenarios of gastrointestinal involvement in patients with systemic sclerosis as they present to the gastroenterologist, with recommendations for the suggested assessment protocol and therapy in each situation