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Proc Natl Acad Sci U S A. 2019 Jul 2;116(27):13670-13679. doi: 10.1073/pnas.1901795116. Epub 2019 Jun 18.

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

Author information

1
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520.
2
Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, CT 06520.
3
Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215.
4
Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215; blowell@bidmc.harvard.edu gerald.shulman@yale.edu.
5
Program in Neuroscience, Harvard Medical School, Boston, MA 02215.
6
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520; blowell@bidmc.harvard.edu gerald.shulman@yale.edu.

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.

KEYWORDS:

AgRP neurons; corticosterone; food intake; leptin; obesity

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