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Glucagon-like peptide-1 (GLP-1) is produced in the gut and central nervous system. Microinjection of GLP-1 analogues into specific brain regions causes hypophagia, induces insulin release and tachycardia. GLP-1 is produced within the brain by preproglucagon (PPG) neurons, situated in the caudal brainstem. PPG neurons project to nuclei involved in cardiovascular control, glucose homeostasis, and food intake. I hypothesised that PPG neurons are the endogenous source of GLP-1 in the brain, and their activation should reproduce the effects seen upon injection of exogenous GLP-1 into the brain. I demonstrated that selective chemogenetic activation of PPG neurons increased heart rate, but, their inhibition did not reduce it. These results demonstrate that PPG neurons can modulate heart rate but are not doing so under resting conditions. Similarly, I showed that PPG neuron activation acutely but not chronically decreases food intake. To further understand under which circumstances PPG neurons are activated to control food intake, c-Fos- immunoreactivity (C-Fos-IR) was used to detect neuronal activity in response to stimuli. There were few C-Fos-IR positive PPG neurons with normal feeding, but intake of highly palatable Ensure (Vanilla milkshake) substantially increased the number of C-Fos-IR positive PPG neurons suggesting that they are activated when consuming a high calorific and/or a high-volume meal. This suggests that PPG neurons induce satiety only in response to large or palatable meals. Neither chemogenetic activation nor ablation of the PPG neurons affected glucose tolerance, arguing that PPG neurons do not modulate blood glucose levels. The results presented here provide evidence for the physiological role of PPG neurons in satiety, implicating them as a possible target for weight loss drugs. Additionally, PPG neurons are capable of raising heart rate, however further studies must define under which conditions PPG neurons induce tachycardia. As these results mimic the effects of exogenous GLP-1, it seems likely that PPG neurons induce satiety and tachycardia through the release of GLP-1.
The second edition of this encyclopedia presents over 400 biologically important signaling molecules and the content is built on the core concepts of their functions along with early findings written by some of the world’s foremost experts. The molecules are described by recognized leaders in each molecule. The interactions of these single molecules in signal transduction networks will also be explored. This encyclopedia marks a new era in overview of current cellular signaling molecules for the specialist and the interested non-specialist alike. Currently, there are more than 30,000 genes in human genome. However, not all the proteins encoded by these genes work equally in order to maintain homeostasis. Understanding the important signaling molecules as completely as possible will significantly improve our research-based teaching and scientific capabilities.
This volume provides comprehensive coverage of the current knowledge of the physiology of the endocrine system and hormone synthesis and release, transport, and action at the molecular and cellular levels. It presents essential as well as in-depth information of value to both medical students and specialists in Endocrinology, Gynecology, Pediatrics, and Internal Medicine. Although it is well established that the endocrine system regulates essential functions involved in growth, reproduction, and homeostasis, it is increasingly being recognized that this complex regulatory system comprises not only hormones secreted by the classic endocrine glands but also hormones and regulatory factors produced by many organs, and involves extensive crosstalk with the neural and immune system. At the same time, our knowledge of the molecular basis of hormone action has greatly improved. Understanding this complexity of endocrine physiology is crucial to prevent endocrine disorders, to improve the sensitivity of our diagnostic tools, and to provide the rationale for pharmacological, immunological, or genetic interventions. It is such understanding that this book is designed to foster.
This unique book – the first ever on bariatric endocrinology – is a comprehensive endocrine and metabolism approach to the diseases that result from excess fat mass accumulation and adipose tissue dysfunction. It takes an approach that places adipose tissue at the center of the clinical approach to patients, as opposed to the complications of adipose tissue accumulation and dysfunction, which has been the dominant approach to date. Initial chapters include discussion of adipose tissue physiology and pathophysiology (adiposopathy), hormonal, central nervous system, and gut microbiome regulation of energy balance and stores, and primary and secondary causes of adipose tissue weight gain. Subsequent chapters cover the evaluation and treatment of dyslipidemia, insulin resistance and hyperglycemic states, hypertension, neoplasia, and gonadal function in men and women. Management strategies, such as nutrition, physical activity, pharmacotherapy, and bariatric procedures, round out the presentation. Each chapter is bookended by bullet-pointed clinical pearls at the beginning and a full reading list at the end. Written and edited by experts in the field of endocrinology and obesity management, Bariatric Endocrinology redefines practice to focus not just on weight loss as measured in pounds lost, but on adipose tissue mass and pathology, decreasing fat mass for adiposity-related diseases and returning adipose tissue to normal function.
The Sixth Edition of A Practical Guide to Diabetes Mellitus offers a unique combination of rigorous pathophysiology with very practical approaches to diabetes prevention and control. This outstanding textbook will equip a cadre of doctors and other health care professionals to deliver high quality care to vulnerable populations around India and far beyond. Based on research as well as clinical practice, the text describes diabetes in relation to physiology, ocular, cardiovascular, neuropathy, pregnancy, emergencies, childhood diabetes, etc. Each chapter beings with a brief outline of the disease concerned followed by introduction, definition/terminology, classification, treatment, conclusion and ending with set of question for self-assessment. Covers step wise images describes insulin administration in subcutaneous and using pen devices in the chapter: Insulin therapy: practical aspects. Feet, Footcare and Neuroarthropathy chapter deals with etiology and pathophysiology and is divided into three parts: Ulceration, Neuroarthropathy and Peripheral Artery Occlusive(PAD) diseases. Infection in diabetes chapter focuses on infection related to head and neck, genitourinary, skin and soft tissue, pulmonology and abdominal. Recent advances includes application of new drugs like Taspoglutide, Albiglutide, Lixisenatide, Newer DPP-IV inhibitors, along with new insulin receptor activators, PPAR agonists, new hepatic targets for glycemic control in diabetes. This book contains more than 300 coloured images and illustrations, 40 clinical cases, 50 questions for quick revision along with answers to the self-assessments question given at the end of book."
This book covers a selected number of hot topics in endocrine and hormone-related pathologies, discussed by eminent scientists and clinicians coming from different countries of the world. It deals with advanced recent trends in the field, including neuroendocrine and pituitary tumors, thyroid dysfunctions, diabetes and a series of endocrine-related diseases, such as those related to the anabolic effects of testosterone, obesity, cancer, the liver complications of diabetes and the pediatric nonalcoholic fatty liver disease. The readers should be able to have a basic, as well as critic and advanced, overview of these selected hot pathologies of the endocrine system.
Childhood obesity and its co-morbidities -- including type 2 diabetes, hypertension, dyslipidemia, sleep apnea, and fatty liver disease -- have seen striking increases in recent years. Despite a wealth of investigation, there is considerable controversy regarding the etiology of childhood obesity and the optimal approaches for prevention and treatment. Pediatric Obesity: Etiology, Pathogenesis, and Treatment addresses the controversy with a range of features that make it a unique resource for those who care for obese children and their families. Written from a perspective that is international in scope, the distinguished authors re-assess the roles of genetic and environmental factors in the pathogenesis of childhood obesity and critically review new studies of the effects of lifestyle, pharmacologic, and surgical interventions. The evidence-based approach of Pediatric Obesity: Etiology, Pathogenesis, and Treatment provides a comprehensive and invaluable guide for all healthcare providers concerned with the evaluation and care of children with nutritional and metabolic disease and with the societal implications of the obesity epidemic.