Abstract
BACKGROUND:
Bariatric surgical procedures, including the laparoscopic adjustable gastric band (LAGB), are currently the only effective treatments for morbid obesity, however, there is no clear understanding of the mechanisms underpinning the efficacy of LAGB. The aim of this study is to examine changes in activation of the sensory neuronal pathways and levels of circulating gut hormones associated with inflation of an AGB.
DESIGN AND RESULTS:
The trajectory within the central nervous system of polysynaptic projections of sensory neurons innervating the stomach was determined using the transsynaptically transported herpes simplex virus (HSV). Populations of HSV-infected neurons were present in the brainstem, hypothalamus and cortical regions associated with energy balance. An elevation of Fos protein was present within the nucleus of the solitary tract, a region of the brainstem involved in the control of food intake, following acute and chronic band inflation. Two approaches were used to test (1) the impact of inflation of the band alone (on a standard caloric background) or (2) the impact of a standard caloric meal (on the background of the inflated band) on circulating gut hormones. Importantly, there was a significant elevation of glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) following oral gavage of a liquid meal in animals with pre-inflated bands. There was no impact of inflation of the band alone on circulating GLP-1, PYY or ghrelin in animals on a standard caloric background.
CONCLUSION:
These data are consistent with the notion that the LAGB exerts its effects on satiety, reduced food intake and reduced body weight by the modulation of both neural and hormonal responses with the latter involving an elevation of meal-related levels of GLP-1 and PYY. These data are contrary to the view that the surgery is purely ‘restrictive’.
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Professor Oldfield, Associate Professor Dixon and Dr Raven are the recipients of an Australian Research Council Linkage Grant (LP100200782), of which Allergan is an industry partner. Associate Professor Dixon reported that he is a consultant for Allergan Inc. and his institutions receive research support from Allergan Inc. Dr Brown reported receiving an honorarium from Allergan Inc. for attending a scientific advisory panel in London in 2009. Dr Brown is director of the Centre for Obesity Research and Education (CORE). CORE receives a grant from Allergan for research support. Dr Raven receives compensation as an employee for Allergan. As such, Dr Raven also has a financial holding in the form of company stock (Allergan). Dr Raven is the co-author on several patent applications associated with similar work, but ownership and all financial rights have been consigned to Allergan. The remaining authors declare no conflict of interest.
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Kampe, J., Stefanidis, A., Lockie, S. et al. Neural and humoral changes associated with the adjustable gastric band: insights from a rodent model. Int J Obes 36, 1403–1411 (2012). https://doi.org/10.1038/ijo.2012.25
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DOI: https://doi.org/10.1038/ijo.2012.25
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