Figlewicz, Dianne P. Adiposity signals and food reward: expanding the CNS roles of insulin and leptin. Am J Physiol Regul Integr Comp Physiol 284: R882-R892, 2003;10.1152/ajpregu.00602.2002The hormones insulin and leptin have been proposed to act in the central nervous system (CNS) as adiposity signals as part of a theoretical negative feedback loop that senses the caloric stores of an animal and orchestrates adjustments in energy balance and food intake. Much research has provided support for both the existence of such a feedback loop and the specific roles that insulin and leptin may play. Most studies have focused on hypothalamic sites, which historically are implicated in the regulation of energy balance, and on the brain stem, which is a target for neural and humoral signals relating to ingestive acts. More recent lines of research, including studies from our lab, suggest that in addition to these CNS sites, brain reward circuitry may be a target for insulin and leptin action. These studies are reviewed together here with the goals of providing a historical overview of the findings that have substantiated the originally hypothesized negative feedback model and of opening up new lines of investigation that will build on these findings and allow further refinement of the model of adiposity signal/CNS feedback loop. The understanding of how motivational circuitry and its endocrine or neuroendocrine modulation contributes to normal energy balance regulation should expand possibilities for future therapeutic approaches to obesity and may lead to important insights into mental illnesses such as substance abuse or eating disorders. central nervous system; dopamine; food intake
FROM HISTORICAL PERSPECTIVE TO MODERN PERSPECTIVEIn 1979, Porte, Woods, and colleagues (130) made the observation that putting a small amount of the metabolic hormone insulin directly into the cerebrospinal fluid (CSF) of nonhuman primates resulted in a significant decline in the animals' food intake and body weight. This observation was made in the context of ongoing studies in the field that suggested that a circulating humoral factor or factors could regulate both size of individual meals, as well as food intake and body weight, over a longer time course (31,83,90,117). In a subsequent review, Porte and Woods (94) proposed that insulin served as an "adiposity signal" whose levels in the brain reflected the size of adipose stores integrated over time and which served to complete a negative feedback loop that links the behavior of feeding with size of adipose stores, such that adipose mass remains fairly constant in adults over a relatively long time. Many studies over the intervening decades have essentially validated this basic concept (e.g., 3, 4, 15, 25, 84). In the mid-90s, a second candidate adiposity signal, Ob-protein or leptin, was identified (133), and the function of these two signals appears to be similar. A major research focus has been on the actions of these two hormones at the medial hypothalamus, which historically has be...