Cited by 178Regulation of Appetite and ObesityAdipokines, Inflammation, and Metabolic DiseasesHypothalamic control of reproductive hormones

The DOI matches its Crossref record; 175 of the 177 references it cites were found in a registry or an index; none of the 212 sources its claims cite is checked for support yet.

Inter‐organ communication: a gatekeeper for metabolic health

Open access
Castillo‐Armengol, Judit, Fajas, Lluis, Lopez‐Mejia, Isabel C·2019·The EMBO Reports

Abstract

Multidirectional interactions between metabolic organs in the periphery and the central nervous system have evolved concomitantly with multicellular organisms to maintain whole‐body energy homeostasis and ensure the organism's adaptation to external cues. These interactions are altered in pathological conditions such as obesity and type 2 diabetes. Bioactive peptides and proteins, such as hormones and cytokines, produced by both peripheral organs and the central nervous system, are key messengers in this inter‐organ communication. Despite the early discovery of the first hormones more than 100 years ago, recent studies taking advantage of novel technologies have shed light on the multiple ways used by cells in the body to communicate and maintain energy balance. This review briefly summarizes well‐established concepts and focuses on recent advances describing how specific proteins and peptides mediate the crosstalk between gut, brain, and other peripheral metabolic organs in order to maintain energy homeostasis. Additionally, this review outlines how the improved knowledge about these inter‐organ networks is helping us to redefine therapeutic strategies in an effort to promote healthy living and fight metabolic disorders and other diseases.

Overview

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Written from the paper’s full text.

TL;DR

This review describes how hormones, cytokines, myokines, adipokines, and neural signals coordinate gut, brain, liver, muscle, adipose, and pancreas to maintain energy homeostasis in feeding, fasting, cold exposure, and exercise. It also summarizes how these inter-organ networks are altered in obesity and type 2 diabetes and discusses therapeutic strategies, especially GLP-1 receptor agonists.

Key findings

  • In feeding, gut hormones such as GLP-1, secretin, and LEAP2 signal to the brain to reduce food intake; GLP-1 and GIP potentiate glucose-stimulated insulin secretion; FGF19 represses hepatic bile acid synthesis; and leptin suppresses food intake. In fasting, ghrelin increases appetite and adiposity, asprosin promotes hepatic glucose production and food intake, FGF21 increases adipose lipolysis and hepatic fatty acid oxidation/ketogenesis, and glucagon drives glycogenolysis and gluconeogenesis.
  • Cold-induced thermogenesis involves hypothalamic orexin/BMP8b, sympathetic norepinephrine, thyroid hormones, FGF21, and bile acids acting on brown adipose tissue; a UCP1-independent pathway mediated by PM20D1 is also described. Exercise-induced IL-6, irisin, and cathepsin B mediate muscle crosstalk with pancreas, liver, adipose tissue, and brain.
  • In obesity and related disorders, inter-organ communication is altered: leptin resistance, increased NPY, decreased adiponectin, increased FGF21 and asprosin, ghrelin resistance, altered GLP-1 after bariatric surgery, and proinflammatory adipokines are reported. The review notes that in pathological situations WAT can account for more than 50% of human body weight.
  • Therapeutic efforts include GLP-1 receptor agonists, which promote satiety and reduce food intake; leptin therapy alone failed to induce significant weight loss or insulin sensitization; FGF21 variants showed only a small trend toward glucose lowering in humans; and an asprosin-neutralizing antibody reduced appetite, body weight, and blood glucose in obese mice. The review also states that more than 15% of the protein-coding genome encodes roughly 3,000 secreted proteins, but only a handful have been properly annotated.

Methods

  • Design: narrative review summarizing well-established concepts and recent advances in inter-organ communication.
  • Data or sample: Not stated in the paper; no primary dataset or systematic sample is reported. The review synthesizes cited literature and includes figures and a table.
  • Main analysis: qualitative synthesis organized by physiological states—feeding/fasting cycles, non-shivering thermogenesis, exercise, and obesity—and by therapeutic implications.

Limitations

  • Stated: the review explicitly excludes the role of the immune system in energy homeostasis, noting it has been discussed elsewhere. It also identifies unresolved or controversial areas, including the role of FGF21, the normal physiology of Lcn5 and Metrnl, and the central mechanism of ghrelin action.
  • Evident: as a narrative review, it does not report a systematic search strategy, inclusion criteria, quality assessment, or meta-analysis.
  • Evident: therapeutic conclusions rely on cited preclinical and early clinical studies and are not systematically appraised.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.15252/embr.201947903

Cites

175 of 175 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Figure 1 Inter‐organ communication under feeding conditions Food ingestion stimulates the secretion of several molecules such as GLP‐1, secretin and LEAP2. These gut hormones signal to the brain to reduce food intake. FGF19 is produced by the intestine and reduces bile acid (BA) synthesis. GLP‐1 and secretin will also stimulate insulin (and reduce glucagon) secretion by the pancreas. In turn, insulin will promote glycogen production and glucose uptake in muscle, decrease glucose production and increase lipogenesis in liver, and increase glucose uptake and lipogenesis from circulating glucose and triglycerides (TGs) in WAT. Leptin, produced by white adipocytes, will act in the CNS to repress food intake. Moreover, insulin can target the brain in order to decrease lipolysis in WAT and glucose production in liver.
Figure 1 Inter‐organ communication under feeding conditions Food ingestion stimulates the secretion of several molecules such as GLP‐1, secretin and LEAP2. These gut hormones signal to the brain to reduce food intake. FGF19 is produced by the intestine and reduces bile acid (BA) synthesis. GLP‐1 and secretin will also stimulate insulin (and reduce glucagon) secretion by the pancreas. In turn, insulin will promote glycogen production and glucose uptake in muscle, decrease glucose production and increase lipogenesis in liver, and increase glucose uptake and lipogenesis from circulating glucose and triglycerides (TGs) in WAT. Leptin, produced by white adipocytes, will act in the CNS to repress food intake. Moreover, insulin can target the brain in order to decrease lipolysis in WAT and glucose production in liver.CC BY · PubMed Central
Figure 2 Inter‐organ communication under fasting conditions Ghrelin is a gut hormone secreted under fasting conditions. It targets the brain to increase food intake. Pancreatic glucagon secretion is also increased by ghrelin, and directly by low blood glucose levels. Glucagon will target the liver to decrease glycolysis and increase hepatic gluconeogenesis and glycogenolysis, as well as WAT to increase lipolysis. Ghrelin can promote adiposity by increasing WAT lipid synthesis and reducing WAT fatty acid (FA) oxidation. Fasting also stimulates the secretion of the adipokines asprosin and adiponectin that will act through the brain to decrease energy expenditure and promote food intake. Asprosin can also increase hepatic gluconeogenesis, whereas adiponectin reduces lipogenesis and increases hepatic FA oxidation. Increased hepatic FGF21 levels under fasting conditions increase lipolysis in WAT.
Figure 2 Inter‐organ communication under fasting conditions Ghrelin is a gut hormone secreted under fasting conditions. It targets the brain to increase food intake. Pancreatic glucagon secretion is also increased by ghrelin, and directly by low blood glucose levels. Glucagon will target the liver to decrease glycolysis and increase hepatic gluconeogenesis and glycogenolysis, as well as WAT to increase lipolysis. Ghrelin can promote adiposity by increasing WAT lipid synthesis and reducing WAT fatty acid (FA) oxidation. Fasting also stimulates the secretion of the adipokines asprosin and adiponectin that will act through the brain to decrease energy expenditure and promote food intake. Asprosin can also increase hepatic gluconeogenesis, whereas adiponectin reduces lipogenesis and increases hepatic FA oxidation. Increased hepatic FGF21 levels under fasting conditions increase lipolysis in WAT.CC BY · PubMed Central
Figure 3 Inter‐organ communication under cold exposure Cold stimuli, sensed by neurons in the skin, activate the thermoregulatory hypothalamic regions of the brain that will secrete orexin and BMP8B to stimulate BAT thermogenesis. Moreover, the SNS is responsible for the local production of NE in BAT. The hypothalamic–pituitary–thyroid axis is also activated in response to cold and promotes the release of thyroid hormones (T3 and T4) in order to contribute to the activation of BAT thermogenesis. Cold exposure can also trigger muscle shivering and thus the production of the myokine irisin. Irisin can in turn stimulate BAT thermogenesis. If cold exposure is sustained over time, WAT undergoes browning and can contribute to thermogenesis. Irisin is one of the molecules that can trigger this process. In addition, cold‐dependent hepatic FGF21 and BA secretion contribute to the browning of WAT. Finally, FGF21 can be produced by WAT; and BMP8b and FGF21 can be produced by BAT, after cold activation and promote thermogenesis in a paracrine manner.
Figure 3 Inter‐organ communication under cold exposure Cold stimuli, sensed by neurons in the skin, activate the thermoregulatory hypothalamic regions of the brain that will secrete orexin and BMP8B to stimulate BAT thermogenesis. Moreover, the SNS is responsible for the local production of NE in BAT. The hypothalamic–pituitary–thyroid axis is also activated in response to cold and promotes the release of thyroid hormones (T3 and T4) in order to contribute to the activation of BAT thermogenesis. Cold exposure can also trigger muscle shivering and thus the production of the myokine irisin. Irisin can in turn stimulate BAT thermogenesis. If cold exposure is sustained over time, WAT undergoes browning and can contribute to thermogenesis. Irisin is one of the molecules that can trigger this process. In addition, cold‐dependent hepatic FGF21 and BA secretion contribute to the browning of WAT. Finally, FGF21 can be produced by WAT; and BMP8b and FGF21 can be produced by BAT, after cold activation and promote thermogenesis in a paracrine manner.CC BY · PubMed Central

Verification

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  • It may state two separate claims as one. 65
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  • The paper relies on this without support.

    Multidirectional interactions between peripheral metabolic organs and the central nervous system maintain whole-body energy homeostasis and ensure adaptation to external cues.

    “Multidirectional interactions between metabolic organs in the periphery and the central nervous system have evolved concomitantly with multicellular organisms to maintain whole‐body energy homeostasis and ensure the organism's adaptation to external cues.”
  • The paper relies on this without support.

    These interactions are altered in pathological conditions such as obesity and type 2 diabetes.

    “These interactions are altered in pathological conditions such as obesity and type 2 diabetes.”
  • The paper relies on this without support.

    Bioactive peptides and proteins, such as hormones and cytokines, produced by both peripheral organs and the central nervous system, are key messengers in inter-organ communication.

    “Bioactive peptides and proteins, such as hormones and cytokines, produced by both peripheral organs and the central nervous system, are key messengers in this inter‐organ communication.”
  • The paper relies on this without support.

    Inter-organ communication is altered in different pathologic conditions, for example, in conditions related to adipose tissue dysfunction, like obesity.

    “Inter‐organ communication is altered in different pathologic conditions, for example, in conditions related to adipose tissue dysfunction, like obesity.”
  • The paper relies on this without support.

    Alterations in hormones and cytokines contribute to the spectrum of obesity-associated pathologies.

    “As such, alterations in hormones and cytokines are currently known to notably contribute to the spectrum of obesity‐associated pathologies.”
  • The paper relies on this without support.

    Pharmacological interventions to modify the production of hormones/cytokines, or directly delivering recombinant hormones/cytokines, are promising approaches to treat obesity-related endocrine diseases.

    “Therefore, pharmacological interventions to modify the production of hormones/cytokines, or directly delivering recombinant hormones/cytokines, are currently being explored as promising approaches to treat a wide variety of obesity‐related endocrine diseases.”
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Citations

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  1. Bernard C (1853) Nouvelle fonction du foie considéré comme organe producteur de matière sucrée chez l'homme et les animaux. Paris: Baillère JB

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Metadata

Authors
Castillo‐Armengol, J., Fajas, L., & Lopez‐Mejia, I. C.
Affiliations
University of Lausanne (CH)
Venue
The EMBO Reports
Published
2019-08-19
Volume
20
Issue
9
Pages
e47903-e47903
ISSN
  • 1469-221X (ISSN-L)
  • 1469-3178
OpenAlex
W2969433956
Cited by
178
References
177
Citations by year
2026: 24 · 2025: 29 · 2024: 35 · 2023: 28 · 2022: 29 · 2021: 19 · 2020: 13 · 2019: 1
FWCI
1.86
Type
journal article
Language
en
Open access
Locations
  • EMBO Reports (publishedVersion)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • SERVAL (Université de Lausanne) (publishedVersion, cc-by)
  • IRIS (submittedVersion, cc-by)
Funders
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (168077)
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Keywords
inter-organ communication, gut-brain axis, energy homeostasis, metabolic crosstalk, hormones, cytokines, bioactive peptides, obesity, type 2 diabetes, metabolic disorders, treatment options
MeSH terms
Animals, Diabetes Mellitus, Type 2, Energy Metabolism, Homeostasis, Humans, Models, Biological, Obesity

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