Targeting Orexin Neurons for Treatment of Obesity is It Feasible in Human Being - A Systematic Review

Abstract

Obesity is increasing at epidemic proportions both in children and adults posing a big public health problem among children as well as adults. With parallel increase in comorbidities like type2 diabetes mellitus (T2DM), metabolic syndrome (MetS) a need arises for developing medical therapies that can maintain long term weight loss. Earlier we have tried to consider multiple options like utilization of drug combinations like Qsymia, Contravene, Liraglutide, thylakoids, probiotics, Combination of glucagon like peptides1 (GLP1) with glucagon etc but nothing has proved to be as efficacious as BS in long term maintenance of weight loss. Earlier we had reviewed the cellular changes related to orexin A and B changes that are isoforms of neuropeptides that get liberated from the lateral hypothalamus (LH). Here we further review the pathophysiology of orexin neurons with regard to their role in neuroinflammation in the central nervous system (CNS) via microglial cell changes and role in spontaneous physical activity (SPA) and sleep physiology commonly termed sleep-wake promoting neuropeptides along with role in reward circuitry and how targeting them might be of help in treating obesity. Possibility is that subtle increases in SPA have been found to improve energy expenditure (EE) and that has been utilized in some workplaces where treadmill like chairs are utilized, restless people who keep sitting and standing do burn calories thus promoting carparks at distance places, no elevators have been thought as some ways by which lethargic individuals refuse to follow exercise might get helped by modulating orexin neurons besides correcting sleep problems coexisting with obesity.