治疗下丘脑性肥胖的药物研究进展

Progress in drug therapy for hypothalamic obesity

下丘脑性肥胖(HO)是一种复杂而罕见的疾病,影响大脑中能量摄入和支出调节通路以及自主神经系统和外周激素信号的调节。目前药物治疗主要通过刺激交感神经兴奋和脂肪组织产热,从而以增加脂肪分解和能量消耗的方式抑制体质量的快速增长。此外,部分药物还可作用于大脑奖励中心,抑制HO患者过度摄食。本文介绍了外源性催产素(OXT)、芬特明/托吡酯合剂(Ph/T)、特索芬辛、赛美拉肽等新近研发药物的临床获益数据、不良反应和应用前景。

Hypothalamic obesity(HO)is a complicated and uncommon disease affecting multiple regulatory pathways of energy intake and metabolism in the brain,regulation of the autonomic nervous system and peripheral hormonal signaling.Currently,drug treatment mainly involves stimulating sympathetic nerve excitation and fat tissue thermogenesis,thereby inhibiting rapid weight gain by increasing fat breakdown and energy consumption.In addition,some drugs can also act on the reward center of the brain to inhibit excessive food intake in HO patients.This article systematically introduces the clinical benefit data,adverse reactions,and application prospects of newly developed drugs such as oxytocin(OXT),phentermine and topiramate(Ph/T),tesofensine,setmelanotide,etc.