Central control of energy balance by amylin and calcitonin receptor agonists and their potential for treatment of metabolic diseases

Basic Clin Pharmacol Toxicol. 2020 Sep;127(3):163-177. doi: 10.1111/bcpt.13427. Epub 2020 May 18.

Abstract

The prevalence of obesity and associated comorbidities such as type 2 diabetes and cardiovascular disease is increasing globally. Body-weight loss reduces the risk of morbidity and mortality in obese individuals, and thus, pharmacotherapies that induce weight loss can be of great value in improving the health and well-being of people living with obesity. Treatment with amylin and calcitonin receptor agonists reduces food intake and induces weight loss in several animal models, and a number of companies have started clinical testing for peptide analogues in the treatment of obesity and/or type 2 diabetes. Studies predominantly performed in rodent models show that amylin and the dual amylin/calcitonin receptor agonist salmon calcitonin achieve their metabolic effects by engaging areas in the brain associated with regulating homeostatic energy balance. In particular, signalling via neuronal circuits in the caudal hindbrain and the hypothalamus is implicated in mediating effects on food intake and energy expenditure. We review the current literature investigating the interaction of amylin/calcitonin receptor agonists with neurocircuits that induce the observed metabolic effects. Moreover, the status of drug development of amylin and calcitonin receptor agonists for the treatment of metabolic diseases is summarized.

Keywords: amylin; amylin receptor agonists; calcitonin receptor agonists; energy balance; metabolic disease; salmon calcitonin.

Publication types

  • Review

MeSH terms

  • Amylin Receptor Agonists / pharmacology*
  • Amylin Receptor Agonists / therapeutic use*
  • Animals
  • Energy Metabolism
  • Humans
  • Hypothalamus
  • Islet Amyloid Polypeptide / physiology
  • Leptin
  • Metabolic Diseases / drug therapy*
  • Mice
  • Rats
  • Receptors, Calcitonin / agonists*
  • Receptors, Calcitonin / therapeutic use*
  • Rhombencephalon

Substances

  • Amylin Receptor Agonists
  • Islet Amyloid Polypeptide
  • Leptin
  • Receptors, Calcitonin