title: From endocrine to rheumatism: do gut hormones play roles in rheumatoid arthritis?
abstract: RA is characterized by chronic inflammation in the musculoskeletal system, in which TNF-α is the key cytokine trigger. TNF-α, previously known as cachectin, is implicated in the modulation of body composition and energy expenditure. Gut hormones, including acyl ghrelin, des-acyl ghrelin, GIP, GLP-1 and PYY, have been known to be the major regulators of appetite, nutrition, energy expenditure and body mass formation. Emerging evidence indicates that blockade of TNF-α by biologics not only ameliorates rheumatoid inflammation, but can affect the secretion and action of gut hormones on appetite, body composition, energy expenditure, muscle catabolism and bone remodelling. A link between the gastrointestinal endocrine axis and the immune system may be established through the interaction of proinflammatory cytokines, including TNF-α and these gut hormones. With the ever-increasing understanding of rheumatoid inflammation and the invention of more biologics to modulate the cytokine network, more attention should be given to the possible immunomodulatory roles of gut hormones in autoimmune inflammatory reactions.
authors.affiliation: Division of Allergy, Immunology, and Rheumatology, Taipei Veterans General Hospital, 201 Shih-Pai Road Section 2, Taipei 112, Taiwan. cytsai@vghtpe.gov.tw.
authors.forename: Chih-Yen
authors.initials: CY
authors.lastname: Chen
authors.forename: Chang-Youh
authors.initials: CY
authors.lastname: Tsai
mesh_terms: D001066:Appetite / Q000502:physiology; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000503:physiopathology*; D001688:Biological Products / Q000627:therapeutic use; D004734:Energy Metabolism / Q000502:physiology; D005749:Gastric Inhibitory Polypeptide / Q000502:physiology*; D054439:Ghrelin / Q000502:physiology*; D052216:Glucagon-Like Peptide 1 / Q000502:physiology*; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D019894:Peptide YY / Q000502:physiology*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D001688:Biological Products; D054439:Ghrelin; D014409:Tumor Necrosis Factor-alpha; D019894:Peptide YY; D005749:Gastric Inhibitory Polypeptide; D052216:Glucagon-Like Peptide 1
keywords: energy balance; gut hormones; inflammation; rheumatoid arthritis