Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2023; 14(2): 76-91
Published online Feb 15, 2023. doi: 10.4239/wjd.v14.i2.76
Insulin: A connection between pancreatic β cells and the hypothalamus
Brenda De la Cruz-Concepción, Yaccil Adilene Flores-Cortez, Martha Isela Barragán-Bonilla, Juan Miguel Mendoza-Bello, Monica Espinoza-Rojo
Brenda De la Cruz-Concepción, Yaccil Adilene Flores-Cortez, Martha Isela Barragán-Bonilla, Juan Miguel Mendoza-Bello, Monica Espinoza-Rojo, Molecular and Genomic Biology Laboratory, Faculty of Chemical-Biological Sciences, Autonomous University of Guerrero, Chilpancingo 39070, Guerrero, Mexico
Author contributions: De la Cruz-Concepción B and Espinoza-Rojo M designed the review and wrote the manuscript; Flores-Cortez YA prepared the figures; Mendoza-Bello JM and Barragán-Bonilla MI designed the table and edited the manuscript.
Conflict-of-interest statement: All authors report having no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Monica Espinoza-Rojo, PhD, Researcher, Molecular and Genomic Biology Laboratory, Faculty of Chemical-Biological Sciences, Autonomous University of Guerrero, Av. Lázaro Cárdenas S/N, Ciudad Universitaria, Chilpancingo 39090, Guerrero, Mexico. monicaespinoza@uagro.mx
Received: October 6, 2022
Peer-review started: October 6, 2022
First decision: November 18, 2022
Revised: December 13, 2022
Accepted: January 16, 2023
Article in press: January 16, 2023
Published online: February 15, 2023
Abstract

Insulin is a hormone secreted by pancreatic β cells. The concentration of glucose in circulation is proportional to the secretion of insulin by these cells. In target cells, insulin binds to its receptors and activates phosphatidylinositol-3-kinase/protein kinase B, inducing different mechanisms depending on the cell type. In the liver it activates the synthesis of glycogen, in adipose tissue and muscle it allows the capture of glucose, and in the hypothalamus, it regulates thermogenesis and appetite. Defects in insulin function [insulin resistance (IR)] are related to the development of neurodegenerative diseases in obese people. Furthermore, in obesity and diabetes, its role as an anorexigenic hormone in the hypothalamus is diminished during IR. Therefore, hyperphagia prevails, which aggravates hyper-glycemia and IR further, becoming a vicious circle in which the patient cannot regulate their need to eat. Uncontrolled calorie intake induces an increase in reactive oxygen species, overcoming cellular antioxidant defenses (oxidative stress). Reactive oxygen species activate stress-sensitive kinases, such as c-Jun N-terminal kinase and p38 mitogen-activated protein kinase, that induce phos-phorylation in serine residues in the insulin receptor, which blocks the insulin signaling pathway, continuing the mechanism of IR. The brain and pancreas are organs mainly affected by oxidative stress. The use of drugs that regulate food intake and improve glucose metabolism is the conventional therapy to improve the quality of life of these patients. Currently, the use of antioxidants that regulate oxidative stress has given good results because they reduce oxidative stress and inflammatory processes, and they also have fewer side effects than synthetic drugs.

Keywords: Insulin, Pancreas, Hypothalamus, Hyperphagia, Hyperglycemia, Stress

Core Tip: Insulin is the connection between the β cells of the pancreas and the hypothalamus. Insulin reaches the arcuate nucleus of the hypothalamus and represses the expression of orexigenic neuropeptides to suppress appetite. However, its function decreases when there is damage to the β cells of the pancreas. Its anorexigenic effect decreases and thus increases appetite. The excess of nutrients, specifically carbohydrates, aggravates the damage to β cells and induces obesity and/or diabetes and oxidative damage. The use of antioxidants constitutes a therapeutic approach that has been approached experimentally to regulate the negative effects of alterations in insulin secretion and function.