IJCM  Vol.2 No.4 , September 2011
Cholecystokinin in the Pathogenesis of Bulimia Nervosa
ABSTRACT
Objective: This review aims to describe the role of the hormone cholecystokinin (CCK) in the pathogenesis of bulimia nervosa (BN), the perpetuation of this illness and the possibility of its use as a target for future therapeutic advances. Methods: Search for cholecystokinin AND bulimia nervosa in Pubmed Central, with no limits, identified 38 articles published up to the present date. Results: It is well established that CCK is altered in the pathogenesis of BN, and that its main role is in the perpetuation of the disorder rather than the cause of it. Discussion: Additional studies will be needed to further understand the mechanisms by which CCK regulates orexigenic pathways. If an orally active, longer acting analogue of CCK could be developed, it would be of significant interest as an appetite suppressant and a key adjuvant in the treatment of patients suffering from BN, particularly in refractory cases.

Cite this paper
nullH. López, R. Molina-Ruiz, L. Molón and M. Díaz-Marsá, "Cholecystokinin in the Pathogenesis of Bulimia Nervosa," International Journal of Clinical Medicine, Vol. 2 No. 4, 2011, pp. 509-515. doi: 10.4236/ijcm.2011.24085.
References
[1]   V. J. Turón Gil, “Trastornos de la Alimentación,” In: A. Nerviosa, Ed., Bulimia y Obesidad, Masson, Barcelona, 1997.

[2]   W. Kaye, “Neurobiology of Anorexia and Bulimia Nervosa,” Physiology & Behavior, Vol. 94, No. 1, 2008, pp. 121-135. doi:10.1016/j.physbeh.2007.11.037

[3]   K. A. Halmi. “Eating Disorders in Females: Genetics, Pathophysiology, and Treatment,” Journal of Pediatric Endocrinology & Metabolism, Vol. 15, No. S5, 2002, pp. 1379-1386.

[4]   D. Kruger, “Bulimia Nervosa: Easy to Hide But Essential to Recognize,” Journal of the American Academy of Physician Assistants (AAPA), Vol. 21, No. 1, 2008, pp. 48-53.

[5]   E. J. Zimmerli, B. T. Walsh, J. L.Guss, M. J. Devlin, H. R. Kissileff, “Gastric Compliance in Bulimia Nervosa,” Physiology & Behavior, Vol. 87, No. 2, 2006, pp. 441- 446. doi:10.1016/j.physbeh.2005.11.010

[6]   S. U. Devaskar, “Neurohumoral Regulation of Body Weight Gain,” Pediatric Diabetes, Vol. 2, No. 3, 2001, pp. 131-144. doi:10.1034/j.1399-5448.2001.002003131.x

[7]   U. F. Bailer and W. H. Kaye, “A Review of Neuropeptide and Neuroendocrine Dysregulation in Anorexia and Bulimia Nervosa,” CNS & Neurological Disorders - Drug Targets Home Page, Vol. 2, No. 1, 2003, pp. 53-59. doi:10.2174/1568007033338689

[8]   A. Capasso, C. Putrella and W. Milano, “Recent clinical Aspects Of Eating Disorders,” Reviews on Recent Clinical Trials, Vol. 4, No. 1, 2009, pp. 63-69. doi:10.2174/157488709787047594

[9]   L. Guelman, “Bases Neurobiológicas de los Trastornos de la Alimentación,” Psicofarmacology, Vol. 6, 2000. http://www.sciens.com.ar/tratadodepsiquiatria/titulos/psico/pdf/Numero06-Nota02.pdf.

[10]   R. Lablanca and J. C. Montero, “Capítulo V: Patogenia de la Obesidad,” In: J. C. Montero, Ed., Obesidad en el adulto, Editorial D&P, Buenos Aires, 1997. pp: 85-122.

[11]   B. G. Hoebel, P. Rada, G. P. Mark, M. Parada and M. Puig de Parada. “Hypothalamic Control of the Mesolimbic Reward System: PVN Galanin and LH Dopamine,” Progress in Obesity Research, Vol. 7, No. 24, 1996, pp. 393-403.

[12]   C. Fuentealba and M. J. Leiva, “Trastornos Alimentarios. Obesidad y Trastornos de la Conducta Alimentaria,” 2011. https://www.ucursos.cl/medicina/2009/1/MPSIQUI5/2/material_docente/previsualiza r?id_material=207760.

[13]   A. Lopez Mato and A. Vieitez. “Trastornos de la Ali- mentación,” In: A. Lopez Mato, Ed., Psiconeuroinmu- nología II, Editorial Polemos, Buenos Aires, 2004.

[14]   A. Lopez Mato and A. Vieitez. “Trastornos de la Alimentación,” In: N. Marchant and A. Monchablon, Eds., Tratado de Psiquiatría, Editorial Grupo Guía, Buenos Aires, 2005.

[15]   D. C. Jimerson and B. E. Wolfe, “Neuropeptides in Eat- ing Disorders,” CNS Spectrums, Vol 9, No. 7, 2004, pp. 516-522.

[16]   R. R. Schick, V. Schusdziarra, T. L. Yaksh and V. L. Go. “Brain Regions Where Cholecystokinin Exerts Its Effect on Satiety,” Annals of New York Academy of Sciences, Vol. 713, 1994, pp. 242-254. doi:10.1111/j.1749-6632.1994.tb44072.x

[17]   J. F. Rehfeld, “Cholecystokinin,” Best Practice & Re- search Clinical Endocrinology, Vol. 18, No. 4, 2004, pp, 569-586.

[18]   R. Chandra and R. A. Liddle, “Cholecystokinin,” Current Opinion in Endocrinology, Diabetes & Obesity, Vol. 14, No. 1, 2007, pp. 63-67. doi:10.1097/MED.0b013e3280122850

[19]   J. Copari, “Alteraciones de los Mecanismos de Control del Apetito y la Saciedad,” Fundación Escuela para la formación y actualización en Diabetes y Nutrición. http://www.fuedin.org/actualizaciones/Nutricion/a06-11/alteracion.html

[20]   G. Smith and J. Gibbs, “Satiating Effect of Chole- cystokinin,” Annals of the New York Academy of Sciences, Vol. 713, 1994, pp. 242-241. doi:10.1111/j.1749-6632.1994.tb19874.x

[21]   P. H. Robinson, P. R. McHugh, T. H. Moran and J. D. Stephenson, “Gastric Control of Food Intake,” Journal of Psychosomatic Research, Vol. 32, No. 2, 1988, pp. 593- 606. doi:10.1016/0022-3999(88)90008-6

[22]   A. Lopez Mato and P. Beretta “Endocannabinoides en Ingesta Saciedad y en Adicciones,” 2011. http://www.ipbi.com.ar/

[23]   J. D. Rosamond, “FPL 15849KF: A Highly Selective CCK-A Agonist with Potent Anorectic Activity,” In: L. Weston and L Savage, Eds., Advances in Understanding and Treatment, Biomedical Library Series, 1995.

[24]   M. Rosenbaum, R. L. Leibel and J. Hirsch, “Obesity,” The New England Journal of Medicine, Vol. 337, 1997, pp. 396-407. doi:10.1056/NEJM199708073370606

[25]   M. Winick. “Control of Appetite,” John Wiley & Sons, Inc., New York, 1988.

[26]   D. C. Jimerson, M. D. Lesem, A. P. Hegg and T. D. Brewerton, “Serotonin in Human Eating Disorders,” An- nals of the New York Academy of Sciences, Vol. 600, 1990, pp. 532-544. doi:10.1111/j.1749-6632.1990.tb16908.x

[27]   M. Devlin, B. T. Walsh, J. L. Guss, H. R. Kissileff, R. A. Liddle and E. Petkova, “Postprandial Cholecystokinin Release and Gastric Emptying in Patients with Bulimia Nervosa,” The American Journal of Clinical Nutrition, Vol. 65, 1997, pp. 114-120.

[28]   Y. Takimoto, A. Inui, H. Kumano and T. Kuboki, “Orexigenic/Anorexigenic Signals in Bulimia Nervosa,” Current Molecular Medicine, Vol. 3, No. 4, 2003. pp: 349-360. doi:10.2174/1566524033479762

[29]   T. D. Jr. Geracioti and R. A. Liddle, “Impaired Cholecystokin Secretion in Bulimia Nervosa,” The New England Journal of Medicine, Vol. 319, 1988, pp. 683-688.

[30]   T. D. Geracioti, M. A. Kling, J. R. Joseph-Vanderpool, S. Kanayama, N. E. Rosenthal, P. W. Gold et al., “Meal-Related Cholecystokinin Secretion in Eating and Affective Disorders,” Psychopharmacology Bulletin, Vol. 25, No. 3, 1989, pp. 444-449.

[31]   H. Tamai, J. Takemura, N. Kobayashi, S. Matsubayashi, S. Matsukura and T. Nakagawa. “Changes in Plasma Cholecystokinin Concentrations after Oral Glucose Tolerance Test in Anorexia Nervosa before and after Therapy,” Metabolism, Vol. 42, No. 5, 1993, pp. 581-584.

[32]   W. H. Kaye and T. E. Weltzin. “Neurochemistry of Bulimia Nervosa,” Journal of Clinical Psychiatry, Vol. 52, 1991.

[33]   R. B. Lydiard, T. D. Brewerton, M. D. Fossey, M. T. Laraia, G. Stuart, M. C. Beinfeld, et al., “CSF Cholecystokinin Octapeptide in Patients with Bulimia Nervosa And in Normal Comparison Subjects,” American Journal of Psychiatry, Vol. 151, No. 7, 1994, p. 1098.

[34]   K. M. Pirke, M. B. Kellner, E. Friess, J. C. Krieg and M. M. Fichter, “Satiety and Cholecystokinin,” International Journal of Eating Disorders, Vol. 15, No. 1, 1994, pp. 63-69. doi:10.1002/1098-108X(199401)15:1<63::AID-EAT2260150108>3.0.CO;2-V

[35]   K. Wlodarczyk-Bisaga and A. Bisaga. “Selected Issues of Biological Aspects of Eating Disorders,” Psychiatria Polska, Vol. 28, No. 5, 1994, pp. 579-591.

[36]   F. Brambilla, M. Brunetta, A. Draisci, A. Peirone, G. Perna, P. Sacerdote, et al., “T-Lymphocyte Concentrations of Cholecystokinin-8 and Beta-Endorphin in Eating Disorders: II. Bulimia Nervosa,” Psychiatry Research, Vol. 59, No. 1-2, 1995, pp. 51-56. doi:10.1016/0165-1781(95)02674-6

[37]   D. C. Jimmerson and B. E. Wolfe, “Neuropeptides in Eating Disorders,” CNS Spectrum, Vol. 9, No. 7, 2004, pp. 516-522.

[38]   P. K. Keel, B. E. Wolfe, R. A. Liddle, K. P. De Young and D. C. Jimerson, “Clinical Features and Psysiological Response to a Test Meal in Purging Disorder and Bulimia Nervosa,” Archives of General Psychiatry, Vol. 64, No. 9, 2007, pp. 1058-1066. doi:10.1001/archpsyc.64.9.1058

[39]   A. C. Prince, S. J. Brooks, D. Stahl and J. Treasure, “Systematic Review and Meta-Analysis of the Baseline Concentrations and Physiologic Responses of Gut Hor- mones to Food in Eating Disorders,” The American Journal of Clinical Nutrition, Vol. 89, No. 3, 2009, pp. 755-765. doi:10.3945/ajcn.2008.27056

[40]   W. H. Kaye, W. H. Berrettini, H. E. Gwirtsman, P. W. Gold, D. T. George, D. C. Jimerson, et al., “Contribution of CNS Neuropeptide (NPY, CRH, and Beta-Endorphin) Alterations to Psychophysiological Abnormalities in Anorexia Nervosa,” Psychopharmacology Bulletin, Vol. 25, No. 3, 1989, pp. 433-438.

[41]   M. Fava, P. M. Copeland, U. Schweiger and D. B. Herzog, “Neurochemical Abnormalities of Anorexia Nervosa and Bulimia Nervosa,” The American Journal of Psychiatry, Vol. 146, No. 8, 1989, pp. 963-971.

[42]   S. J. Hadley and B. T. Walsh, “Gastrointestinal Distur- bances in Anorexia Nervosa and Bulimia Nervosa,” Cur- rent Drug Targets - CNS & Neurological Disorders, Vol. 2, No. 1, 2003, pp. 1-9.

[43]   S. Zipfel, I. Sammet, N. Rapps, W. Herzog, S. Herpertz and U. Martens, “Gastrointestinal Disturbances in Eating Disorders: Clinical and Neurobiological Aspects,” Auto- nomic Neuroscience-Basic & Clinical, Vol. 129, 2006, pp, 99-106.

[44]   B. J. Rolls, M. M. Hetherington, S. A. Stoner and A. E. Andersen, “Effects of Preloads of Differing Energy and Macronutrient Content on Eating Behavior in Bulimia Nervosa,” Appetite, Vol. 18, 1997, pp. 26-33.

[45]   F. Bramilla, “Aetiopathogenesis and Pathophysiology of Bulimia Nervosa; Biological Bases and Implications for Treatment,” CNS Drugs, Vol. 15, No. 2, 2001, pp. 119- 136.

[46]   L. S. Usdan, L. Khaodhiar and C. M. Apovian, “The En- docrinopathies of Anorexia Nervosa,” Endocrine Practice, Vol. 14, No. 8, 2008, pp. 1055-63.

[47]   N. C. Barbarich, W. H. Kaye and D. Jimerson “Neuro- transmitter and Imaging Studies in Anorexia Nervosa: New Targets for Treatment,” Current Drug Targets - CNS & Neurological Disorders, Vol. 2, No. 1, 2003, pp. 61-72. doi:10.3945/ajcn.2008.27056

[48]   D. A. Klein and B. T. Walsh., “Eating Disorders: Clinical Features and Pathophysiology,” Physiology & Behavior, Vol. 81, No. 2, 2004, pp. 359-374. doi:10.1016/j.physbeh.2004.02.009

[49]   E. A. Lawson and A. Klibanski, “Endocrine Abnormali- ties in Anorexia Nervosa,” Nature Reviews Endocrinology, Vol. 4, No. 7, 2008, pp. 407-414. doi:10.1038/ncpendmet0872

[50]   A. L. Hirschberg, S. Naessén, M. Stridsberg, B. Bystr?m and J. Holtet. “Impaired Cholecystokinin Secretion and Disturbed Appetite Regulation in Women with Polycystic Ovary Syndrome,” Gynecological Endocrinology, Vol. 19, No. 2, 2004, pp. 79-87. doi:10.1080/09513590400002300

[51]   E. Phillip, K. M. Pirke, M. B. Kellner and J. C. Krieg. “Disturbed Cholecystokinin Secretion in Patients with Eating Disorders,” Life Science, Vol. 48, No. 25, 1991, pp. 2443-2450. doi:10.1016/0024-3205(91)90379-P

[52]   A. Márquez and A. Mato López, “Viejos y Nuevos Péptidos en los Trastornos de la Alimentación,” 2011. www.aapb.org.ar/act-cient/Viejos-nuevos-pepetidos-Kalina. doc.

 
 
Top