Appetite control involves an integration of the drive signals arising form
energy stores in the body with the satiety signals generated by periodic ep
isodes of food consumption. Serotonin (5-hydroxytryptamine, 5-HT) has been
implicated in the processes of within-meal satiation and postmeal satiety (
5-HT1B and 5-HT2C postsynaptic receptors) which are concerned with the sign
als arising form the pattern of food intake. Central nervous system (CNS) 5
-HT is sensitive to circulating levels of the precursor tryprophan, certain
macronutrients and peripheral satiety factors such as cholecystokinin (CCK
) and enterostatin. Hypothalamic 5-HT receptor systems inhibit neuropeptide
Y (NPY), a potent stimulator of hunger and food intake. in contrast to the
linking of 5-HT with the consequences of food ingestion, the hormone lepti
n (OB protein) is regarded as a signal linking adipose tissue status with a
number of key CNS circuits. Leptin itself stimulates CNS leptin receptors
(OB-r receptor) which link with pro-opiomelanocortin (POMC)/MC-4 receptors.
The effects of leptin may also be modulated by factors such as the cortico
trophin-releasing factor (CRF), cocaine and amphetamine-regulated transcrip
t (CART), orexins and galanin. Very little evidence exists to support any d
irect link between the actions of 5-HT and leptin, suggesting that they are
separate systems. 5-HT is a part of an integrated network for short-acting
satiety signals (episodic in nature), and leptin is a hormonal indicator o
f long-term (tonic) energy reserves. At a conceptual level, these may repre
sent the distinction between 'satiety' and 'drive'. Interestingly, both 5-H
T and leptin modulate the action of NPY, which may form a part of a common
output pathway for the expression of appetite.