[The pharmacotherapy of obesity]. / Az elhízás gyógyszeres kezelése.

Obesity is considered the most concerning and blatantly visible--yet most neglected--public health problem by the WHO. The steadily increasing number of overweight and obese people has reached 2.3 billion and 700 million worldwide, respectively. Obesity is a complex condition, one that presents serious health risks with respect to type 2 diabetes, ischemic heart disease, and hypertension, therefore controlling the global obesity epidemic decreases not only health problems, but also expenditure. The underlying cause of obesity is a metabolic disorder of genetic, central nervous system or endocrine etiology that manifests in increased nutritional intake and/or decreased physical activity ultimately leading to excessive lipogenesis. The natural treatment of obesity, that is often advised, is comprised of healthy lifestyle choices, namely low-calorie diet and exercise. However, the pharmaceutic treatment of obesity is just as important; having a better compliance rate, anti-obesity drugs also improve quality of life and patient-care outcome concerning accompanying diseases. In most countries only one drug is currently available against obesity: orlistat, which is a specific and irreversible lipase inhibitor. One of the reasons for the scarce number of anti-obesity drugs is the complex pathomechanism involved in obesity. Interference with the intricate biochemical processes that govern alimentation may lead to widespread adverse effects. The advances of the field however, have prompted novel drug leads. In the past few years FDA has approved new drugs for the treatment of obesity, recently liraglutide in 2014. The approval of drug combinations, such as phentermine/topiramate and bupropion/naltrexone are also noteworthy, the components of which have been previously approved, but not necessarily for obesity as main indication. Furthermore, there are many anti-obesity drug candidates currently in clinical phase trials, with promisingly modest adverse effect profiles; hence the expansion of the anti-obesity agents in the near future can be foreseen. The present work summarizes the central and peripheral regulatory pathways of energy consumption, nutrition, and appetite. The possible drug targets, the currently available and novel anti-obesity agents, and the new trends in obesity research are also discussed.

The deiodinase family of selenoproteins.

The realization some forty years ago that several iodothyronine compounds are present in the circulation suggested that deiodination occurs in various tissues. Subsequently, deiodination was indeed documented in in vivo studies. Later, using in vitro assay techniques, three deiodinase processes, termed types 1, 2 and 3, were defined that differed in terms of tissue distribution, reaction kinetics, efficiency of substrate utilization and sensitivity to inhibitors. Although purification of the deiodinase enzymes has continued to be problematic, recent molecular cloning studies have identified cDNAs for these three deiodinase isoforms from multiple species. These cDNAs have provided important insights into the structural characteristics of this family of enzymes. Foremost among the structural features has been the demonstration that all three deiodinase isoforms contain at their active site the uncommon amino acid selenocysteine which is of critical importance to their catalytic activity. The availability of cDNAs for these enzymes provides important reagents for pursuing additional studies aimed at defining their biochemical features and roles in thyroid hormone economy.