Showing posts with label obesity. Show all posts
Showing posts with label obesity. Show all posts

Wednesday, February 11, 2015

Thinking Skinny Thoughts Won’t Help


Biology concepts – undulipodia, primary cilia, chemosensing, obesity, depression, hydrocephalus, lithium

Winston Churchill once said that men occasionally stumble on the truth, but most people pick themselves up and carry on as if nothing had happened.


Gregor Mendel was Augustinian monk who really
joined the order because they would allow him to
study and learn for the rest of his life. Sounds like
the gig I would enjoy. Since he was a monk, do you
think he got angry that his discoveries were
ignored for 35 years?
In some cases we are shown the truth but don’t recognize it, as with Gregor Mendel’s discovery of the laws of genetics. Using his various pea plants, the Augustinian friar’s work was presented in 1865 and published 1866 – and then was forgotten for decades.

Mendel's paper was referenced only three times over next 35 years and his work wasn’t rediscovered until 1900. Two scientists gave Mendel much credit for the primacy of his work, but it really wasn’t until a fourth individual, William Bateson, came along that Mendel became widely known and his work accepted. It was Bateson coined the phrase “Mendel’s laws of inheritance.” Why did he champion Mendel so greatly – because he questioned Darwinism as incomplete. Well, it was incomplete at that time.

Just as the world was rediscovering Mendel, the primary cilium was discovered for the first time. The world didn’t exactly ignore it; we just had to wait for technology to catch up. Zimmerman first described the solitary hair sticking out of most cells in an 1898 German paper, but the next significant paper discussing primary cilia didn’t appear until 1961! We had to wait for the electron microscope and molecular biology to catch up.


The electron microscope was the piece of
equipment that allowed for deeper investigation
of the primary cilium structure. Even though the
first electron ‘scope was operational in 1931 (M.
Knoll and E. Ruska, inventors), it still took 30 years
to turn it’s power on the primary cilium. Was it
considered just an immotile cilium, or did someone
suspect it had more jobs to do? Molecular biological
techniques in the 1990’s answered that question and
led to an explosion of study on the solitary antenna
of most cells.
Last week we discussed how primary cilia are like the antennae of cells, they stick out into the extracellular environment and react to flow pressure (kidney tubule cells), vibration (hair cells of cochlea), chemicals (hormones and such) or even light (photoreceptor cilia). Now we’re realizing some of the amazing things that this sensing controls – your brain for instance.

You know that your brain works by transmitting electrical impulses through specific neural pathways. But chemistry in the brain is just as important as electricity. Hormones, neurotransmitters, even non-chemical signals like temperature and flow are converted to chemical and electrical signals via primary cilia.

As with so many other things, we learn biology best by studying what happens when things go wrong. You won’t believe the diseases that are being linked to this most innocuous of cell structures. Without any exaggeration, primary cilia make you smart, skinny, and happy. Let’s find out how.

Inside your brain are fluid filled cavities called ventricles. The ventricular system of the brain is connected through the ventricles and travel part way down your spinal column as well. They are filled with cerebrospinal fluid (CSF) and this fluid has many functions.


Here is the ventricular system of the vertebrate
brain. Blue = lateral ventricles, cyan= inter-
ventricular foramina, yellow = third ventricle,
red = cerebral aquaduct, purple = fourth ventricle,
green = central canal. What the image doesn’t show
is the connection that allows CSF to surround the
brain in the subarachanoid space, between the
brain and the skull. This is where 85% of the
CSF can be found.
Like an internal helmet, one of the functions of the CSF is to cushion the brain, acting as a shock absorber. But it does so much more than that. CSF also stabilizes the chemistry of the brain, and helps with blood perfusion by mediating the pressure in the cranium. Finally, the CSF removes waste products from the central nervous system.

The cells that line the ventricles are neuroepithelial cells called ependymal cells. They have motile cilia (2˚ cilia), as well as microvilli – which we learned last week aren’t cilia-like at all. The ependymal cell cilia beat in a specific direction depending on where they are in the system. The coordinated beating keeps the CSF flowing through the ventricles; flow is key to its functions.

The microvilli have a different job; they absorb CSF and transfer it into the brain tissue as a way of keeping the brain in the proper chemical environment. In this way, it helps mediate the CSF functions described above.

But there is a second cell type in the ependymal layer. B1 cells are pre-ependymal cells. When called upon, they differentiate to form more ependymal cells. These B1 cells are located just below the ependymal layer, but they have small areas where they stick up and touch the CSF. And here they each have a primary cilium.

A 2014 study showed that the B1 primary cilia actually control the function of the ependymal cell motile cilia. And since the motile cilia of B1 cells control pressure and flow of CSF in the ventricular system, it’s really the primary cilia who are in charge.

Because of this, a problem with the motile cilia of the ependymal cells or the primary cilia of B1 cells leads to disrupted CSF control and hydrocephalus. Hydrocephalus (hydro = water, and cephalo = brain) leads to increased intracranial pressure and this is lethal for neural tissue. Mental retardation, other complications, and death are the results of hydrocephalus.

So we already see that these short projections that were ignored for so long have one crucial job in the brain. But there’s more. It isn’t just their presence that matters; it’s their length.


Huntington’s chorea, or just plain Huntington’s
disease, is insidious; it’s lethal and there is no
treatment. It results in debilitating movements of
the motor system. Even though the genetic mutation
is with you your whole life, the disease doesn’t show
up until middle age, probably after you have had kids.
So you don’t know that you passed it on until it’s too
late. There is a test for it – would you want to know
if you had it?
Primary cilia have specific lengths in different cell types. Too long or too short and it’s like they aren’t there at all. In kidney tubule cells, increased urine flow bends the cilia, so they transmit signals to the cells, but too much signaling would be bad. Increased flow shortens the primary cilia so they become less responsive, and this is the control mechanism. In the ependymal layer, both motile and primary cilia length are crucial.

A genetic problem in a single cilial gene leads to a disease called Huntington’s chorea (means dance for the strange movements the patients make). A 2011 paper showed that the mutation lengthens both motile and primary cilia in the ventricles.  This in turn alters the beating of the motile cilia and disrupts flow of the CSF. This isn’t the only defect in the disease, but changes in CSF are thought to exacerbate the disease.

Interestingly, the changes in intracranial pressure via primary cilia changes can lead to obesity. How could CSF and eating be connected? Well, in a couple of ways – let’s investigate further.

There are several syndromes that include obesity in their list of symptoms, diseases like Bardet-Biedl syndrome, Carpenter syndrome, and others. The commonality in these diseases is that there are mutations that affect some aspect of primary cilia function, production, or maintenance. Changes in primary cilia can affect your weight?


No big message here, just thought the primary cilium
looked like Alfalfa from Our Gang. Length is crucial for
primary cilia– I suppose Alfalfa kept his a particularly
length too.
A 2007 paper narrowed down the subset of cells where the primary cilia are disrupted by putting different primary cilia under the control of different regulators in mice. Then they could wait until the mice grew up and turn off the primary cilia in various cell types. They found that it is just the POMC neurons in the hypothalamus that regulate obesity. This means that it is a brain and behavioral issue, not a problem with energy metabolism in the body.

POMC neurons make alpha-MSH and multifunctional hormone. This is released from the POMC neurons and acts on downstream pathways to tell you to stop eating. If the primary cilia on the POMC neurons are too short or absent, you experience hyperphagia (hyper = beyond, and phagia = eating), ie. compulsive eating. You just can’t stop eating.

Many of the syndromes that start as primary cilia problems show both compulsive eating AND hydrocephalus. So this explains how hydrocephalus may affect obesity in one, way, but there’s another. If you have a brain injury that damages the ependymal or B1 cilia, then hydrocephalus might result. The POMC neurons are located right next to the third ventricle, so increased intracranial pressure during hydrocephalus can damage them and lead to compulsive eating directly.


Notice how close the third ventricle is to the POMC
neurons of the hypothalamus. Hydrocephalus alone can
induce changes in primary cilia length on them so they
won’t respond to insulin or leptin. Then you
eat compulsively.
The question remains as to what signal(s) the POMC primary cilia are sensing in order to tell you to stop eating. It is probably several, chemicals that say you are full or have enough fat. Leptin, the hormone released by fat cells is certainly one of them. A 2014 study in obese mice with leptin deficiency or leptin resistance proved this. The primary cilia on POMC neurons in hypothalamus are short in these mice due to lack of leptin signaling, and therefore they don’t work well and don’t stimulate alpha-MSH release.

So, here we have a miniscule part of your neurons cells that, if not exactly the needed length, can take away your intelligence AND your beach-ready physique. But it gets worse.

Many of these same ciliopathies (disease of cilia function) are also associated with clinical depression. The problem is, we don’t know how they lead to depression. Depression is often thought to be a problem of serotonin signaling in the brain, but it can be multifactorial. Here’s one interesting result though – lithium lengthens primary cilia.

Lithium is used to treat depression, and we don’t yet really know why it works. But lithium also increases the length of primary cilia in many cell types of the brain. Considering that many depressed people gain weight, could depression and compulsive eating be linked by primary cilia length? Lithium treats them both. This could explain why people coming out of depressive episodes often lose weight.

The popular soft drink &-Up contained lithium citrate
until 1950. It is used as a mood stabilizer now, and we
know it promotes weight gain, but here they advertize it
as slenderizing. The name, 7-Up, is a mystery, but the
atomic mass of lithium is seven - hmmm.

Sounds like we’re really on to something here. People who are treated for depression and get better often lose weight. Is it because they a) feel better and then do more activity, or is it because 2) their POMC primary cilia are longer and this suppresses their appetite?

No way for number two. Biology is never that simple. It turns out that one of the major side effects of lithium treatment for mood stabilization is weight gain. It has to do with lithium affecting the function of the thyroid gland, this being one of the major regulators of your metabolism. Your metabolism slows down and you gain weight.

Maybe if we just inject the lithium into the brain ventricles…. You want to volunteer for that weight loss program?

Next week, how can primary cilia control whether mankind ever gets to step foot on Mars or help the Enterprise on its five year mission to seek out new worlds? By controlling bones….. no, not Bones McCoy, just bones.




Tong, C., Han, Y., Shah, J., Obernier, K., Guinto, C., & Alvarez-Buylla, A. (2014). Primary cilia are required in a unique subpopulation of neural progenitors Proceedings of the National Academy of Sciences, 111 (34), 12438-12443 DOI: 10.1073/pnas.1321425111

Han, Y., Kang, G., Byun, K., Ko, H., Kim, J., Shin, M., Kim, H., Gil, S., Yu, J., Lee, B., & Kim, M. (2014). Leptin-promoted cilia assembly is critical for normal energy balance Journal of Clinical Investigation, 124 (5), 2193-2197 DOI: 10.1172/JCI69395

Davenport JR, Watts AJ, Roper VC, Croyle MJ, van Groen T, Wyss JM, Nagy TR, Kesterson RA, & Yoder BK (2007). Disruption of intraflagellar transport in adult mice leads to obesity and slow-onset cystic kidney disease. Current biology : CB, 17 (18), 1586-94 PMID: 17825558

Keryer, G., Pineda, J., Liot, G., Kim, J., Dietrich, P., Benstaali, C., Smith, K., Cordelières, F., Spassky, N., Ferrante, R., Dragatsis, I., & Saudou, F. (2011). Ciliogenesis is regulated by a huntingtin-HAP1-PCM1 pathway and is altered in Huntington disease Journal of Clinical Investigation, 121 (11), 4372-4382 DOI: 10.1172/JCI57552

Miyoshi, K., Kasahara, K., Miyazaki, I., & Asanuma, M. (2009). Lithium treatment elongates primary cilia in the mouse brain and in cultured cells Biochemical and Biophysical Research Communications, 388 (4), 757-762 DOI: 10.1016/j.bbrc.2009.08.099




For more information or classroom activities, see:

Ventricular System –

Huntington’s disease –

POMC –

Lithium -



Wednesday, May 14, 2014

Cold Keeps You Warm

Biology concepts – thermoregulation, TRPM8, vasoconstriction, brown adipose tissue, agonists/antagonists


Pep-O Mint was the first Lifesaver flavor, invented
in 1912. This was followed quickly by the Lifesaver
car in 1918. Built on a Dodge truck chassis, the
important word was dodge, since the car didn’t have
a windshield and the driver had to stick his head out
the side window to see ahead.
Let’s do a demonstration. Borrow a peppermint lifesaver from a friend (well, not borrow really - you’re not going to give it back). Place it between your teeth, so you can close your lips around it and suck air in through the hole (this will be the control for our experiment). 

Now put the candy in your mouth like normal and suck on it for a minute or two – don’t chew it up.  Swallow to get the saliva out of your mouth and take out the candy. Now take in a long slow breath of air. How does it feel? Did the room get colder in the last two minutes?

If you are like most people, the air feels colder in your mouth now that you've eaten menthol (peppermint). Just like capsaicin can make hot things seem hotter via TRPV1, the cold sensing channel we talked about last week, TRPM8, can make room temperature air seem colder.

The TRPM8 cold sensing ion channel is important for keeping our body temperature in a normal range. Just like TRPV1 senses when we are too warm and initiates cooling mechanisms, TRPM8 tells us we are cold and institutes procedures to make us warmer. One way is to stimulate vasoconstriction, so less heat is lost from the blood through our skin. I’m sure you have noticed that your skin is paler when you are out in the cold. This is from vasoconstriction limiting the amount of blood moving into the surface vessels.

When your core temperature varies from your skin
temperature by too much, TRPM8 will institute
heat conserving and/or generating mechanisms.
For heat conservation, more of the blood (left
cartoon) that goes the skin can be shunted through
the capillaries before it gets to the surface. This
helps reduce the amount of heat loss via radiation
of the heat in the blood. On the right is the effect of
the arrector pili muscles. When cold, they contract
and raise the hairs, trap air, and therefore trap body
heat against the skin so less heat is loss. The
contraction also mounds up the skin – goosebumps.

TRPM8 can also stimulate shivering and the burning of fat to generate warmth. Through the sensations and reactions of TRPV1 and TRPM8, animals learn to maintain a more or less constant body temperature, seeking out temperatures that are good for physiology and avoiding temperatures that would change their core temperature by too much. This was shown in a series of studies described in a 2013 paper, where mice without temperature sensing receptors TRPV1 and/or TRPM8 would not avoid hot or cold temperatures and were prone to hyperthermia and or hypothermia.

So how does the TRPM8 channel sense cold? We saw that with TRPV1 the heat induced a conformation change that caused the channel to open and calcium to flow in and start a neural action potential. Could cold induce a conformation change as well? Maybe. What was seen in a 2011 study was that TRPM8 neurons started firing when the temperature dropped to 28.4˚C (83 ˚F). As the temperature dropped, the neurons would fire more and more strongly, so it could act as a thermostat.

When the temperature dropped severely (to 10˚C) the core temperature changed little, but skin temperature dropped considerably. The TRPM8 thermostat was targeted to keeping the organs and brain warm, not the skin.  It accomplishes this by diverting heat via the blood away from the skin. A 2012 study showed that TRPM8 antagonists brought a systemic hypothermia, but repeated use of the antagonist reduced the magnitude of the temperature drop – so unlike most TRPV1antagonists (that bring bad hyperthermia), TRPM8 antagonists might be helpful in medicine.


We don’t yet know how cold activates TRPM8. In
warmth, the channel is closed. With cooler
temperature or menthol (M), the channel is open,
but we don’t know if cold achieves this by a
conformation change. If really cold, the regulatory
proteins break away and the channel can’t work.
So TRPM8 is active in a range of temperatures.
But this still doesn’t answer the questions as to how TRPM8 can detect cool temperatures. It may or may not be a conformation change, but what does occur is an alteration in the apparent temperature threshold of the neuron. The cold temperature should inhibit firing (cold slows metabolism and chemical activity), but here it increases the metabolism and biochemical activities. TRPM8 makes the neuron seem warmer so that the firing is easier, and this transfers information that the area is in fact colder! That’s an exception.

However it manages the feat, TRPM8 is important for keeping mammals warm. It might even help you lose weight. Chronic cold stimulates TRPM8 all the time, and this ramps up your heat production. A 2012 study showed that for mice, chronic cold could actually prevent them from becoming obese.

Heat production takes energy, and burning more energy helps you lose weight. But there is an important balancing act at work here. Our fat also protects us against losing too much heat in the cold. Look at whales, they have a layer of blubber all over their body to insulate them from the cold water. It has been shown that people with an even layer of fat all over their body make good cold weather swimmers, like Lynne Cox, who swam from her perfectly good boat to the shores of Antarctica and across the Bering Strait in 4˚C (40˚F) water.

On the other hand, bactrian camels keep their fat limited to two humps (one for dromedaries) in order to prevent against having too much insulation in their desert environment. Camels need to be able to dissipate lots of heat. And no, the humps aren’t for storing water! Remember we said that one of the great things about fat is that you can store lots of energy in a small space precisely because can be stored without water.


In brown adipose tissue, there are ATP synthase
proteins (for making ATP) and uncoupling proteins
(for generating heat) in the inner mitochondrial
membrane. When cold, the number of UCP proteins is
increased, as is the number of mitochondria. About
65% of the energy of the proto gradient formed by the
respiratory chain can be converted to ATP by the ATP
synthase. But using the UCP to allow protons back in
means that 100% of the energy is changed to
heat, no ATP is made.
It seems that TRPM8 can stimulate the burning of fat to produce heat. We talked about this before with capsaicin as well. Brown adipose tissue has more mitochondria and more of a protein called UCP1 (uncoupling protein). UCP separates mitochondrial energy burning from ATP production; all the energy goes to making heat.

A 2014 study showed that chronic cold makes brown fat AND white fat upregulate UCP and generate more mitochondria. It makes white fat more like brown fat and this means that more fat is burned. In mice, this chronic cold is enough to keep them from becoming obese, even on a high glucose diet. So if you want to stay skinny, turn your thermostat way down all year round.

The study that showed that chronic cold kept mice from getting fat wasn’t as cruel as it may sound. They didn’t keep the mice at cold temperature all the time, they used a chemical that could mimic the cold and make the TRPM8 channels fire all the time. What did they use? Menthol.

This is a good place to point out the similar exception for TRPV1 and TRPM8. They are both proteins that can be activated by both environmental factors and by chemicals. We saw that TRPV1 is activated by capsaicin and other chemicals. The opening of the channel and firing of the neurons in response to these chemicals was interpreted exactly the same as if the neurons were exposed to damaging heat.


There are many agonists for TRPM8, similar to TRPV1.
In fact, some things that activate TRPM8 also activate
TRPV1. An interesting one is the synthetic agonist called
icilin. It is thousands of time more active on TRPM8 than
cool temperatures. However, it binds to TRPM8 in a
completely different way as compared to menthol and
cool temperatures.
With TRPM8, menthol (in mints) and some other chemicals open the ion channels just as cool/cold temperatures would, and our brains trick us into thinking the mouth or skin is colder than it really is. That’s what is behind our lifesaver trick at the beginning of the post. The air wasn’t any colder; your brain makes you think it was.

Menthol is a terpene alkaloid contained in plants of the genus Mentha (mint, from the Greek mintha). This genus includes 25 species of aromatic herbs, such as peppermint, spearmint, and pennyroyals. Most mints can be and are used in making foods and drinks, but the pennyroyals also contain toxic compounds that will induce liver failure and kill you.

At low concentrations in the mouth or on skin, menthol produces a pleasant cooling sensation, but higher concentrations produce burning, irritation and pain (this has to do with how it activates TRPV1, TRPV3, TRPM8, and TRPA1, depending on the concentration).

In the oral cavity, a small amount of menthol actually desensitizes TRPV1 activation by heat and capsaicin, so chili peppers might not seem so spicy. Biochemical evidence shows that menthol sparks a release of glutamate from neurons. But an increase in glutamate neurotransmitter can actually stop the type C nociceptive neurons from firing (an inhibitory neurotransmitter in this case).

Pennyroyal is a member of the mentha genus (left). It, like
many plants (right image is orange mint), has been used in
medicine. It can be ground and drunk with water to settle a
sick tummy or to induce perspiration. However, pennyroyal
has to be used carefully. In addition to menthol, it contains a
chemical called pulegone. Too much pulegone and here
come the seizures, organ failure and death. Don’t confuse
the two mints.

At this same time, menthol (or other TRPM8 agonists) will sensitize TRPM8 receptors, the combination of these two results means that sucking in air after a wintergreen or peppermint candy will make the air seem colder, but might also make a hot cup of coffee seem cold as well.

I think the only way to resolve these ideas is to start a controlled experiment. What do you predict would happen if you froze a chili pepper and then took a bite? How about eating peppermint laced with capsaicin, or a strong peppermint flavored tea that has been heated to near boiling? Who will win out, TRPM8 or TRPV1?

It may not be so easy to figure out. The agonists and antagonists of the TRPs can have effects on multiple receptors and the effects can be different at different concentrations. Menthol sensitizes TRPM8, but if the temperature is above 37˚ C (98˚ F) it actually makes TRPV3, a heat sensor, more active (2006).


Camphor comes from some species of laurel trees (left), as well as
from some herbs of the mint family, like camphor basil (right).
Dried rosemary leaves are up to 20% camphor. Camphor has
been used for many things, including as a flavoring in asian
sweets, an analgesic, an insect repellent, and a rust proofing
agent. I find it hard to rectify those uses with one another.
Take oil of wintergreen in BenGay for example. We showed that it was a TRPV1 agonist, so it could induce analgesia by counter irritation. But it is also a TRPM8 agonist. In the oral cavity at lower concentrations than used in BenGay, it activates TRPM8 and desensitizes TRPV1. The lifesaver trick will work with peppermint, spearmint, and wintergreen flavors; they all activate TRPM8.  

And then there’s camphor. Like menthol, camphor is terpenoid chemical. Camphor can make things seem cool (by activating and sensitizing TRPM8), but it’s more complicated. It actually potentiates both heat and cold sensations. A 2013 study shows that it can sensitize or potentiate TRPV1 (painful hot) and TRPM8 (non-painful cool). Camphor can even activate the noxious cold sensor TRPA1 that we will talk about in a couple of posts. This means that it can be analgesic or painful, warming and cooling.

It becomes even more confusing when you realize that camphor activates TRPM8, just like menthol, but can inhibit the activation of TRPM8 by menthol. Weird, right? Well, consider this – Vick's VapoRub contains menthol and camphor as its active ingredients. Next week, we'll investigate how they can work together to open your nose and make you feel both warm and fuzzy while they cool and invigorate you at the same time.



Pogorzala LA, Mishra SK, & Hoon MA (2013). The cellular code for mammalian thermosensation. The Journal of neuroscience : the official journal of the Society for Neuroscience, 33 (13), 5533-41 PMID: 23536068

Rossato M, Granzotto M, Macchi V, Porzionato A, Petrelli L, Calcagno A, Vencato J, De Stefani D, Silvestrin V, Rizzuto R, Bassetto F, De Caro R, & Vettor R (2014). Human white adipocytes express the cold receptor TRPM8 which activation induces UCP1 expression, mitochondrial activation and heat production. Molecular and cellular endocrinology, 383 (1-2), 137-46 PMID: 24342393

Ma S, Yu H, Zhao Z, Luo Z, Chen J, Ni Y, Jin R, Ma L, Wang P, Zhu Z, Li L, Zhong J, Liu D, Nilius B, & Zhu Z (2012). Activation of the cold-sensing TRPM8 channel triggers UCP1-dependent thermogenesis and prevents obesity. Journal of molecular cell biology, 4 (2), 88-96 PMID: 22241835

Selescu T, Ciobanu AC, Dobre C, Reid G, & Babes A (2013). Camphor activates and sensitizes transient receptor potential melastatin 8 (TRPM8) to cooling and icilin. Chemical senses, 38 (7), 563-75 PMID: 23828908



For more information or classroom activities, see:

Thermoregulation –




Wednesday, April 23, 2014

Chili Peppers Run Hot And Cold

Biology concepts – obesity, brown adipose tissue, agonist/antagonist, protective hypothermia, hyperthermia, reactive oxygen species, ischemia, hypoxia

When The Wizard of Oz was released in 1939, it just barely turned a profit. The '39 version was the third attempt at filming the children’s classic, and the first two efforts had not fared much better.


I don’t see how people didn’t take to the Wizard of Oz right away.
It had new technology for the movies, a good villain, and all those
little people. The tin man on the left was played by Jack Haley, but
originally it was supposed to Buddy Ebsen (Jed from the Beverly
Hillbillies). Unfortunately, the lead metal in the makeup almost
killed him during the makeup/costume tests. Glenda the good witch
(Billie Burke) had that squeaky voice. She only began acting
after her husband, Flo Ziegfeld, Jr. (son of the Ziegfeld Follies
creator), went belly up on Black Monday in 1929.
Over time, what was first considered bad has become a classic. In what many people consider the best year ever in film, The Wizard of Oz is now a favorite among favorites, more than Goodbye Mr. Chips, Mr. Smith Goes to Washington, Stagecoach, or even Gone With the Wind – all produced in 1939.

It’s smart to hang on to useless things and knowledge, something might change. For Oz – it was television. For some reason, this film translated better to TV than it did the big screen. The Library of Congress now rates it as the most viewed film ever. And it wasn’t even shown on TV until 1956. The weird part – very few people in 1956 owned a color television, so Dorothy’s entrance into the land of Oz was no big deal for most folks until the late 1960’s.

Why am I telling you this story? Because the same thing happens in biology and medicine. Problems can become assets if the right environment is created or the proper setting is found. We've been discussing the capsaicin receptor, TRPV1, for some weeks, and this is where I find a negative being turned into a positive.

As you know, the TRPV1 capsaicin receptor is primarily a heat sensing receptor for thermoregulation of the body. If activated by noxious (painful) high temperatures, it generates a pain signal and initiates a cooling program for the body, including sweating.

In an effort to block TRPV1 to create analgesia (no pain), the problem has been that blockers also stop thermoregulation and the patient overheats. This prevents most TRPV1 antagonists (substances that bind the receptor but don’t allow function) from being used as analgesics. But what about in other situations?

I was wondering if TRPV1 antagonists might be helpful in obesity, by helping burn off some fat through increased cooling activity. If they are indeed helpful, nobody knows about it yet. I couldn’t find even one paper that studied TRPV1 antagonists as a way to induce increased energy expenditure and weight loss. In fact, I learned just the opposite. Capsaicin and other TRPV1 agonists might help with weight loss.


On the left is brown fat and white fat. You can see that brown fat
actually looks browner because of all the mitochondria that it
contains. White fat contains a lot more lipid. The right cartoon
shows that a cold challenge initiates uncoupled fat metabolism in
brown fat, creating heat. But the cold also releases more fatty acids
from white fat, which can then be burned by the brown fat. The
involvement of bone comes from bone breakdown. Breakdown
releases a protein that stimulate white fat to release fatty acids,
this would provide energy for the brown fat.
We have discussed how TRPV1 activation by noxious heat helps to cool the body, but it turns out that noxious cold leads to TRPV1 activation as well, but in these cases, it brings an increase in heat production. So TRPV1 can cool you down or warm you up as needed. Pretty cool. You'll have to wait a few weeks to find out how a heat receptor senses noxious cold.

The heat induced by cold comes from increased activity of brown adipse tissue (BAT) – brown fat. We have talked about BAT before, how it is especially important for infants because they lose heat so easily. Brown fat has lots of mitochondria, but they don’t make ATP. They convert all the energy they burn into heat.

New research is showing that BAT can be important to adults as well. Those people that have more BAT tend to have less white fat, the kind that makes you bigger. What is more, a 2013 paper shows that cold temperature exposure can help create more BAT, and this effect is mimicked by capsaicin and other TRPV1 agonists.

If you expose adults to mildly cold temperatures for six hours a day, they start to make more BAT and this means they burn more energy for heat; therefore less energy is left to be stored as white fat. But the study also showed that giving the people capsaicin for weeks in a row generated the same increase in BAT and stopped white fat accumulation.

One mechanism involved is that TRPV1 agonists stimulate an increase in uncoupling protein (UCP) expression in BAT. This is the protein that permits the BAT mitochondria to produce lots of heat instead of lots of ATP and a little heat. The uncoupling protein activity in BAT uses excess calories to produce heat, so those calories are not available to make fat.


Here is how a stem cell becomes a fat cell (adipocyte).
The mesenchymal cell can go two directions, one
toward fat and one toward muscle. But notice you can
get to a brown fat cell through the pathway meant for
muscle cells. PG stands for prostaglandins; different
profiles of prostaglandins lead to a decision to become
a brown fat cell or a white fat cell. We know this picture
is incomplete now, because we have evidence that
TRPV1 agonists can drive the decision between
brown fat and white fat.
But there may also be another mechanism at work. A 2014 study in laboratory petri dishes shows that cells destined to become white fat cells can be stopped from changing by capsaicin. In cells called preadipocytes, capsaicin stopped their proliferation (dividing to become more cells) and their differentiation (changing) to become full-fledged adipocytes (fat cells). Another study (2012) showed that in liver, capsaicin could prevent the accumulation of white fat build up (called fatty liver) and could actually induce UCP protein expression in some fat cells, turning them into liver BAT. Amazing.

This all sounds fine, but the proof is in the pudding, so to speak. Capsaicin and other TRPV1 agonists have been shown to reduce white fat and total body mass in rabbits fed a high-fat/1% capsaicin diet, in mice fed a high sucrose diet, and in human patients kept cold or fed hotTomorrow I’m going to start eating hot peppers in a cold house – I’ll shrink away before your eyes.

What about on the other end of the thermometer? People freeze to death when they get too cold, and TRPV1 agonists will cool you off when too warm. No TRPV1 activity causes a reactive hyperthermia, and too much TRPV1 activity will induce a reactive hypothermia. But is there a time when inducing cold in a body with capsaicin would be a good thing?

Would we be talking about it if there weren’t an exception? It's called protective hypothermia, and it has become a very important treatment adjunct during stroke and some over conditions.


Ischemia (left) is often associated with coronary (heart) arteries.
Ischemia means a reduction in blood flow to a tissue or the whole
body. With less blood flow comes less oxygen, so tissue cells suffer.
Several mechanisms can lead to a lessening of blood flow. On the
right is hypoxia, which is often used when referring to the brain or
specific organs. Hypoxia is a reduction in oxygen to the tissues,
whether it comes from a reduction in blood flow or some other
reason, like fewer red blood cells, lower oxygen in the air, etc.
Protective hypothermia is an induced cold that is used to protect tissues from post-ischemic injury. When there is a reduction in blood (ischemia) or oxygen (hypoxia) to a tissue or organ, the cells are starved for oxygen and then become starved for ATP (you need oxygen to make ATP). With lower oxygen over time, either from low oxygen or reduced blood flow, the tissues get used to having lower oxygen levels.

Getting used to it would include down-regulating the systems that would normally combat the damage that could be caused by reactive oxygen species (ROS). Whenever oxygen is being used in tissues, ROS are an unfortunate by-product. Their name tells you that they’re reactive, which means they can react with many molecules in the cell and they will do significant damage.

When normal blood flow or oxygen perfusion is re-established, the sudden increase in O2 causes a spike in ROS (reperfusion injury) – until the cell can ramp up its antioxidant capabilities again. What medicine needs to do is find a way to increase the O2 without increasing the ROS damage.

Cold seems to do the trick. Reducing the temperature of the body reduces cell death and ROS after cardiac arrest, stroke, neonatal encephalopathy, or traumatic spinal/brain injury. Why? There have been a few ideas why.

The old hypothesis was that the lower temperature would reduce cellular metabolism, so that there is less need for O2. This would imply that the lower the temperature, the better. But very low temperatures might lead to injury or damage on their own. Also, extended cold could bring pneumonia or promote sepsis. Maybe colder isn’t always better.


There are many ways to get a perfusion injury when
oxygenation of the tissues is reestablished after hypoxia.
We talked about the free radicals (ROS) in the post. The
other injuries are a bit less obvious. We mentioned the
problems with membranes and the increase in apoptosis. 
The other two are related to spasm of the muscle cells in
the vessels which would again reduce oxygen levels, and
a nonspecific activation of coagulation and cell killing that
would lead to damage as well.
Now scientists think protective hypothermia works in a couple of different ways. Colder temperatures bring a neuroprotective effect by preventing apoptosis (programmed cell death). Less O2 means less ATP being made, and a decrease in ATP usually means that the mechanisms for maintaining proper ion movements in and out of the cell are hampered. Increased ion flux triggers apoptosis. So lower temperature brings less ion flux, less damage, and less cellular suicide.

Even a small decrease in temperature can stabilize the cell membrane independent of ATP levels. This makes sense; membranes are mostly lipid, and lower temperatures make fats stiffer – like cold butter. This will decrease ion movement across the membrane and reduce cell damage.

Lastly, decreased body temperature brings less reperfusion injury. In this case, maybe the old hypothesis was correct. Colder tissues metabolize less, so less oxygen will be needed and less ROS will be produced.

So cold is helpful, but how do you do it? You can lower the body temperature by using cooled IV fluid, cold mist in the nose, or even wrapping specific body parts in cooled blankets. But perhaps TRPV1 agonists could help cool the body from the inside.

As of early 2014, the evidence for TRPV1 agonists is only in mouse models, but it’s looking good. A study in 2011 showed the an injection of capsaicin into the abdominal cavity three hours before inducing hypoxia reduced the volume of dead tissue and the amount of apoptosis in the brains of the mice.


This is the fruit of the Evodia rutaecarpa Bentham plant. It has been
used in Chinese herbal medicine for hundreds of years. We are
starting to learn why it does what it does. It has been shown to be
an anti-cancer, anti-obesity, anti-vomiting, anti-hypertension
anti-ulcer, anti-pain drug. Five thousand years of
culture leads to good drugs like this.
Two 2013 studies added strength to the 2012 study. One experiment used a Chinese herbal medicine that contained a chemical called evodiamine. It had been known that evodiamine helped in stroke victims, but we didn’t know why. Evodiamine was shown to be a TRPV1 agonist in 2012, and the 2013 study showed that after a stroke, the agonist increased cell survival mechanisms and reduced apoptosis.

The other study from 2013 showed that capsaicin also helps in reperfusion injury. Mice were given strokes by blocking an artery in the brain and then unblocking it to replenish the blood and oxygen. Injecting capsaicin within 90 minutes of the re-establishment of blood flow produced a mild hypothermia, reduced the volume of dead tissue in the brain, and increased neural function. This didn’t occur in mice without TRPV1, so we know the capsaicin receptor was responsible. Sounds like emergency rooms are going to start stocking hot peppers.

Today we discussed interesting uses for capsaicin and its receptor in temperature-related functions. Next week, some weird functions for TRPV1 that have little or nothing to do with temperature.


Yoneshiro T, Aita S, Matsushita M, Kayahara T, Kameya T, Kawai Y, Iwanaga T, & Saito M (2013). Recruited brown adipose tissue as an antiobesity agent in humans. The Journal of clinical investigation, 123 (8), 3404-8 PMID: 23867622

Feng Z, Hai-Ning Y, Xiao-Man C, Zun-Chen W, Sheng-Rong S, & Das UN (2014). Effect of yellow capsicum extract on proliferation and differentiation of 3T3-L1 preadipocytes. Nutrition (Burbank, Los Angeles County, Calif.), 30 (3), 319-25 PMID: 24296036

Yoneshiro T, & Saito M (2013). Transient receptor potential activated brown fat thermogenesis as a target of food ingredients for obesity management. Current opinion in clinical nutrition and metabolic care, 16 (6), 625-31 PMID: 24100669

Muzzi M, Felici R, Cavone L, Gerace E, Minassi A, Appendino G, Moroni F, & Chiarugi A (2012). Ischemic neuroprotection by TRPV1 receptor-induced hypothermia. Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism, 32 (6), 978-82 PMID: 22434066

Cao Z, Balasubramanian A, & Marrelli SP (2014). Pharmacologically induced hypothermia via TRPV1 channel agonism provides neuroprotection following ischemic stroke when initiated 90 min after reperfusion. American journal of physiology. Regulatory, integrative and comparative physiology, 306 (2) PMID: 24305062


For more information or classroom activities, see:

Brown adipose tissue –

Protective hypothermia -