The conventional wisdom that obesity is simply a result of consuming more calories than you burn is being challenged by researchers at UT Health San Antonio. Marzieh Salehi, MD, an endocrinologist and professor of medicine, asserts that the body's complex communication network between the gut and other organs plays a crucial role in metabolic health.
The Gut-Organ Axis
Salehi's research focuses on the intricate signaling pathways initiated even before food enters the mouth. "We know that by the time that you're smelling, you're looking at the food, and then you're swallowing the food … a lot of signals being triggered, which start affecting different organs, such as muscles, fat, liver, brain," Salehi explained. This communication, or miscommunication, can significantly impact nutrient metabolism.
Studying High-Risk Populations
To further investigate these communication breakdowns, Salehi is conducting a clinical trial focusing on individuals with spinal cord injuries, a population at higher risk for obesity and diabetes. "We have preliminary data showing that they do have problems with the cross-communication. So whether it's a neural signal which is affected, or some of the gut hormones are affected, we don't know," she stated.
Semaglutide's Role
The clinical trial will assess the impact of semaglutide, the active ingredient in drugs like Ozempic and Wegovy, on blood glucose regulation in spinal cord injury patients with type 2 diabetes. While semaglutide has shown promise in treating obesity, its precise mechanism of action regarding gut-organ communication remains unclear. This study aims to shed light on this interaction, potentially paving the way for targeted therapies.
Precision Medicine for Metabolic Conditions
Salehi envisions a future where treatments are tailored to individual needs based on specific signaling abnormalities. "We could change the recipe for individual people — something we call precision medicine — depending on what signal we need to target the outcome," she said. This approach could address the diverse manifestations of metabolic disorders, such as fatty liver disease without diabetes or high glucose levels without kidney dysfunction.
Funded by a $3 million grant from the National Institutes of Health, Salehi's research has the potential to transform the understanding and treatment of obesity and diabetes, particularly in vulnerable populations.
