Orexin-A

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Orexin-A‏‎ is a type of neuropeptide that plays a significant role in regulating sleep-wake cycles, appetite, and energy homeostasis. It is one of the two orexin peptides, the other being Orexin-B‏‎. Both are produced in the hypothalamus, a region of the brain that controls many bodily functions.

Structure and Function

Orexin-A‏‎ is a 33-amino acid peptide that is highly conserved across species. It is produced by the prepro-orexin gene, which also produces Orexin-B‏‎. The orexin system consists of these two peptides and two G-protein coupled receptors, OX1R and OX2R. Orexin-A‏‎ has equal affinity for both receptors, while Orexin-B‏‎ preferentially binds to OX2R.

Orexin-A‏‎ and Orexin-B‏‎ are primarily produced by neurons in the lateral hypothalamus. These neurons project widely throughout the brain, allowing the orexins to regulate a variety of functions. The orexins are particularly important for maintaining wakefulness; loss of orexin-producing neurons is a cause of the sleep disorder narcolepsy.

Role in Sleep-Wake Regulation

Orexin-A‏‎ plays a crucial role in the regulation of the sleep-wake cycle. It promotes wakefulness and inhibits REM sleep. In individuals with narcolepsy, a disorder characterized by excessive daytime sleepiness and cataplexy, there is a loss of orexin-producing neurons in the hypothalamus. This loss is thought to be the primary cause of the symptoms of narcolepsy.

Role in Appetite and Energy Homeostasis

In addition to its role in sleep regulation, Orexin-A‏‎ also regulates appetite and energy homeostasis. It stimulates food intake and increases energy expenditure, contributing to the regulation of body weight. Orexin-A‏‎'s role in energy homeostasis is thought to be mediated through its effects on the autonomic nervous system.

Clinical Significance

Given its role in sleep and energy homeostasis, Orexin-A‏‎ is a potential target for the treatment of disorders such as narcolepsy, insomnia, and obesity. Several drugs that target the orexin system are currently in development or in clinical trials.

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Contributors: Prab R. Tumpati, MD