The supraclavicular fossa is the dominant location for human brown adipose tissue (BAT). Activation of BAT promotes non-shivering thermogenesis by utilization of glucose and free fatty acids and has been the focus of pharmacological and non-pharmacological approaches for modulation in order to improve body weight and glucose homeostasis. Sympathetic neural control of supraclavicular BAT has received much attention, but its innervation has not been extensively investigated in humans. Dissection of the cervical region in human cadavers was performed to find the distribution of sympathetic nerve branches to supraclavicular fat pad. Furthermore, proximal segments of the 4th cervical nerve were evaluated histologically to assess its sympathetic components. Nerve branches terminating in supraclavicular fat pad were identified in all dissections, including those from the 3rd and 4th cervical nerves and from the cervical sympathetic plexus. Histology of the proximal segments of the 4th cervical nerves confirmed tyrosine hydroxylase positive thin nerve fibers in all fascicles with either a scattered or clustered distribution pattern. The scattered pattern was more predominant than the clustered pattern (80% vs. 20%) across cadavers. These sympathetic nerve fibers occupied only 2.48% of the nerve cross sectional area on average. Human sympathetic nerves use multiple pathways to innervate the supraclavicular fat pad. The present finding serves as a framework for future clinical approaches to activate human BAT in the supraclavicular region.
La fossa sopraclaveare è la sede dominante del tessuto adiposo bruno umano (BAT). L'attivazione del BAT promuove la termogenesi senza brivido mediante l'utilizzo di glucosio e acidi grassi liberi ed è stata al centro di approcci farmacologici e non farmacologici per la modulazione al fine di regolare il peso corporeo e l'omeostasi del glucosio. Il controllo del sistema nervoso simpatico del BAT sopraclaveare ha ricevuto molta attenzione, ma la sua innervazione non è stata ampiamente studiata negli esseri umani. È stata eseguita la dissezione della regione cervicale in cadaveri umani per trovare la distribuzione dei rami dei nervi simpatici al cuscinetto adiposo sopraclaveare. Inoltre, i segmenti prossimali del 4 ° nervo cervicale sono stati valutati istologicamente per descrivere le sue componenti simpatiche. Rami nervosi che terminano nel cuscinetto adiposo sopraclaveare sono stati identificati in tutte le dissezioni, comprese quelle del 3 ° e 4 ° nervo cervicale e del plesso simpatico cervicale. L'istologia dei segmenti prossimali del 4 ° nervo cervicale ha confermato fibre nervose sottili positive alla tirosina idrossilasi in tutti i fascicoli con un modello di distribuzione sparso o raggruppato. Il modello sparso era predominante (80% contro 20%) nei cadaveri. Queste fibre nervose simpatiche occupavano in media solo il 2,48% dell'area trasversale del nervo. I nervi simpatici umani utilizzano percorsi multipli per innervare il cuscinetto adiposo sopraclaveare. La presente scoperta serve da quadro per futuri approcci clinici per attivare il BAT umano nella regione sopraclaveare.
Innervazione simpatica del tessuto adiposo bruno sopraclavicolare: uno studio anatomico dettagliato.
GATTI, ALESSANDRO
2023/2024
Abstract
The supraclavicular fossa is the dominant location for human brown adipose tissue (BAT). Activation of BAT promotes non-shivering thermogenesis by utilization of glucose and free fatty acids and has been the focus of pharmacological and non-pharmacological approaches for modulation in order to improve body weight and glucose homeostasis. Sympathetic neural control of supraclavicular BAT has received much attention, but its innervation has not been extensively investigated in humans. Dissection of the cervical region in human cadavers was performed to find the distribution of sympathetic nerve branches to supraclavicular fat pad. Furthermore, proximal segments of the 4th cervical nerve were evaluated histologically to assess its sympathetic components. Nerve branches terminating in supraclavicular fat pad were identified in all dissections, including those from the 3rd and 4th cervical nerves and from the cervical sympathetic plexus. Histology of the proximal segments of the 4th cervical nerves confirmed tyrosine hydroxylase positive thin nerve fibers in all fascicles with either a scattered or clustered distribution pattern. The scattered pattern was more predominant than the clustered pattern (80% vs. 20%) across cadavers. These sympathetic nerve fibers occupied only 2.48% of the nerve cross sectional area on average. Human sympathetic nerves use multiple pathways to innervate the supraclavicular fat pad. The present finding serves as a framework for future clinical approaches to activate human BAT in the supraclavicular region.| File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/18172