Adiponectin and gastric fundus: a potential target for gut-brain axis dysfunctions

Adiponectin (ADPN) is a pleiotropic hormone produced by adipose tissue involved in the control of body weight, energy expenditure, and feeding behaviors. Alongside a central effect, ADPN acts on peripheral organs such as the stomach, where it can favor gastric fundus relaxation, reinforcing central satiety signals. Notably, ADPN serum levels are dysregulated in several conditions affecting the gastrointestinal tract. Moreover, altered hormone levels coexist with disorders related to the gut–brain axis malfunctioning, that is, eating disorders and inflammatory bowel diseases. Aiming at considering the effective utility of ADPN in a wide range of clinical conditions, there is an urgent need to identify its targets, clarify its mechanism of action, and downstream effectors. In this view, the present review highlights the advancement in elucidating ADPN effects on gastric fundus, describing its ability to cause morphofunctional alterations of smooth muscle cells, affecting their excitability, contractile machinery, and motor response. This comprehensive overview also provides a critical appraisal on the potential translational applications, including the possibility to consider ADPN as a biomarker for the diagnosis and staging of different clinical conditions. Finally, this review explores the potential employment of ADPN analogues for treating disorders characterized by functional gastric disturbances or altered feeding behaviors.