AgRP together with NPY represent a distinct set of ARC-expressed orexigenic peptides. AgRP is classically referred to as a member of the central melanocortin system, which in addition to AgRP comprises α-melanocyte stimulating hormone, α-MSH (see below for description of α-MSH actions) and two melanocortin receptors identified as melanocortin receptor-3 (MC3R) and melanocortin receptor-4 (MC4R). Whereas, α-MSH is an agonist of both MC3R and MC4R, AgRP serves to antagonize the actions of α-MSH at these same receptors with highest antagonist activity on MC4R. In addition to antagonizing the effect of α-MSH at the MC3R and MC4R, AgRP suppresses the basal activity of the MC4R, thus defining AgRP as an inverse agonist.
I had the tummy tuck a year after my take down surgery. I was told by a wound care nurse that sometimes when you get older you have to revert back to the illeostomy. One of the best things I ever did, self esteem wise and I think if I do have to revert back, I won’t have the significant skin problems I had with the stoma and bag. Weight loss and sagging skin unfortunately causes the ostomy bags to not adhere properly. I had to lose an addtional 50 pounds to promote a successful J pouch surgery. I haven’t had pouchitis in the past 7 years (take down done in 2003 at 49 years old), used 6 immodium up until recently which helped, don’t eat much dairy. I have started taking Methotrexate for enteropathic arthritis. Turns out UC perpetuates arthritis or goes along with other auto-immune conditions (I have Hashimoto’s). It was tough going through the surgeries but somehow you find strength knowing that you will be able to live a somewhat altered “normal” lifestyle with some adjustments in diet. I will say that you have to relinguish some of the “control freak” and realize you can’t sweat the small stuff because most of it isn’t a priority. Good luck.