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Neurokinin B (NKB) is an endogenous hypothalamic neuropeptide belonging to the tachykinin family. It serves as a critical regulator of the reproductive endocrine axis by stimulating the pulsatile secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus. This action is mediated primarily through the neurokinin 3 receptor (NK3R), which is encoded by the TACR3 gene. NKB is currently utilized as an investigational biologic in mechanistic clinical trials, notably at Imperial College London, to evaluate its acute effects on the reproductive axis and metabolic parameters in individuals with conditions such as type 2 diabetes mellitus and hypogonadotrophic hypogonadism. Beyond its role in reproduction, NKB signaling in the hypothalamic thermoregulatory center is implicated in the pathophysiology of menopausal hot flashes, making the NKB/NK3R pathway a significant target for therapeutic antagonism in vasomotor symptoms, polycystic ovary syndrome, and endometriosis.
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