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Publication : Molecular therapy of obesity and diabetes by a physiological autoregulatory approach.

First Author  Cao L Year  2009
Journal  Nat Med Volume  15
Issue  4 Pages  447-54
PubMed ID  19270710 Mgi Jnum  J:149375
Mgi Id  MGI:3848386 Doi  10.1038/nm.1933
Citation  Cao L, et al. (2009) Molecular therapy of obesity and diabetes by a physiological autoregulatory approach. Nat Med 15(4):447-54
abstractText  Hypothalamic brain-derived neurotrophic factor (BDNF) is a key element in the regulation of energy balance. Here we investigated the therapeutic efficacy of BDNF by gene transfer in mouse models of obesity and diabetes. Gene transfer of BDNF led to marked weight loss and alleviation of obesity-associated insulin resistance. To facilitate clinical translation and ensure that BDNF protein expression was appropriately decreased as weight loss progressed, thus preventing cachexia, we developed a molecular autoregulatory system involving a single recombinant adeno-associated virus vector harboring two expression cassettes, one constitutively driving BDNF and the other driving a specific microRNA targeting BDNF. The microRNA element was controlled by a promoter (that controlling the Agrp gene encoding agouti-related peptide) responsive to BDNF-induced physiological changes. Hence, as body weight decreased and agouti-related protein is induced, microRNA expression was activated, inhibiting transgene expression. In contrast to the progressive weight loss associated with a nonregulated approach, this microRNA-approach led to a sustainable plateau of body weight after notable weight loss was achieved. This strategy mimics the body's endogenous physiological feedback mechanisms, thereby resetting the hypothalamic set point to reverse obesity and metabolic syndrome.
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