title: Molecular therapy of obesity and diabetes by a physiological autoregulatory approach.
abstract: 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.
authors.affiliation: Cancer Genetics and Neuroscience Program, Department of Molecular Virology, Immunology and Medical Genetics, and the Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Cao
authors.forename: En-Ju D
authors.initials: EJ
authors.lastname: Lin
authors.forename: Michael C
authors.initials: MC
authors.lastname: Cahill
authors.forename: Chuansong
authors.initials: C
authors.lastname: Wang
authors.forename: Xianglan
authors.initials: X
authors.lastname: Liu
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: During
mesh_terms: D000818:Animals; D001921:Brain / Q000502:physiology; D019208:Brain-Derived Neurotrophic Factor / Q000235:genetics* / Q000502:physiology; D003920:Diabetes Mellitus / Q000517:prevention & control*; D004195:Disease Models, Animal; D004734:Energy Metabolism; D005786:Gene Expression Regulation; D018014:Gene Transfer Techniques; D017930:Genes, Reporter; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D051379:Mice; D008822:Mice, Transgenic; D009765:Obesity / Q000150:complications / Q000517:prevention & control*; D015431:Weight Loss / Q000235:genetics
chemical_list: D019208:Brain-Derived Neurotrophic Factor