ARTICLE
ocl.2011.0399
Auteur(s) : Claire-Marie Vacher claire-marie.vacher@u-psud.fr,
Odile Couvreur, Elsa Basire, Alain Aubourg, Delphine Crépin,
Flavien Berthou, Nicolas Vicaire, Mohammed Taouis
Laboratoire de Neuroendocrinologie Moléculaire de la Prise
Alimentaire,
Centre de Neurosciences Paris Sud (CNPS),
UMR 8195,
CNRS,
Université Paris Sud,
Faculté des Sciences d’Orsay,
F-91405 Orsay,
France
Obesity is a chronic, metabolic disease of complex and multiple
causes leading to an imbalance between energy intake and output,
and to the accumulation of large amounts of body fat. It is caused
by inherited as well as acquired factors, including excessive food
intake, sedentary lifestyle and unhealthy eating habits. During the
past 20 years, obesity among adults has risen significantly with
urbanization, economic development and market globalization.
According to the World Health Organization (WHO) statements, more
than one billion people worldwide are overweight or suffer from
obesity, and the number of affected children has more than doubled
since 1980 in the USA and Europe. In France, the latest data from
Roche show that overweighting and obesity affect, respectively,
more than 30% and 14.5% of adults (ObEpi-Roche, 2009). But far more
worrying are the increasing and acceleration of this problem into
developing countries and, based on current trends, it is predicted
that the levels of obesity will continue to rise unless action is
taken now (McLellan, 2002). The consequences of obesity for adults
are well known. Obesity contributes to the development of many
diseases, including diabetes, hypertension, dyslipidemia (for
instance, high total cholesterol or high levels of triglycerides),
stroke, cardiovascular disease, and some cancers (Abelson and
Kennedy, 2004). As a result, the obesity epidemic has prompted
important efforts to develop safe and potent therapies. However,
currently approved drugs for obesity such as appetite suppressants
have limited efficacy and act acutely, with patients rapidly
regaining weight after the cessation of treatment. The
neurocytokine ciliary neurotrophic factor (CNTF) seems to deviate
from this paradigm since its administration to rodents or patients
maintains lowered body weights several weeks after terminating
treatment (Lambert et al., 2001).
CNTF is a 200-amino acid cytokine that belongs to the IL-6
family. It is expressed in both the peripheral and the central
nervous systems by neuronal and glial cells. Originally, CNTF was
shown to promote the survival of ciliary ganglion neurons (Barbin
et al., 1984; Helfand et al., 1976) and to play a
major role in the adult nervous system's early response to lesions.
Today, we know that its spectrum of functions is much broader since
it includes the differentiation and/or survival of a variety of
nervous cells such as motor neurons, oligodendrocytes and
astrocytes (Hughes et al., 1988; Mayer et al., 1994;
Sendtner et al., 1992). In an initial clinical trial
designed to test the efficacy of a CNTF analogue
(Axokine®, Regeneron Pharmaceuticals, Tarrytown, NY) in
the treatment of amyotrophic lateral sclerosis, a degenerative
motor neuron disease, some patients suffered a substantial weight
loss (Miller et al., 1996a; Miller et al., 1996b).
Since then the mechanisms by which CNTF induces weight loss have
been deciphered using animal models: CNTF mimics the ability of
leptin to reduce food intake and to induce fat loss.
Indeed, similar to leptin, an adipocyte-secreted cytokine well
known for its role in the long-term homeostasis of body weight,
CNTF reduces appetite and body fat by providing a signal of energy
intake and energy stores in the body to the arcuate nucleus (ARC)
of the hypothalamus, a nucleus involved in hunger control (Markus,
2005). Adjacent to the third ventricle and to the median eminence,
the ARC is ideally located to be a putative brain sensor of factors
circulating in the blood and the cerebrospinal fluid. Notably, ARC
integrates changes in circulating levels of nutrients and hormones
such as leptin and insulin to respond to the energy body
requirements (Schwartz, 2000). The ARC contains two main neuronal
populations that exert contrary effects on energy balance.
Neuropeptide Y (NPY)-producing neurons stimulate while
pro-opiomelanocortin (POMC)-synthesizing neurons inhibit appetite.
In rats, the anorexigenic action of exogenous CNTF has been
associated to a decrease in NPY gene expression (Xu et al.,
1998) and to an increase in POMC transcription (Ambati et
al., 2007). Interestingly, the chronic administration of CNTF
causes a decrease in food intake and body weight without inducing a
rebound effect at the cessation of treatment, usually observed
after a sustained reduction in caloric intake. This effect has been
attributed to a resensitization of the ARC to leptin due to a
CNTF-induced neurogenesis (Kokoeva et al., 2005).
Efforts to understand the mechanisms of action of CNTF in the
nervous system have led to the identification of a three-component
receptor complex for this cytokine. CNTF first binds to its
specific CNTF receptor (CNTFRα), which does not play a direct role
in signal transduction (Davis et al., 1993a). CNTFRα exists
in two forms, membrane bound and soluble. The glycosyl
phosphatidylinositol linkage of CNTFRα to the cell membrane can be
cleaved by phospholipases releasing CNTFRα to act as a soluble
protein (Taga et al., 1989). Then, binding of CNTF to the
membrane-bound or soluble CNTFRα induces heterodimerisation of the
“β” components of the receptor complex, gp130 and LIF receptor β
(LIFRβ), which trigger intracellular signaling cascades (Davis
et al., 1993b). The β components of CNTF receptor complex
are preassociated in an inactive state with the cytoplasmic Jak/Tyk
tyrosine kinases. The β component dimerisation initiates the
activation of mitogen-activated protein kinase/extracellular
signal-regulated kinase (MAPK/ERK) and Jak/Tyk kinases, which, in
turn, phosphorylate the signal transducer and activator of
transcription 3 (STAT3). In this condition, phospho-STAT3 forms a
dimer that translocates to the nucleus where it activates the
transcription of target genes (Stahl and Yancopoulos, 1993). The
activation of this signaling pathway by CNTF is negatively
modulated by the suppressor of cytokine signaling (SOCS) family of
proteins (Bjorbaek et al., 1999). Thus, in rodents, CNTF
shares signaling cascades with leptin in the ARC. More interesting
is the fact that CNTF, which signals through leptin-like pathways,
has been shown to bypass leptin resistance in diet-induced obesity
model, a more representative model of human obesity (Gloaguen et
al., 1997; Munzberg et al., 2005). We have shown that
leptin but not CNTF is able to induce protein-tyrosine
phosphatase-1B (PTP-1B) expression. In addition, and contrary to
leptin, CNTF signaling was not affected by PTP-1B over-expression,
suggesting that PTP-1B is a key divergent element between CNTF and
leptin signaling pathways. This may at least partially explain the
efficacy of CNTF administration to reduce food intake and body
weight in leptin resistant state (Benomar et al., 2009).
It is noteworthy that CNTF is highly expressed both in neurons
and astrocytes of the hypothalamic nuclei that regulate energy
balance, including the POMC anorexigenic neurons located in the
ARC. To test the hypothesis of a relationship between the
hypothalamic expression of CNTF and the control of energy
homeostasis, the influence of a 6-week high-sucrose diet was
studied on CNTF levels in the hypothalamus and the ARC in rats
(Vacher et al., 2008). The high-sucrose diet induces a
2-fold increase in CNTF hypothalamic levels compared to control.
Interestingly, while no association is observed between CNTF
hypothalamic levels and body weight in control animals, a
significant inverse correlation appears in rats fed the
high-sucrose diet (figure 1).
Indeed, in these conditions, animals with lower body weight exhibit
higher amounts of CNTF in the hypothalamus. The variations in
protein contents parallel those of mRNA levels. Moreover, the
increase in CNTF expression is specific to the ARC, as evidenced by
an immunohistochemical analysis. Thus, CNTF may be considered as an
endogenous modulator of energy homeostasis in the ARC that possibly
contributes to the protection of some individuals against diet
induced weight gain. CNTF could account for individual differences
in the susceptibility to obesity. Genetic polymorphisms studies
corroborate the involvement of endogenous CNTF in the control of
body weight. Indeed, it has been found that a null mutation in CNTF
gene is associated with a significant increase in body mass in
humans (Heidema et al., 2010; O’Dell et al., 2002),
and that variants in CNTF or CNTFRα gene in humans are associated
to lower age at onset of eating disorders (Gratacos et al.,
2010).
The anorexigenic properties of exogenous and endogenous CNTF
have conferred to this cytokine a promising therapeutic potential
in the treatment of obesity. However, the comprehension of the
physiological significance of neural CNTF action is still
incomplete because CNTF lacks a signal peptide (Sendtner et
al., 1994), and thus may not be secreted by the classical
exocytosis pathways. We have previously shown that CNTF
distribution shares similarities with that of its receptor subunits
in the rat ARC. Indeed, a majority of neurons and astrocytes
express both CNTF and CNTFRα, and both β components of the receptor
are ubiquitous in the rat ARC (figure 2)
(Vacher et al., 2008). Thus, as previously envisaged in cell
culture (Monville et al., 2002), a direct intracellular
action may constitute a plausible mechanism of CNTF action. The
involvement of such a process in the protective action of
endogenous CNTF against diet-induced weight gain deserves further
investigation. Nevertheless, these data could influence future drug
discovery efforts for the development of new therapeutic targets
against obesity.
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