Aims/hypothesis: Age-related obesity is associated with impaired hypothalamic pro-opiomelanocortin (Pomc) gene expression. We assessed whether overproduction of POMC in the hypothalamus ameliorates age-related obesity in rats. Methods: Recombinant adeno-associated virus (rAAV) encoding Pomc (rAAV-Pomc) or control vector was delivered bilaterally into the basomedial hypothalamus of aged obese rats with coordinates targeting the arcuate nucleus. Energy balance, glucose metabolism, brown adipose tissue thermogenesis and mRNA levels of hypothalamic neuropeptides and melanocortin receptors were assessed. Results: Forty-two days after Pomc gene delivery, hypothalamic Pomc expression increased 12-fold while agouti-related protein and neuropeptide Y mRNA levels remained unchanged. Using a punch technique, we detected the highest Pomc RNA level in the arcuate nucleus. Pomc overexpression reduced food consumption from day 10 after vector injection, but this anorexic effect abated by day 30. In contrast, there was a steady decrease in body weight without apparent attenuation. Pomc gene delivery decreased visceral adiposity and induced uncoupling protein 1 in brown adipose tissue in aged rats. Serum NEFA and triglyceride levels were also diminished by rAAV-Pomc treatment. Improved glucose metabolism and insulin sensitivity were observed on day 36 but not day 20 after Pomc gene delivery. The expression of hypothalamic melanocortin 3 and 4 receptor decreased by 17% and 25%, respectively in rAAV-Pomc rats. Conclusions/ interpretation: This study demonstrates that targeted Pomc gene therapy in the hypothalamus reduces body weight and visceral adiposity, and improves glucose and fat metabolism in aged obese rats. Thus long-term activation of the central melanocortin system may be a viable strategy to combat age-related obesity and diabetes.

Aims/hypothesis Central pro-opiomelanocortin (Pomc) gene therapy ameliorates genetic-or age-related obesity. We hypothesised that this treatment would delay or prevent dietary obesity in young, lean rats. Materials and methods Recombinant adeno-associated virus encoding Pomc (rAAV-Pomc) was delivered bilaterally into the basomedial hypothalamus of lean rats for 42 days. Food intake, body weight, serum hormones, brown adipose tissue (BAT) uncoupling protein 1 (UCP1) and mRNA levels of hypothalamic neuropeptides and melanocortin receptors were assessed. Beginning on day 43, half of the rats remained on chow while the others received a high-fat diet for 89 days. We examined energy balance and responsiveness to the melanocortin agonist melanotan II (MTII) or the antagonist SHU9119. Results Pomc gene delivery produced elevated hypothalamic Pomc mRNA (fourfold) and α-melanocyte-stimulating hormone levels in the arcuate nucleus (twofold). Food intake and body weight were not altered by rAAV-Pomc in rats fed standard-chow. In rAAV-Pomc rats at day 42, perirenal fat and serum leptin decreased but overall visceral adiposity did not; expression of the hypothalamic agouti-related protein (Agrp) mRNA was elevated, whereas expression of melanocortin 3 and 4 receptor mRNA was reduced; BAT UCP1 protein increased nearly fourfold. The rAAV-Pomc rats fed the high-fat diet consumed more energy and gained more body weight compared with chow-or high-fat-fed controls that did not receive Pomc gene delivery. The anorexic response to MTII was impaired, whereas the orexigenic effect of SHU9119 was enhanced by rAAV-Pomc pretreatment. Conclusions/interpretation Delivery of the Pomc gene alters energy homeostasis in lean rats, predisposing them to dietinduced obesity. Diminished hypothalamic melanocortin receptors, increased Agrp expression, and potential rewiring of brain circuits may underlie the exacerbated obesity.

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