Mitochondrial uncoupling as a target in the treatment of obesity

PURPOSE OF REVIEW: Obesity is associated with many health problems and its prevalence is rapidly increasing worldwide. Very few pharmaceutical compounds are available for obesity treatment. Strategies for the development of compounds can be targeted to the outcomes of reduced dietary energy intake and/or increased energy expenditure/thermogenesis. In this review, we focus on recent discoveries that advance our understanding of mitochondrial uncoupling as a target for the treatment of obesity. There are various mechanisms whereby uncoupling can occur and for the purpose of this review, we elaborate upon the uncoupling that can occur (1) through the original uncoupling protein, UCP1, in brown adipocytes, or in 'converted' white adipose tissue, and (2) in skeletal muscle. RECENT FINDINGS: Studies have identified a number of novel receptors and regulatory proteins involved in the emergence of brown adipocytes in white adipose tissue. Molecular and pharmacologic approaches in knockout and transgenic mice have demonstrated their relevance to obesity treatment. Recent research into uncoupling mechanisms in skeletal muscle indicates that uncoupling can occur through basal and inducible processes. SUMMARY: Uncoupling is a naturally occurring phenomenon whose underlying mechanisms require substantial further study for the development of antiobesity therapies.