Advances in pharmacotherapy for obesity

Anorectic drugs are increasingly being used in obesity to induce and/or maintain weight loss. We have focused on the development of metabolic enhancers. These compounds increase energy expenditure, which is important because weight loss is associated with metabolic re-adjustment to reduce energy output. Thus, metabolic enhancers ensure that energy expenditure is maintained when food intake is reduced. beta(3)-adrenoceptor agonists are thermogenic agents that increase energy output by stimulating heat generation. Early selective beta(3)-agonists were effective in producing weight loss in obese rats, but were largely ineffective in humans. In addition, many interacted with other types of beta receptor to produce side-effects. The development of a Chinese hamster ovary cell (CHO) transfection system, using the human beta(3)-adrenoceptor gene, resulted in potential new selective human beta(3)-agonists being identified. However, the in vitro activity of these agents does not necessarily reflect their action in vivo, due to the presence of other receptor types and G proteins in the target cells, and interactions between them. The characterization of a selective beta(3)-antagonist, SR59230A, has allowed us to examine beta(3)-agonist activity in different experimental systems. The CHO transfection system has been used to show that SR59230A is effective in blocking agonist activity against both the rat adrenoceptor, and three human beta(3)-receptor isoforms. In addition, SR59230A shows competitive inhibition of agonist activity in both rat and human model systems. This antagonist may therefore provide a pharmacological tool for the functional study of by newly identified beta(3)-receptor agonists.