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. 2021 Mar 31:2:100080.
doi: 10.1016/j.endmts.2021.100080. Epub 2021 Jan 20.

Targeting the G protein-coupled estrogen receptor (GPER) in obesity and diabetes

Affiliations

Targeting the G protein-coupled estrogen receptor (GPER) in obesity and diabetes

Geetanjali Sharma et al. Endocr Metab Sci. .

Abstract

Obesity has become a global epidemic in the modern world with the numbers of obese individuals having risen at alarming rates in the last decades. Obesity represents a serious medical condition that can lead to multiple complications, such as diabetes, dyslipidemia, cardiovascular disease including hypertension and atherosclerosis, stroke and increases in the risk of many types of cancer. Very few effective options exist to treat obesity, with many removed from the market due to associated complications. Obesity and metabolic syndrome display a sexual dichotomy, with (premenopausal) females displaying protection from weight gain and metabolic dysfunction compared to men. These beneficial effects are generally attributed to a class of female ovarian hormone, estrogens, which exert pleiotropic effects in multiple metabolic tissues, such as adipose, skeletal muscle, liver and pancreas. Multiple receptors mediate the actions of estrogens, including the classical nuclear estrogen receptors (ER α and ER β) and the G protein-coupled estrogen receptor (GPER). While the roles of nuclear ERs are more established, evidence of GPER function in metabolic homeostasis is still emerging. In this review, we will discuss the latest advances concerning the contributions of GPER towards obesity and metabolism utilizing GPER-selective pharmacological (agonists or antagonists) or genetic (GPER knock out mice or cells) tools. We present evidence that GPER regulates body weight, fat distribution, inflammation and glucose and lipid homeostasis via effects on metabolic tissues. Selective agonism of GPER by its agonist G-1 can alleviate symptoms of obesity and metabolic dysfunction in multiple murine models, thereby limiting weight gain, reducing insulin resistance and inflammation and improving glucose and lipid homeostasis in vivo. Thus, GPER represents a novel therapeutic target, with G-1 a first-in-class therapeutic agent, to treat obesity and its associated comorbidities, including diabetes.

Keywords: Estrogen; GPER; diabetes; inflammation; metabolism; obesity.

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Conflict of interest statement

Declaration of interests The authors declare that they have competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Competing interests The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. E.R.P. is an inventor on U.S. Patent Nos. 10,251,870, 10,561,648 and 10,682,341 and G.S. and E.R.P. are inventors on U.S. patent No. 10,471,047, all for the therapeutic use of compounds targeting GPER (“Method for treating obesity, diabetes, cardiovascular and kidney diseases by regulating GPR30/GPER”). E.R.P. is an inventor on U.S. Patent Nos. 7,875,721 and 8,487,100 for GPER-selective ligands and imaging agents (“Compounds for binding to ER α/ β and GPR30, methods of treating disease states and conditions mediated through these receptors and identification thereof”).

Figures

Figure 1.
Figure 1.
Schematic representation of the proposed effects of GPER activation on body weight and glucose homeostasis. In this model, GPER activation promotes thermogenesis in BAT and fatty acid oxidation in BAT and WAT. BAT stimulated by the sympathetic nervous system promotes thermogenesis. With GPER activation, WAT exhibits smaller adipocytes, likely due to decreased hypoxia and inflammation, resulting in improved insulin sensitivity. Increased fatty acid oxidation coupled with attenuated inflammation upon stimulation of GPER improves skeletal muscle, pancreatic and liver function with improved pancreatic β-cell survival and insulin secretion, resulting in lower fasting glucose and insulin levels, thereby restoring glucose homeostasis. Increased thermogenesis and fat oxidation, with a concomitant decrease in glucose and insulin levels, result in a reduction in body weight. Body weight and glucose homeostasis in turn regulate by each other. Red arrows denote reductions, whereas green arrows depict increases upon GPER stimulation. See text for additional details

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