Central inhibition of HDAC6 re-sensitizes leptin signaling during obesity to induce profound weight loss

Leptin resistance during excess weight gain significantly contributes to the recidivism of obesity to leptin-based pharmacological therapies. The mechanisms underlying the inhibition of leptin receptor (LepR) signaling during obesity are still elusive. Here, we report that histone deacetylase 6 (HDAC6) interacts with LepR, reducing the latter’s activity, and that pharmacological inhibition of HDAC6 activity disrupts this interaction and augments leptin signaling. Treatment of diet-induced obese mice with blood-brain barrier (BBB)-permeable HDAC6 inhibitors profoundly reduces food intake and leads to potent weight loss without affecting the muscle mass. Genetic depletion of Hdac6 in Agouti-related protein (AgRP)-expressing neurons or administration with BBB-impermeable HDAC6 inhibitors results in a lack of such anti-obesity effect. Together, these findings represent the first report describing a mechanistically validated and pharmaceutically tractable therapeutic approach to directly increase LepR activity as well as identifying centrally but not peripherally acting HDAC6 inhibitors as potent leptin sensitizers and anti-obesity agents. [Display omitted] •HDAC6 interacts with leptin receptor (LepR), deacetylates, and reduces its activity•BBB-permeable HDAC6 inhibitors act as anti-obesity agents through increasing leptin sensitivity•AgRPARC neurons are the direct target of HDAC6 inhibitor’s anti-obesity effect Guan et al. in this study document that HDAC6 can directly bind and deacetylate leptin receptor and reduce its activity. BBB-permeable HDAC6-specific inhibitors overcome leptin resistance by directly targeting LepR-HDAC6 interaction in AgRPARC neurons, which leads to a profound reduction in appetite and potent and durable weight loss.