Although β
3-adrenoceptor (β
3AR) agonists have not become drugs for the treatment of obesity or diabetes, they offer perspectives on obesity drug discovery,
the physiology of energy expenditure and receptor pharmacology. β
3AR agonists, some of which also stimulate other βARs in humans, selectively stimulate fat oxidation in rodents and humans.
This appears to be why they improve insulin sensitivity and reduce body fat whilst preserving lean body mass. Regulatory authorities
ask that novel anti-obesity drugs improve insulin sensitivity and reduce mainly body fat. Drugs that act on different targets
to stimulate fat oxidation may also offer these benefits. Stimulation of energy expenditure may be easy to detect only when
the sympathetic nervous system is activated. Leptin resembles β
3AR agonists in that it increases fat oxidation, energy expenditure and insulin sensitivity. This is partly because it raises
sympathetic activity, but it may also promote fat oxidation by directly stimulating muscle leptin receptors. The β
1AR and β
2AR can, like the β
3AR, display atypical pharmacologies. Moreover, the β
3AR can display variable pharmacologies of its own, depending on the radioligand used in binding studies or the functional
response measured. Studies on the β
3AR demonstrate both the difficulties of predicting the in vivo effects of agonist drugs from in vitro data and that there
may be opportunities for identifying drugs that act at a single receptor but have different profiles in vivo.
Keywords β3-adrenoceptor agonist - Atypical β-adrenoceptor - Leptin - Energy expenditure - Fat oxidation - Obesity drug - Insulin sensitivity - Ligand-directed signalling
This article is dedicated to Professor Hans Zaagsma in recognition of his contribution to the discovery of the β3-adrenoceptor.