Uniting GDF15 and GFRAL: Therapeutic Opportunities in Obesity and Beyond
Abstract
Growth differentiation factor-15 (GDF15) is a circulating protein that has been implicated in multiple biological processes, including energy homeostasis, body weight regulation, and cachexia driven by cancer and chronic disease. The potential to target GDF15 in the treatment of energy-intake disorders, including obesity and anorexia, is an area of intense investigation, but has been limited by the lack of an identified receptor, signaling mechanism, and target tissue. GDNF family receptor α-like (GFRAL) was recently identified as the neuronal brainstem receptor responsible for mediating the anorectic actions of GDF15. Herein, we provide a brief overview of GDF15 biology with a focus on energy homeostasis, and highlight the implications of the recent receptor identification to this field and beyond.
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Activation of GFRAL in the brain leads to activation of a neuronal network involving the nucleus of the solitary tract, the hypothalamus, and the central amygdala, reducing food intake and appetite.
“In the brain, activation of the GFRAL receptor leads to a complex activation of a neuronal network involving the nucleus of the solitary tract, the hypothalamus, and the central amygdala, reducing food intake and appetite ( Figure 1 ) (96).”
From GDF-15 as a Weight Watcher for Diabetic and Non-Diabetic People Treated With Metformin (2020) · cites this paper as [96]
GDF15 binds with high affinity to GFRAL and its co-receptor RET, inducing phosphorylation of RET and downstream signaling through AKT, ERK1/2, and PLCγ pathways.
“GDF15 binds with high affinity to GFRAL and its co-receptor RET, which induces phosphorylation of RET, leading to downstream signaling through the AKT, ERK1/2, and phospholipase C (PLCγ) pathways [201,213,215].”
From Hepatokines and metabolism: Deciphering communication from the liver (2021) · cites this paper as [201]
GFRAL is exclusively expressed in the human brainstem and is responsible for the metabolic effects of GDF15 on regulating appetite.
“GFRAL is exclusively expressed in the human brainstem and is responsible for the metabolic effects of GDF15 on regulating appetite [201,215].”
From Hepatokines and metabolism: Deciphering communication from the liver (2021) · cites this paper as [201]
Administration of GDF15 to wild-type mice produced responses similar to transgenic mice, but these mice exhibited consistent reduction in food intake.
“Conversely, administration of GDF15 to wild-type mice produced responses similar to those in transgenic mice; however, these mice exhibited consistent reduction in food intake [201,213].”
From Hepatokines and metabolism: Deciphering communication from the liver (2021) · cites this paper as [201]
GDF15 is associated with numerous biological processes and diseases including cancer, cardiovascular disease, and obesity.
“Growth differentiation factor 15 (GDF15), also called macrophage inhibitory cytokine-1, is associated with numerous biological processes and diseases including cancer, cardiovascular disease, and obesity [[199], [200], [201], [202]].”
From Hepatokines and metabolism: Deciphering communication from the liver (2021) · cites this paper as [201]
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Zimmers, T. A., Gutierrez, J. C., & Koniaris, L. G. (2009) · Journal of Cancer Research and Clinical Oncology · doi:10.1007/s00432-009-0691-4 · Cited by 43 · see citing works
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GDF15—From Biomarker to Allostatic Hormone
O’Rahilly, S. (2017) · Cell Metabolism · doi:10.1016/j.cmet.2017.10.017 · Cited by 43 · see citing works
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Growth/differentiation factor-15 and its role in peripheral nervous system lesion and regeneration
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Loss of neurturin in frog—Comparative genomics study of GDNF family ligand-receptor pairs
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CXXC4 activates apoptosis through up-regulating GDF15 in gastric cancer
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Degradation Paradigm of the Gut Hormone, Pancreatic Polypeptide, by Hepatic and Renal Peptidases
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GDF15 Provides an Endocrine Signal of Nutritional Stress in Mice and Humans
Patel, S., Alvarez-Guaita, A., Melvin, A., Rimmington, D., Dattilo, A., Miedzybrodzka, E. L., Cimino, I., Maurin, A.-C., Roberts, G. P., Meek, C. L., et al. (2019) · Cell Metabolism · doi:10.1016/j.cmet.2018.12.016 · Cited by 509 · see citing works
Growth/Differentiation Factor-15 (GDF-15): From Biomarker to Novel Targetable Immune Checkpoint
Wischhusen, J., Melero, I., & Fridman, W. H. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.00951 · Cited by 506 · see citing works
GDF15 induces anorexia through nausea and emesis
Borner, T., Shaulson, E. D., Ghidewon, M. Y., Barnett, A. B., Horn, C. C., Doyle, R. P., Grill, H. J., Hayes, M. R., & De Jonghe, B. C. (2020) · Cell Metabolism · doi:10.1016/j.cmet.2019.12.004 · Cited by 255 · see citing works
Hepatokines and metabolism: Deciphering communication from the liver
Jensen-Cody, S. O., & Potthoff, M. J. (2021) · Molecular Metabolism · doi:10.1016/j.molmet.2020.101138 · Cited by 252 · see citing works
Baek, S. J., & Eling, T. (2019) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2019.02.008 · Cited by 194 · see citing works
Benichou, O., Coskun, T., Gonciarz, M. D., Garhyan, P., Adams, A. C., Du, Y., Dunbar, J. D., Martin, J. A., Mather, K. J., Pickard, R. T., et al. (2023) · Cell Metabolism · doi:10.1016/j.cmet.2022.12.011 · Cited by 115 · see citing works
Li, M., Duan, L., Cai, Y.-L., Li, H.-Y., Hao, B.-C., Chen, J.-Q., & Liu, H.-B. (2020) · Cardiovascular Diabetology · doi:10.1186/s12933-020-01092-7 · Cited by 71 · see citing works
GDF-15 as a Weight Watcher for Diabetic and Non-Diabetic People Treated With Metformin
Ouyang, J., Isnard, S., Lin, J., Fombuena, B., Peng, X., Chen, Y., & Routy, J.-P. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.581839 · Cited by 39 · see citing works
- Authors
- Mullican, S. E., & Rangwala, S. M.
- Corresponding author
- Rangwala, Shamina M.
- ORCID
- Mullican, Shannon E.
- Venue
- Trends in Endocrinology & Metabolism
- Publisher
- Elsevier BV
- Published
- 2018-08
- Volume
- 29
- Issue
- 8
- Pages
- 560-570
- ISSN
- 1043-2760 (ISSN-L)
- OpenAlex
- W2805288114
- Cited by
- 127
- References
- 88
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 10 · 2023: 18 · 2022: 18 · 2021: 16 · 2020: 30 · 2019: 18 · 2018: 2
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Trends in Endocrinology and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › GDF15 and Related Biomarkers
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fibroblast Growth Factor Research
- Keywords
- GDF15, GFRAL, growth differentiation factor 15, obesity, anorexia, energy homeostasis, appetite regulation, receptor identification, cachexia, brainstem, therapeutic target
- MeSH terms
- Animals, Anorexia, Humans, Obesity, Glial Cell Line-Derived Neurotrophic Factor Receptors, Growth Differentiation Factor 15
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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