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Growth differentiation factor 15 (GDF15), an atypical member of the TGF-β superfamily, is a cellular stress-induced cytokine involved in mitochondrial stress and the unfolded protein response (UPR). Plasma GDF15 levels are increased in a wide range of diseases, such as cancer, inflammation, cardiovascular disease, and during dysregulation of energy homeostasis. GDF15 is therefore currently considered as a biomarker predicting adverse disease outcomes but also as a target to treat metabolic disorders or cancer-induced cachexia. Indeed, body weight and food intake were reduced in obese mice and monkeys overexpressing GDF15 or administered long-acting recombinant GDF15. Neutralization of GDF15 or its receptor with a monoclonal antibody improved cancer or chemotherapy-induced anorexia and weight loss in mice and/or nonhuman primates. A recent 12-week multiple ascending dose study in overweight or obese individuals showed that administration of a long-lasting analog of GDF15, LY3463251, decreased food intake and appetite scores, resulting in a modest reduction in body weight. Additionally, GDF15 delayed gastric emptying through a vagal-mediated mechanism which may contribute to the decrease in hunger signaling and initiated lipolysis via the sympathetic nervous system.


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