This invention was made with government support under Grant Number DK118940 awarded by the National Institutes of Health. The government has certain rights in the invention.

[001] Introduction

[002] Brown adipose tissue (BAT), acts as a thermoregulator by uncoupling oxidative phosphorylation through uncoupling protein 1 (UCP1) and holds the promise of enhancing energy expenditure for the treatment of metabolic diseases. Adrenergic signaling is viewed as a key regulator of thermogenesis and UCP1 expression in BAT, while also operating as a potent contractile stimulator in muscle. However, current approaches for treating obesity -related disease by relying on activation of B-adrenergic receptors or nuclear transcription factors (PPARgamma) activators (rosiglitazone) have been fraught with severe side-effects.

[003] Upon adrenergic stimulation, BAT utilizes key components of muscular contractile machinery, specifically the actomyosin network, to generate tensional responses. Furthermore, during differentiation, brown and beige adipocytes have a unique type II myosin (MyH) expression pattern. Disruption of the actomyosin network using type II myosin inhibitors such as blebbistatin or 2,3BDM results in a decrease in brown adipose function. See, Tharp et ah, 2018, Cell Metabolism 27, 602-615.

[004] Summary of the Invention

[005] The invention provides therapeutic methods and pharmaceutical compositions for treating obesity and obesity-associated disorders such as type-2 diabetes, cardiovascular disease, and non-alcoholic fatty liver disease with an activator of type II myosin.

[006] In an aspect the invention provides a method of treating obesity or an obesity-related disease comprising: administering to a person in need thereof a type II myosin activator, and optionally detecting a resultant improvement in the obesity or an obesity-related disease.

[007] In an aspect the invention provides a method of stimulating respiration in brown or beige adipocytes comprising contacting the adipocytes with a type II myosin activator, and optionally detecting a resultant increased respiration of the adipocytes.

[008] In embodiments:

[009] the activator binds MyH4;

[010] the activator binds MyHl 1 ;

[Oil] the activator is selected from Table 1;

[012] the activator is selected from Table 2; and/or [013] the activator is selected from Myh4_#35, Myh4_#43, Myh4_#55, Myh4_#63 and Myhl 1 _2153.

[014] In an aspect the invention provides a pharmaceutical composition for treating obesity or obesity-associated disorders such as type-2 diabetes, cardiovascular disease, and non-alcoholic fatty liver disease, comprising an adipocyte a type II myosin activator and a different anti obesity or anti-obesity related disorder medicament, preferably in a combined unit dosage.

[015] In embodiments:

[016] the medicament is selected from:

[017] a medicament for inhibiting weight gain such as a food intake inhibitor or a food absorption inhibitor;

[018] a medicament for inhibiting weight gain such as Orlistat, Sibutramine, Lorcaserin, Rimonabant, Metformin , Exenatide , Pramlintide, phentermine/topiramate; and [019] a medicament for reducing serum LDL, cholesterol, LDL-c, or triglycerides, such as atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev, Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), simvastatin (Zocor), cholestyramine (Prevalite, Questran), colesevelam (Welchol), colestipol (Colestid), ezetimibe (Zetia), ezetimibe-simvastatin (Vytorin), fenofibrate (Lofibra, TriCor), gemfibrozil (Lopid), Niacin (Niaspan), Omega-3 fatty acid (Lovaza);

[020] the activator binds MyH4;

[021] the activator binds MyHl 1 ;

[022] the activator is selected from Table 1;

[023] the activator is selected from Table 2; and/or

[024] the activator is selected from Myh4_#8, Myh4_#15, Myh4_#35, Myh4_#43, Myh4_#55, Myh4_#63 and Myhl 1 2153.

[025] The invention encompasses all combinations of the particular embodiments recited herein, as if each combination had been laboriously recited.

[026] Brief Description of the Drawings

[027] Figs.lA-lF: Adrenergic Induction of Tension in Brown Adipocytes. From ‘ Actomyosin-Mediated Tension Orchestrates Uncoupled Respiration in Adipose Tissues. A. Single-cell measurements of isoproterenol -induced stiffness in cultured brown adipocytes. B: BAT explant response to isoproterenol treatment (100 mM). C: AFM assessment of cellular stiffness across a monolayer of fully differentiated brown adipocytes 30min after treatment with 1 mM isoproterenol and lOOpM blebbistatin. D: Storage modulus of intact BAT from mice housed at 23 ^° C or exposed to 24 H of 4 ^° C. E: Cellular respiration in brown adipocytes treated with 1 mM isoproterenol, IOOmM blebbistatin, or 1 mM isoproterenol and IOOmM blebbistatin. F: Relative gene expression of brown adipocytes treated with 1 mM isoproterenol, IOOmM blebbistatin, or 1 mM isoproterenol and IOOmM blebbistatin.

[028] Figs. 2A-2D: Type II MyH4 Targeted UCP1 Induction. A: Relative UCP1 expression from brown adipocytes treated with 1 mM isoproterenol and IOmM MyH4 activator for ~24 H. (Consolidation of the positive compounds from 92 compounds tested). B: Relative UCP1 expression of brown adipocytes treated with IOmM Myh4 activator for ~24 H. C: Time course of UCP1 induction in brown adipocytes treated with IOmM of MyH4 compound #55. D: Dose titration of the relative UCP1 expression of brown adipocytes treated with MyH4 compound #55 alone for ~24 H.

[029] Figs. 3A-3D: Type II MyHl 1 Targeted UCP1 Induction. A: Relative UCP1 expression from brown adipocytes treated with 1 mM isoproterenol and IOmM MyHl 1 activator for ~24 H. (Consolidation of the positive compounds from 74 compounds tested). B: Relative UCP1 expression of brown adipocytes treated with IOmM MyHl 1 activator for ~24 H. C: UCP1 protein from brown adipocytes treated with or without MyHl 1 compound #2153 for 24 H, gel.

D. UCP1 protein from brown adipocytes treated with or without MyHl 1 compound #2153 for 24 H, bar graph.

[030] Figs. 4A-C: Cellular Respiration in Brown and Beige Adipocytes. A. Cellular Respiration of brown adipocytes treated for 1 H with 10mM MyH4 compound #35 and with 1 mM of isoproterenol. B/C: Cellular respiration of human derived ZenBio cell line differentiated to beige adipocytes treated overnight with 10mM MyH4 compound #43 and with or without 1 mM of isoproterenol.

[031] Fig. 5. sBAT cells (brown adipocyte cell line) were treated overnight with lOuM of either Myh 4 activator #8, #55, or #15 and luM of isoproterenol for 24 hours. 24 hours post treatment, a mitochondrial stress test was done to determine cellular respiration using a Seahorse XFe24 Analyzer. Oligomycin, FCCP, Rotenone, and Antimycin were injected at lOuM nal to determine basal, uncoupled, and maximal respiration. Cells were harvested with RIPA and cellular respiration was normalized to protein content.

[032] Description of Particular Embodiments of the Invention

[033] Unless contraindicated or noted otherwise, in these descriptions and throughout this specification, the terms “a” and “an” mean one or more, the term “or” means and/or. The examples and embodiments described herein are for illustrative purposes only and that various modifications or changes in light thereof will be suggested to persons skilled in the art and are to be included within the spirit and purview of this application and scope of the appended claims. All publications, patents, and patent applications cited herein, including citations therein, are hereby incorporated by reference in their entirety for all purposes.

[034] We disclose therapeutic methods and pharmaceutical compositions for treating obesity and obesity-associated disorders with an activator of type II myosin. We report that we can stimulate brown and beige adipose tissue by increasing myosin activity. We used a convolutional neural network for structure-based drug discovery, including the development of homology models to target Myosin proteins and 166 compounds we predicted to bind to either MyH4 or MyHl 1. We report that increasing the ATPase activity of the myosin isoforms results in an increase in brown and beige adipose function, including respiration, as a result of increased UCP1 expression and cellular respiration, and that Myosin II activators show the ability to increase the expression of uncoupling protein 1 (UCP1), a pivotal determinant of uncoupled respiration, in murine and human brown and beige cells.

[035] Animal models of human obesity and obesity-associated disesase. After demonstrating that the compounds are effective to stimulate respiration in brown adipocytes, we applied the activators to two animal models of human obesity and obesity related disorders (such as type-2 diabetes, cardiovascular disease, and non-alcoholic fatty liver disease) to demonstrate these compounds may be used to treat human obesity and obesity associated disorders [036] B6.Cg-Lepob/J (Jackson laboratory, Bar Harbor ME). Mice homozygous for the obese spontaneous mutation, Lepob (commonly referred to as ob or ob/ob), exhibit obesity, hyperphagia, transient hyperglycemia, glucose intolerance, and elevated plasma insulin. Obesity is characterized by an increase in the number and size of adipocytes. Although hyperphagia contributes to the obesity, homozygotes gain excess weight and deposit excess fat even when restricted to a diet sufficient for normal weight maintenance in lean mice.

[037] C57BL/6J(Jackson laboratory, Bar Harbor ME). C57BL/6J is an inbred strain susceptible to diet-induced obesity, type 2 diabetes, and atherosclerosis. Hu et al. Cell Metab. 2018 Sep 4;28(3):415-431.e4; Takahashi et al. JNutr Sci Vitaminol (Tokyo). 1999 Oct;45(5):583-93.

[038] High Fat Diet: D 12492; Rodent Diet With 60 kcal% Fat, fed continuously, two months

[039] Administration. Both oral and intraperitoneal (IP) injection routes were established at graduating dosages: IP injection: 1, 10 and 100 mg/kg compound in saline, administered weekly over two months; oral: 20, 100 and 500 mg/kg compound mixed with food and fed continuously for 2 months.

[040] Table 1. Active Type II myosin activator: MyH4 activators. sBAT: positive mitochondrial stress test for cellular respiration, see e.g. Fig.5; Ob/Ob: reduced weight in B6.Cg-Lepob/J mice, supra; HFD: lower weight gain in high fat diet C57BL/6J mice, supra. Active compounds provide significant (p< 05, +++) at at least one graduated dose.

[041] Table 2. Active Type II myosin activator: MyHll activators sBAT: positive mitochondrial stress test for cellular respiration, see e.g. Fig.5; Ob/Ob: reduced weight in

B6.Cg-Lepob/J mice, supra; HFD: lower weight gain in high fat diet C57BL/6J mice, supra. Active compounds provide significant (p< 05, +++) results at at least one graduated dose.