Melanocortin 4 receptor

Melanocortin 4 receptor is a protein that in humans is encoded by the MC4R gene. It encodes the MC₄ protein, a G protein-coupled receptor that binds α-melanocyte stimulating hormone (α-MSH). In murine models MC₄ receptors have been found to be involved in feeding behaviour, the regulation of metabolism, sexual behaviour, and male erectile function.

In 2008, MC4R mutations were reported to be associated with inherited human obesity. They were found in heterozygotes, suggesting an autosomal dominant inheritance pattern. However, based on other research and observations, these mutations seem to have an incomplete penetrance and some degree of codominance. It has a prevalence of 1.0-2.5% in people with body mass indices greater than 30, making it the most commonly known genetic defect predisposing people to obesity.

Clinical significance

In 2009, two very large genome-wide association studies of body mass index (BMI) confirmed the association of variants about 150 kilobases downstream of the MC4R gene with insulin resistance, obesity, and other anthropometric traits.MC4R may also have clinical utility as a biomarker for predicting individual susceptibility to drug-induced adverse effects causing weight gain and related metabolic abnormalities. Another GWAS performed in 2012 identified twenty SNPs located ~190 Kb downstream of MC4R in association with severe antipsychotic-induced weight gain. This locus overlapped with the region previously identified in the 2009 studies. The rs489693 polymorphism, in particular, sustained a statistically robust signal across three replication cohorts and demonstrated consistent recessive effects. This finding was replicated again by another research group in the following year. In accordance with the above, MC₄ receptor agonists have garnered interest as potential treatments for obesity and insulin resistance, while MC₄ receptor antagonists have attracted interest as potential treatments for cachexia.