Hypothalamic CYP46A1 cholesterol metabolism regulates diet-induced obesity

Obesity is a growing global health challenge which affects over 38% of the population and increases the risk of developing metabolic disorders. Effective long-term treatment options remain limited and often lead to significant side effects. The hypothalamus plays a central role in metabolic regulation by integrating peripheral and central signals to maintain energy homeostasis. While the hypothalamus regulates peripheral lipid metabolism, the role of lipid metabolic pathways within the hypothalamus itself remains unclear. Therefore, the molecular mechanisms linking hypothalamic activity to the development of obesity remain poorly understood. Given that cholesterol is the most abundant brain lipid, we investigated molecular players involved in its local regulation. Here, we identify the rate-limiting enzyme for brain cholesterol degradation, Cyp46a1, as a critical regulator of diet-induced obesity. We show that Cyp46a1 expression is significantly reduced in the hypothalamus of C57BL/6J mice exposed to a high-fat diet, suggesting a role in metabolic dysregulation. We used recombinant Adeno-Associated Viruses (AAV) to modulate Cyp46a1 expression in the arcuate nucleus, a key hypothalamic region regulating energy balance. We evaluated longitudinal changes in body weight, adipocyte size, PPAR-{gamma} expression, and hepatic lipid accumulation and pancreatic histopathology in mice undergoing chow or high fat diets. These experiments demonstrated that hypothalamic Cyp46a1 regulates body weight, adipocyte size, and hepatic and pancreatic histopathology. Conversely, CYP46A1 overexpression protects against high-fat diet-induced obesity and improves glucose homeostasis and insulin sensitivity, likely via crosstalk with hepatic and pancreatic function. Moreover, we found that hypothalamic CYP46A1 expression selectively modulates gut microbiota composition, linking this enzyme to the microbiota-gut-brain axis. Finally, we found that Cyp46a1 levels influence cognitive and motor performance, suggesting broader physiological relevance. Collectively, our findings reveal a previously unrecognized role of hypothalamic Cyp46a1 and cholesterol pathway control in obesity pathophysiology and metabolic homeostasis. These findings identify hypothalamic Cyp46a1 as a promising therapeutic target for obesity and its related comorbidities.