GDNF family receptor alpha-like (GFRAL) expression is restricted to the caudal brainstem

Abstract The TGF-β cytokine, growth differentiation factor 15 (GDF15) is a critical mediator of the physiologic response to a range of cellular stresses. While circulating levels of GDF15 are normally very low, these levels increase substantially under a number of acute and chronic pathogenic states including mycotoxin exposure, infection and cancer. GDF15 controls a range of physiologic outputs including reduced appetite, gastric motility, hyperalgesia, emesis, energy expenditure and immune cell function via the GDNF family receptor alpha-like (GFRAL). While the area postrema and nucleus of the solitary tract (AP/NTS) within the caudal brainstem are the only known sites of Gfral-expressing cells, Gfral may also be expressed in other cell types. We therefore utilized single molecule in-situ hybridizations and genetic mouse models to label Gfral-expressing cells from development to adult mouse. With both approaches, we found Gfral-labelled cells in the brainstem and extremely rare Gfral-labelled cells in peripheral tissues in the mouse under normal physiological conditions. Confirming these findings, single nucleus RNA-sequencing of human tissues demonstrated nearly undetectable levels of Gfral mRNA in sites outside the AP/NTS. Our findings confirm AP/NTS neurons are the major site of Gfral expression. Competing Interest Statement RJS has received research support from Novo Nordisk, Fractyl, Astra Zeneca, Congruence Therapeutics, Eli Lilly, Bullfrog AI, Glycsend Therapeutics and Amgen. RJS has served as a paid consultant for Novo Nordisk, Eli Lilly, CinRx, Fractyl, Structure Therapeutics, Crinetics and Congruence Therapeutics. RJS has equity in Calibrate, Rewind and Levator Therapeutics. The remaining authors declare no competing interests.