White fat and adipose organoid modulation and therapeutic transplantation

Abstract

Methods and compositions for controlling fat cell phenotypes are provided.

Description

WHITE FAT AND ADIPOSE ORGANOID MODULATION ANDTHERAPEUTIC TRANSPLANTATIONCROSS-REFERENCE TO RELATED APPLICATIONS

[0001] Tliis application claims priority to U.S. Provisional Application No. 63 / 455,129, filed March 28, 2023, and U.S. Provisional Application No. 63 / 594,225, filed October 30, 2023, the disclosures of which are herein incorporated by reference in their entirety for all purposes.STATEMENT AS TO RIGHTS TO INVENTIONS MADE UNDER FEDERALLY SPONSORED RESEARCH AND DEVELOPMENT

[0002] Illis invention was made with government support under R01 DK124769 awarded by the National Institutes of Health. The government has certain rights in the invention.BACKGROUND OF THE INVENTION

[0003] Tumors are complex tissues composed of cancerous and non-cancerous cells in a hypoxic and nutrient-deprived microenvironment. The tumor microenvironment (TME) contains heterogeneous cell populations, including immune cells, mesenchymal support cells, and matrix components contributing to tumor growth and progression (1). In order to survive this environment, tumors are capable of reprogramming metabolic pathways to better utilize available substrates in the surrounding TME, ultimately becoming dependent on these pathways for continued growth and survival (2). In contrast to normal cells, the main pathway of glucose metabolism in cancer cells is aerobic glycolysis, termed the Warburg effect (3). Glucose uptake and production of lactate is increased in these cells, even in the presence of oxygen and functional mitochondria (3). The increase in glycolytic flux allows glycolytic intermediates to supply subsidiary pathways to fulfill the metabolic demands of proliferatingcells. During hypoxia, cancer cells also undergo metabolic reprogramming to increase lipid utilization, as fatty acids produce twice the energy of glucose (4, 5).

[0004] Tire re are many efforts to target cancer glucose and fatty acid metabolism for therapeutic purposes. For glycoly sis, these include drugs that target hexokinase 2 (HK2), which is involved in the initial steps in glycolysi s, using ATP from the mitochondria to phosphorylate glucose, or drags that target glucose transporters (GLUT1 and GLUT4) (2, 6-8). Several drags are also used to target lipid metabolism in cancer (9-12). These include drugs that target lipid uptake (targeting proteins such as LXR, CD36 and FABP4 / 5), lipogenic enzymes (such as ACC, ACLY, FASN, and SCD1) and proteins involved in intracellular lipid homeostasis (such as CPT 1 A, PPARG and others) (13, 14). In addition, recent work has shown that cold activation of brown adipose tissue (BAT), which dissipates energy by non-shivering thermogenesis, increases adipocyte glucose uptake, lipid metabolism and significantly inhibits tumor growth (15). However, situating cancer patients in cold conditions for extended periods is challenging.BRIEF SUMMARY OF THE INVENTION

[0005] In some embodiments, a composition is provided that comprises a targeted polypeptide linked to a transcriptional activator, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to a polynucleotide encoding a polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator 1 alpha (PPARGC1A / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120, FOXO1, GLUT1, GLUT2, GLUT3, GLUT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRS1, DGAT1, DGAT2, UPP1, CKB, and ACACA or as found in Table 2, wherein the composition upregulates expression of the at least one polypeptide when introduced to a cell. In some embodiments, the targeted polypeptide is a catalytically-inactive nuclease. In some embodiments, the catalytical ly-in active nuclease is derived from (i) a zinc finger nuclease (ZFN); a transcription activator-like effector nuclease (TALEN); (iii) a clustered regularly interspaced short palindromic repeats (CRISPR) nuclease. In some embodiments, catalytically inactive nuclease is derived from a clustered regularly interspaced short palindromic repeats (CRISPR) nuclease, wherein the composition further comprises a gRNA that targets the portion of the promoter or enhancer sequence. In some embodiments, the gRNA comprises a sequence having at least 90%, 95%, 98%, 99% or 100%identity to a sequence of any one of SEQ ID NOs: 1-55. In some embodiments, the targeted polypeptide is a catalytically-inactive nuclease dCas9.

[0006] In some embodiments, the transcriptional activator is selected from the group consisting of HSF1, VP16, VP48, VP64, VP160, p53, p65, RTA, MyoDl, SET7, ESDI, CIB1, AD2, CR3, GATA4, SP1, MEF2C, TAX, SETO, VP64-p65-RTA (VPR), Histone Acetyltransferase p300, TET1 Hydroxylase Catalytic Domain, Synergistic activation mediator (SAM), S unTag, and PPAR-gamma. In some embodiments, wherein the transcriptional activator is VP64. In some embodiments, the transcriptional activator is VP64, and the targeted polypeptide is catalyticaliy-inactive nuclease dCas9,

[0007] In some embodiments, a composition is provided that comprises a targeted polypeptide linked to a transcriptional repressor, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to a polynucleotide encoding a polypeptide selected from the group consisting of ACACB and NRIP1, wherein the composition downregulates expression of the at least one polypeptide when introduced to a cell. In some embodiments, a cell comprises the targeted polypeptide. In some embodiments, a polynucleotide comprises one or more expression cassettes encoding the targeted polypeptide. In some embodiments, the targeted polypeptide is a catalytically inactive nuclease, and the expression cassettes comprise (i) a first expression cassette comprising a first promoter operably linked to a first nucleic acid encoding a gRNA and (ii) a second expression cassete comprising a second promoter operably linked to a second nucleic acid encoding the catalytically -inactive nuclease and the transcriptional activator. In some embodiments, a cell comprises the polynucleotide comprises one or more expression cassettes encoding the targeted polypeptide. In some embodiments, the cell is an adipocyte.

[0008] In some embodiments, an engineered adipocyte or adipose stem cell is provided that comprises a targeted polypeptide linked to a transcriptional activator, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to at least one polynucleotide encoding a polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator 1 alpha (PPARGC1A / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120, FOXO1, GLUT!, GLUT2, GLIJT3, GLUT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRSI, DGAT1, DGAT2, UPP1, CRB, and ACACA or as found in Table 2, wherein the targeted polypeptide upregulates expression of the at least one polypeptide compared to a wild-type adipocyte or adipose stem cell.

[0009] In some embodiments, an engineered adipocyte or adipose stem cell is provided that comprises: (i) a targeted polypeptide linked to a transcriptional repressor, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to at least one polynucleotide encoding a polypeptide selected from the group consisting of ACACB and NRIP1, wherein the targeted polypeptide downregulates expression of the at least one polypeptide compared to a wild-type adipocyte or adipose stem cell: or (ii) an siRNA or antisense molecule that comprises a sequence complementary to ACACB and NRIPl and downregulates expression of the at least one polypeptide compared to a wild-type adipocyte or adipose stem cell. In some embodiments, the targeted polypeptide is a catalytically inactive nuclease. In some embodiments, the catalytically inactive nuclease is derived from (i) a clustered regularly interspaced short palindromic repeats (CRISPR) nuclease, and the engineered adipocyte or adipose stem cell further comprises a gRNA that targets the portion of the promoter or enhancer sequence; (ii) a zinc finger nuclease (ZFN); or (lii) a transcription activator-like effector nuclease (TALEN).

[0010] In some embodiments, an engineered adipocyte or adipose stem cell is provided that comprises a heterologous expression cassette, wherein the heterologous expression cassette comprises a promoter operably linked to at least one polynucleotide encoding a polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator 1 alpha (PPARGC1A / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120, FOXO1, GLUT1, GL.UT2, GLUT3, GLUT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRS1, DGAT1, DGAT2, UPP1, CKB, and ACACA or as found in Table 2, wherein the heterologous expression cassette overexpresses the at least one polypeptide compared to a wild-type adipocyte or adipose stem ceil.

[0011] In some embodiments, an engineered adipose organoid is composed of engineered adipocytes or adipose stem cell.

[0012] In some embodiments, a method is provided for preventing or treating a metabolic disease or a symptom of aging in a subject. In some embodiments, the method comprises: upregulating or overexpressing at least one polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator 1 alpha (PPARGC1 A / PCG1A),UPP1, CKB, and AC AC A or as found in Table 2, or downregulating ACACB orNRIPl, in an adipocyte of the subject, thereby preventing or treating a metabolic disease.

[0013] In some embodiments, upregulating the polypeptide comprises introducing to the subject a therapeutically effective amount of a composition comprising a targeted polypeptide linked to a transcriptional activator, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to a polynucleotide encoding the polypeptide. In some embodiments, the targeted polypeptide is a catalytically inactive nuclease, wherein the catalytically inactive nuclease is (i) a clustered regularly interspaced short palindromic repeats (CRISPR) nuclease, and the engineered adipocyte or adipose stem cell further comprises a gRNA that targets the portion of the promoter or enhancer sequence; (ii) a zinc finger nuclease (ZFN); or (iii) a transcription activator-like effector nuclease (TALEN).[0014 j In some embodiments, overexpressing the polypeptide comprises introducing to the subject a therapeutically effective amount of a composition comprising a heterologous expression cassette comprising a promoter operably linked to a coding sequence encoding the polypeptide.

[0015] In some embodiments, the introducing comprises introducing the composition intravenously, intramuscularly, or a combination thereof.

[0016] In some embodiments, downregulating the polypeptide comprises CRISPR interference (CRISPRi), RNA interference (RNAi), or antisense therapy.

[0017] In some embodiments, a method for preventing or treating a metabolic disease in a subject is provided that comprises introducing to the subject a therapeutically effective amount of the engineered adipocytes or adipose stem cells or the engineered adipose organoids. In some embodiments, before the introducing, isolating adipocytes or adipose stem cells from the subject and engineering the ceils to have the upregulated expression or the overexpression. In some embodiments, the method further comprises culturing the engineered cells into an engineered adipose organoid, and introducing the engineered adipose organoid to the subject. In some embodiments, the introducing engineered adipocytes, or adipose stem cells, or the engineered adipose organoid are autologous. In other embodiments, the introducing engineered adipocytes, or adipose stem cells, or the engineered adipose organoid are

[0018] In some embodiments, the introducing comprises introducing the engineered adipocytes, adipose stem cells, or the engineered adipose organoid intravenously, intramuscularly, or a combination thereof. In some embodiments, the subject is a human. In some embodiments, the method improves at least one symptom selected from the group consisting of body weight loss, cold tolerance, oxygen consumption, whole body energy expenditure, glucose and fatty acid utilization, glucose sensitivity, and insulin sensitivity.

[0019] In some embodiments, a method for preventing or treating diabetes in a subject is provided that comprises introducing to the subject a therapeutically effective amount of (i) the composition, or (ii) a heterologous expression cassete comprising a promoter operably linked to at least one polynucleotide encoding a polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator 1 alpha (PPARGC1 A / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120, FOXO1. GLUT1, GLUT2, GLUTS, GL.UT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRS1, DGAT1, DGAT2, UPP1 , CKB, and ACACA or as found in Table 2, or (iii) the engineered adipocytes or adipose stem cells or (iv) the engineered adipose organoid.

[0020] In some embodiments, the subject is a human. In some embodiments, the introducing engineered adipocytes, or adipose stem cells, or the engineered adipose organoid are autologous. In other embodiments, the introducing engineered adipocytes, or adipose stem cells, or the engineered adipose organoid are allogeneic. In some embodiments, the introducing comprises introducing the composition, or the heterologous expression cassette, or the engineered adipocytes or adipose stem cells, or the engineered adipose organoid intravenously, intramuscularly, or a combination thereof.

[0021] In some embodiments, a method for preventing or treating cancer in a subject is provided that comprises: introducing to the subject a therapeutically effective amount of (i) the composition, or (li) a heterologous expression cassette comprising a promoter operably linked to at least one polynucleotide encoding a polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7), PP ARG coactivator 1 alpha (PPARGC1A / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120, FOXO1, GLUT! , GLUT2, GLUT3, GLUT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRS1 , DGAT1, DGAT2, UPP1, CKB, and ACACA or as found in Table 2, or (hi) the engineered adipocytes or adipose stem cells or (iv) the engineered adipose organoid. In some embodiments, the subject is a human. In some embodiments, the introducing engineered adipocytes, or adipose stem cells.or the engineered adipose organoid are autologous. In other embodiments, the introducing engineered adipocytes, or adipose stem ceils, or the engineered adipose organoid are allogeneic.

[0022] In some embodiments, the introducing coinprises introducing the composition, or the heterologous expression cassette, or the engineered adipocytes or adipose stem cells, or the engineered adipose organoid is intravenously, intramuscularly, or a combination thereof. In some embodiments, the method results in suppression of glycolysis or fatty acid metabolism in cells.

[0023] In some embodiments, an adipocyte or adipose stem cell is provided that is engineered to consume a metabolite preferentially consumed by cancer cells compared to noncancer cells in an individual. In some embodiments, the engineered adipocyte or adipose stem cell is engineered to express uridine phosphorylase (UPP1). In some embodiments, a method of treating or preventing cancer in an individual is provided in which the method comprises introducing into the individual the engineered adipocyte or adipose stem cell as described above or elsewhere herein in proximity- to cancer cells that preferentially consume the metabolite engineered adipocyte or adipose stem cells, thereby inhibiting growth of the cancer cells. In some embodiments, the cancer cells are pancreatic ductal adenocarcinoma cells and the engineered adipocyte or adipose stem cells are introduced into the breast of the individual.

[0024] In some embodiments, any cell described above or elsewhere herein can be provided in a biocompatible matrix, optionally comprising poly caprolactone. In some embodiments, the cells are delivered into an individual (e.g., a human), for example to achieve a therapeutic effect, and optionally at a later point can be removed from the individual.DEFINITIONS

[0025] Unless specifically indicated otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by those of ordinary skill in the art to which this disclosure belongs. In addition, any method or material similar or equivalent to a method or material described herein can be used m the practice of the present disclosure. For purposes of the present disclosure, the following terms are defined.

[0026] The terms “a,” “an,” or “the” as used herein not only include aspects with one member, but also include aspects with more than one member. For instance, the singular forms “a,” “an,” and “the” include plural referents unless the context clearly dictates otherwise. Thus,tor example, reference to "‘a cell” includes a plurality of such cells and reference to "‘the agent” includes reference to one or more agents known to those skilled in the art, and so forth.

[0027] Tire term “about” as used herein refers to the usual error range for the respective value readily known to the skilled person in this technical field. For example, for Ko and ICso values ± 20%, ± 10%, or ± 5%, are within the intended meaning of the recited value.

[0028] The words "protein", "peptide", and "polypeptide" are used interchangeably to denote an ammo acid polymer or a set of two or more interacting or bound amino acid polymers. 'The terms apply to amino acid polymers in which one or more amino acid residue is an artificial chemical mimetic of a corresponding naturally occurring amino acid, as well as to naturally occurring amino acid polymers, those containing modified residues, and non-naturally occurring amino acid polymer.|0029] The term “amino acid” refers to naturally occurring and synthetic amino acids, as well as amino acid analogs and amino acid mimetics that function similarly to the naturally occurring amino acids. Naturally occurring amino acids are those encoded by the genetic code, as well as those amino acids that are later modified, e.g. , hydroxyproline, y-carboxyglutamate, and O-phosphoserine. Ammo acid analogs refers to compounds that have the same basic chemical structure as a naturally occurring amino acid, e.g., an a carbon that is bound to a hydrogen, a carboxyl group, an amino group, and an R group, e.g., homoserine, norleucine, methionine sulfoxide, methionine methyl sulfoniurn. Such analogs may have modified R groups (e.g., norleucine) or modified peptide backbones, but retain the same basic chemical structure as a naturally occurring amino acid. Amino acid mimetics refers to chemical compounds that have a structure that is different from the general chemical structure of an amino acid, but that functions similarly to a naturally occurring ammo acid.

[0030] Ammo acids may be referred to herein by either their commonly known three letter symbols or by the one-letter symbols recommended by the IUPAC-IUB Biochemical Nomenclature Commission. Nucleotides, likewise, may be referred to by their commonly accepted single-letter codes.

[0031] “Conservatively modified variants” applies to both amino acid and nucleic acid sequences. With respect to particular nucleic acid sequences, conservatively modified variants refer to those nucleic acids which encode identical or essentially identical amino acid sequences, or where the nucleic acid does not encode an amino acid sequence, to essentially identical or associated, e.g. , naturally contiguous, sequences. Because of the degeneracy of thegenetic code, a large number of functionally identical nucleic acids encode most proteins. For instance, the codons GCA, GCC, GCG and GCU all encode the amino acid alanine. Thus, at every' position where an alanine is specified by a codon, the codon can be altered to another of the corresponding codons described without altering the encoded polypeptide. Such nucleic acid variations are ‘‘silent variations,” which are one species of conservatively modified variations. Every nucleic acid sequence herein which encodes a polypeptide also describes silent variations of the nucleic acid. One of skill will recognize that in certain contexts each codon in a nucleic acid (except AUG, which is ordinarily the only codon for methionine, and TGG, which is ordinarily the only codon for tryptophan) can be modified to yield a functionally identical molecule. Accordingly, silent variations of a nucleic acid which encodes a polypeptide is implicit in a described sequence with respect to the expression product, but not with respect to actual probe sequences.

[0032] A “conservative” substitution as used herein refers to a substitution of an amino acid such that charge, hydrophobicity, and / or size of the side group chain is maintained. Illustrative sets of ammo acids that may be substituted for one another include (i) positively-charged ammo acids Lys, Arg and His; (ii) negatively charged ammo acids Glu and Asp; (iii) aromatic amino acids Phe, Tyr and Trp; (iv) nitrogen ring amino acids His and Trp; (v) large aliphatic nonpolar amino acids Vai, Leu and IIe; (vi) slightly polar amino acids Met and Cys; (vii) small-side chain amino acids Ser, Thr, Asp, Asn, Gly, Ala, Glu, Gin and Pro; (viii) aliphatic amino acids Vai, Leu, He, Met and Cys; and (ix) small hydroxyl ammo acids Ser and Thr. Reference to the charge of an amino acid in this paragraph refers to the charge at physiological pH.

[0033] The terms “nucleic acid” and “polynucleotide” are used interchangeably and as used herein refer to both sense and anti-sense strands of RNA, cDNA, genomic DNA, and synthetic forms and mixed polymers of the above. In particular embodiments, a nucleotide refers to a ribonucleotide, deoxynucleotide or a modified form of either type of nucleotide, and combinations thereof. The teams also include, but is not limited to, single- and double-stranded forms of DNA. In addition, a polynucleotide, e.g., a cDNA or mRNA, may include either or both naturally occurring and modified nucleotides linked together by naturally occurring and / or non-naturally occurring nucleotide linkages. Nucleic acid molecules, e.g., oligonucleotide probes or priomers, may be modified chemically or biochemically or may contain non-natural or derivatized nucleotide bases, as will be readily appreciated by those of skill in the art. Such modifications include, for example, labels, methylation, substitution of one or more of the naturally occurring nucleotides with an analogue, intemucleotide modifications such asuncharged linkages (e.g., methyl phosphonat.es, phosphotriesters, phosphoramidat.es, carbamates, etc.), charged linkages (e.g., phosphorothioates, phosphorodithioates, etc.), pendent moieties (e.g., polypeptides), intercalators (e.g,, acridine, psoralen, etc.), chelators, alkylators, and modified linkages (e.g., alpha anomeric nucleic acids, etc.). The above term is also intended to include any topological conformation, including single-stranded, double- stranded, partially duplexed, triplex, hairpinned, circular and padlocked conformations. A reference to a nucleic acid sequence encompasses its complement unless otherwise specified. Tirus, a reference to a nucleic acid molecule having a particular sequence should be understood to encompass its complementary strand, with its complementary sequence. The term also includes codon-optimized nucleic acids that encode the same polypeptide sequence.

[0034] The term "vector," as used herein, refers to a nucleic acid molecule capable of propagating another nucleic acid to which it is linked. The term includes the vector as a self- replicating nucleic acid structure as well as the vector incorporated into the genome of a host cell into w'hich it has been introduced. A “vector” as used here refers to a recombinant construct in which a nucleic acid sequence of interest is inserted into the vector. Certain vectors are capable of directing the expression of nucleic acids to which they are operatively linked. Such vectors are referred to herein as "expression vectors".

[0035] The term ‘■recombinant” or ’‘engineered” when used with reference, e.g., to a cell, or nucleic acid, protein, or vector, indicates that the cell, nucleic acid, protein or vector, has been modified by the introduction of a heterologous nucleic acid or protein or the alteration of a native nucleic acid or protein, or that the cell is derived from a cell so modified. Thus, for example, recombinant cells express genes that are not found within the native (non- recombinant) form of the cell or express native genes that are otherw ise abnormally expressed, under expressed or not expressed at all.[0036 j The term “heterologous” when used with reference to portions of a nucleic acid indicates that the nucleic acid comprises two or more subsequences that are not found in the same relationship to each other in nature. For instance, the nucleic acid is typically recombinantly produced, having two or more sequences from unrelated genes arranged to make a new' functional nucleic acid, e.g., a promoter from one source and a coding region from another source. Similarly, a heterologous protein indicates that the protein comprises two or more subsequences that are not found in the same relationship to each other m nature (e.g. , a fusion protein).

[0037] The terms “therapy,” “treatment,” and “amelioration” refer to any reduction in the severity of symptoms. For example, in the case of treating cancer, treatment can refer to reducing the number of cancer cells or growth rate or cell death of non-cancer cells, etc. As used herein, the terms “treat” and “prevent” are not intended to be absolute terms. Treatment and prevention can refer to any delay in onset, amelioration of symptoms, improvement in patient survival, increase in survival time or rate, etc. Treatment and prevention can be complete (no detectable symptoms remaining) or partial, such that symptoms are less frequent of severe than in a patient without the treatment described herein. The effect of treatment can be compared to an individual or pool of individuals not receiving the treatment, or to the same patient prior to treatment or at a different time during treatment. In some aspects, the severity of disease is reduced by at least 10%, as compared, e.g., to the individual before administration or to a control individual not undergoing treatment. In some aspects the severity of disease is reduced by at least 25%, 50%, 75%, 80%, or 90%, or in some cases, no longer detectable using standard diagnostic techniques.

[0038] lire terms “effective amount,” “effective dose,” “therapeutically effective amount,” etc. refer to that amount, of the therapeutic agent sufficient to ameliorate a di sorder, as described above. For example, for the given parameter, a therapeutically effective amount will show an increase or decrease of therapeutic effect at least 5%, 10%, 15%, 20%, 25%, 40%, 50%, 60%, 75%, 80%, 90%, or at least 100%. Therapeutic efficacy can also be expressed as “-fold” increase or decrease. For example, a therapeutically effective amount, can have at least a 1.2- fold, 1 .5-fold, 2-fold, 5-fold, or more effect over a. control.

[0039] As used herein, the term “pharmaceutically acceptable” is used synonymously with physiologically acceptable and pharmacologically acceptable. A pharmaceutical composition will generally comprise agents for buffering and preservation in storage, and can include buffers and carriers for appropriate delivery, depending on the route of administration.J0040] The terms “dose” and “dosage” are used interchangeably herein. A dose refers to the amount of active ingredient given to an individual at each administration. The dose will vary depending on a number of factors, including frequency of administration; size and tolerance of the individual; severity of the condition; risk of side effects; the route of administration; and the imaging modality of the detectable moiety (if present). One of skill in the art will recognize that tire dose can be modified depending on the above factors or based on therapeutic progress. The term “dosage form” refers to the particular format of the pharmaceutical, and depends onthe route of administration . For example, a dosage form can be in a liquid, e.g. , a saline solution for injection.

[0041] “Subject,” “patient,” “individual” and like terms are used interchangeably and refer to, except where indicated, mammals such as humans and non-human primates, as well as rabbits, rats, mice, goats, pigs, dogs, cats, and other mammalian species. The term does not necessarily indicate that the subject has been diagnosed with a particular disease, but typically refers to an individual under medical supervision. A patient can be an individual that is seeking treatment, monitoring, adjustment or modification of an existing therapeutic regimen, etc.

[0042] An "expression cassette" refers to a nucleic acid construct that, when introduced into a host cell, results in transcription and / or translation of an RNA or polypeptide, respectively.

[0043] The term "operably linked" refers to a functional linkage between a nucleic acid expression control sequence (such as a promoter, or array of transcription factor binding sites) and a second nucleic acid sequence, wherein the expression control sequence directs transcription of the nucleic acid corresponding to the second sequence.

[0044] The term "promoter," as used herein, refers to a polynucleotide sequence capable of driving transcription of a coding sequence in a cell. Thus, promoters can includec i s -acting transcriptional control elements and regulatory sequences that are involved in regulating or modulating the timing and / or rate of transcription of a gene. For example, a promoter can be a cri-acting transcriptional control element, including an enhancer, a promoter, a transcription terminator, an origin of replication, a chromosomal integration sequence, 5' and 3' untranslated regions, or an intronic sequence, which are involved in transcriptional regulation. These cis- acting sequences typically interact with proteins or other biomolecules to carry out (turn on / off, regulate, modulate, etc.) gene transcription.

[0045] The phrase "percent identical" or equivalents used in the context of two nucleic acids or polypeptides, refers to a sequence that has at least a specified level of identity, e.g., at least 50% sequence identity with a reference sequence (e.g., any SEQ ID NO included herein). Alternatively, percent identity can be any integer from 50% to 100%. Some embodiments include at least: 50%, 55%, 60%, 65%, 70%. 75%, 80%, 85%, 90%, 91%, 92%, 93%. 94%, 95%, 96%, 97%, 98%, or 99%, compared to a reference sequence using the programs described herein, e.g., BLAST using standard parameters, as described below'.

[0046] For sequence comparison, typically one sequence acts as a reference sequence, to which test sequences are compared. When using a sequence comparison algorithm, test and reference sequences are entered into a computer, subsequence coordinates are designated, if necessary, and sequence algorithm program parameters are designated. Default program parameters can be used, or alternative parameters can be designated. The sequence comparison algorithm then calculates the percent sequence identities for the test sequences relative to the reference sequence, based on the program parameters.

[0047] A "comparison window", as used herein, includes reference to a segment of any one of the numbers of contiguous positions selected from the group consisting of from 20 to 600, usually about 50 to about 200, more usually about 100 to about 150 in which a sequence may be compared to a reference sequence of the same number of contiguous positions after the two sequences are optimally aligned. Methods of alignment of sequences for comparison are well- known m the art. Optimal alignment of sequences for comparison can be conducted, e.g,, by the local homology algorithm of Smith & Waterman, Adv. Appl. Math. 2:482 (1981 ), by the homology alignment algorithm of Needleman & Wunsch, J. Mol. Biol. 48:443 (1970), by the search for similarity method of Pearson & Lipman, Proc. Nat'l. Acad. Sci. USA 85:2444 (1988), by computerized implementations of these algorithms (GAP, BESTFIT, FASTA, and TFASTA in tlie Wisconsin Genetics Software Package, Genetics Computer Group, 575 Science Dr., Madison, WI), or by manual alignment and visual inspection.

[0048] Algorithms that are suitable for determining percent sequence identity and sequence similarity are the BLAST and BLAST 2.0 algorithms, which are described in Altschul et al. (1990) J. Moi. Biol. 215: 403-410 and Altschul etal. (1977) Nucleic Acids Res. 25: 3389-3402, respectively. Software for performing BLAST analyses is publicly available through the National Center for Biotechnology Information (NCBI) web site.BRIEF DESCRIPTION OF THE DRAWINGS

[0049] FIG.1A-F. CRISPRa browning activation in human white adipocytes. (A) qRT-PCR of UCP1, PPARGC1A, and PRDM16 in human white adipocytes transduced with CRISPRa targeting UCP1, PPARGC1 A, and PRDM16. Data are represented as mean ± S.D *<0.05. (B) qRT-PCR of TFAM, DIO2, CPTlb, and NRF1 in CRISPRa-modulated adipocytes. Data are represented as mean ± S.D *<0.05, ***<0.001. (C) Oxygen consumption rate (OCR) ofCRISPRa-modulated adipocytes measured by the seahorse assay. Uncoupled OCR. wasmeasured under oligomycin treatment, while maximal OCR was measured under FCCP. (D) Glucose uptake of CRISPRa-modulated adipocytes with or without insulin. Data are represented as mean ± S.D *<0.05, **<0.01, ***<0.001. (E) OCR of CRISPRa-modulated cells was measured by the seahorse assay in BSA- or BSA-Palmitate- medium. Data are represented as mean ± S.D *<0.05, ***<0.001. (F) Exogenous fatty acid oxidation of CRISPRa-modulated adipocytes was calculated by the difference of area under the curve of OCR between BSA- and BSA-Palmitate- media upon FCCP treatment. Data are represented as mean ± S.D *<0.05, **<0.01.

[0050] FIG.2A-K. CRISPRa-modulated adipocytes inhibit cancer cell growth in vitro. (A) Schematic of the co-culturing model of cancer cells and CRISPRa-treated adipocytes using transwell plates and their subsequent phenotyping. (B) Representative images of cancer cells, including breast (MCF7, MDA-MD-436), colon (SW-1417), pancreatic (Pane 10.05), and prostate cancer (DU- 145) that were co-cultured with CRISPRa upregulatmg 1. CP I . PPARGCla, and PRDM16 or control (dCas9-VP64 only) adipocytes. (C) Cancer cell numbers per view’ of image (4 iniages / replicates per condition). Data are represented as mean ± S.D * * *<0.001 . (D) qRT-PCR of the proliferation marker gene, MKI67, for cancer cells co-cultured with CRISPRa-modulated adipocytes. Data are represented as mean ± S.D *<0.05, **<0.01, ***<0.001. (E) Basal glycolysis measured by calculating area under the curve of extracellular acidification rate upon glucose treatment. Data are represented as mean ± S.D *<0.05, **<0.01, ***<0.001. (F) Maximal glycolysis measured by calculating area under the curve of extracellular acidification rate upon oligomycin treatment. Data, are represented as mean ± S.D *<0.05, **<0.01, ***<0.001. (G-H) Glucose uptake of cancer cells co-cultured with CRISPRa- modulated adipocytes without (G) or with (H) insulin. Data are represented as mean ± S.D *<0.05, **<0.01, ***<0.001. (I) qRT-PCR of glucose transporter, GLUT4, and glycolytic enzyme, GCK in cancer cells. Data are represented as mean± S.D *<0.05, **<0.01, ***<0.001. (J) Exogenous fatty acid oxidation of cancer cells calculated by the difference of area under the curve of OCR between BSA- and BSA-Palmitate- media upon FCCP treatment. Data are represented as mean ± S.D **<0.01 , ***<0.001. (K) qRT-PCR of fatty acid transporter, CD36, and fatty acid regulatory transporter, CPTlb in cancer cells that were co-cultured with CRISPRa-treated adipocytes. Data are represented as mean ± S.D *<0.05, ***<0.001.

[0051] FIG.3A-F. Co-transplantation of xenografts with UCP I -CRISPRa modulated human adipose organoids suppresses tumor growth. (A) Schematic of the co-transplantation model for xenografts and CRISPRa-UCPl treated human adipose organoids in immune -deficientSCID mice and their subsequent phenotyping. (B) Representative images of xenograft tumors from various cancer ceils lines, including breast (MCF7 and MDA-MD-436), colon (SW- 1417), pancreatic (Pane 10.05), and prostate cancer (DU-145) that were co-transplanted with UCPl-CRISPRa human adipose organoids or control (dCas9-VP64 only) adipose organoids (n=8 mice per treatment). (C) Volume of xenograft tumors that were co-transplanted with CRISPRa-modulated human adipose organoids compared to control (dCas9-VP64 only) (n=6- 8 mice). Data are represented as mean ± S.D ***<0.001. (D-E) Immunofluorescence staining and quantification of Ki 67 (D), CA9 (E), and CD31 (F) in cryosections of xenograft tumors (n= 4 sections per treatment). Data are represented as mean ± S.D ***<0.001 .

[0052] FIG.4A-L. Implantation of Ucpl-CRISPRa adipose organoids in pancreatic and breast cancer genetic mouse models suppresses cancer development. (A) Schematic of the transplantation model for Ucpl-CRISPRa treated mouse adipose organoids in KPC pancreatic cancer mice and their subsequent phenotyping. (B) Representative images of the pancreas implanted with Ucpl-CRISPRa or control (dCas9-VP64 only) mouse adipose organoids (n=5- 6 mice per treatment). (C) Weight of the pancreas transplanted with Ucpl-CRISPRa modulated mouse adipose organoids compared to control (dCas9-VP64 only) (n=5-6 mice). Data are represented as mean ± S.D **<0.01. (D) qRT-PCR of proliferation marker gene, MKI67, metabolic genes, including Glut2, Gck, Cd36, and Ctplb, from pancreatic tumors cotransplanted with Ucpl-CRISPRa modulated adipocytes. Data are represented as mean ± S.D *<0.05, **<0.01. (E) Immunofluorescence quantification of Ki67, CA9, and CD31 in cryosections of tumors (n= 4 sections per treatment). Data are represented as mean ± S.D *<0.05, **<0.01. (F) Schematic oftlie transplantation model for Ucpl-CRISPRa treated mouse adipose organoids in the mammary gland or on the back of MMTV-PyMT breast cancer mice and their subsequent phenotyping. (G) Representative images of the breast tumor that were implanted with Ucpl-CRISPRa or control (dCas9-VP64 only) adipose organoids in the mammary gland or on the back of the mice (Dorsal) (n=4-5 mice per treatment). (H) Volume of the tumors transplanted with Ucpl-CRISPRa adipose organoids compared to control (dCas9-VP64 only) (n=4-5 mice). Data are represented as mean ± S.D *<0.05, **<0.01. (I) qRT-PCR of proliferation marker gene, MKI67, metabolic genes, including GLUT4, GCK, CD36, and CPTlb, from breast tumors co-transplanted with Ucpl-CRISPRa modulated adipocytes. Data are represented as mean ± S.D *<0.05, **<0.01, ***<0.001. (J-L) Immunofluorescence staining and quantification of Ki67 (J), CA9 (K), and CD31 (L) in tumorcryosections (n= 4 sections per treatment). Data are represented as mean ± S.D **<0.01,***<0.001.

[0053] FIG.5A-E. Cancer organoids co-cultured with UCPl-CRISPRa, both from dissected breast tissue, lead to tumor suppression. (A) Schematic of the co-culturing model of UCPl- CRISPRa modulated human mammary adipocytes and breast cancer organoids from dissected breast tumors. (B) Representative images of breast tumor organoids from five dissected breast tumors that were co-cultured with UCPl-CRISPRa adipocytes or control (dCas9-VP64 only) adipocytes. (C) Breast cancer organoid size and numbers. Data are represented as mean ± S.D *<0.05, **<0.01, ***<0.001. (D) qRT-PCR of proliferation marker gene, MKI67. Data are represented as mean ± S.D *<0.05, **<0.01. (E) qRT-PCR of metabolic genes, including GLUT4, GCK, CD36, and CPTlb of breast cancer organoids that were co-cultured with CRISPRa-modulated adipocytes. Data are represented as mean ± S.D *<0.05, **<0.01, ***<0.001.

[0054] FIG.6A-J. CRISPRa modulating Ucpl, Ppargcla, and Prdml6 reduces adiposity in mice. (A) Schematic of AAV-CRISPRa targeting Ucpl, Ppargcla, and Prdml6 in C57B1 / 6J mice on chow diet. (B) Representative images and body weight of mice treated with AAV-CRISPRa or dCas-VP64 only (control). (C) Fat mass and lean mass measured by DEXA (dual energy X-ray absorptiometry'). (D) Representative images and mass of fat depots, including BAT, iWAT, and pWAT, and kidney. (E) RT-qPCR ofmCherry, Ucpl, Ppargcla, and Prdml6 in adipose tissue, liver, and muscle. (F) Core body temperature measured via rectal of mice kept at 4°C. (G) Whole-body oxygen consumption measured my CLAMS (Comprehensive Lab Animal Monitoring System). (H) Glucose tolerance test performed after overnight fasting, (I) Insulin tolerance test. (J) Plasma insulin measured by ELISA. Data are represented as mean ±S.D *<0.05, **<0.01, ***<0.001.

[0055] FIG.7A-F, CRISPRa modulating Ucpl, Ppargcla, and Prdm 16 protects mice against high fat diet-induced obesity. (A) Schematic of AAV -CRISPRa targeting Ucpl , Ppargc la, and Prdml6 in C57B1 / 6J mice on high fat diet (HFD). Body weight (B) and representative images (C) of mice treated with AAV-CRISPRa or dCas-VP64 (control). (D) Fat mass and lean mass measured by DEXA and representative images of fat depots, including BAT, iWAT, and pWAT, and kidney. (E) Insulin tolerance test performed after overnight fasting. (F) Insulin tolerance test. Data are represented as mean ± S.D *<0.05, **<0.01, ***<0.001.

[0056] FIG.8A-J, CRISPRa modulating Ucpl, Ppargcla, and Prdml 6 reduces weight gain and improves insulin response in ob / ob mice. Schematic of AAV-CRISPRa targeting Ucpl, Ppargcla, and Prdml 6 injecting in ob / ob mice treated at four weeks (A) or 10 weeks (B). Body weight of ob / ob mice treated at four weeks (C) or 10 weeks (D). (E) Representative images of ob / ob mice treated with AAV-CRISPRa at four weeks (left) or 10 weeks (right). (F) Representative images of fat depots, including BAT, iWAT, and pWAT and fat mass and lean mass measured by DEX A of mice treated with AAV-CRISPRa at four weeks (left) or 10 weeks (right). (G) Insulin tolerance test and (H) insulin tolerance test of ob / ob mice treated with AAV - CRISPRa at four weeks (left) or 10 weeks (right). (I) Plasma insulin and (J) free fatty acid of ob / ob mice treated at four weeks. Data are represented as mean ± S.D *<0.05, **<0.01, ***<0.001.

[0057] FIG.9A-K. Transplantation of CRISPRa modulated mouse adipose tissue or human adipose organoids protects mice against obesity, (A) Schematic showing the transplantation of iWAT of mice treated with AAV-CRISPRa targeting Ucpl , Ppargcla, and Prdml 6 in C57BL / 6J mice. (B) Body weight of mice transplanted with fat of mice treated with AAV- CRISPRa or dCas-VP64 (control). (C) Glucose tolerance test. (D) Insulin tolerance test. (E) Plasma insulin and free fatty acid levels. (F) Schematic showing the transplantation of human adipose organoids treated with AAV-CRISPRa targeting UCP1, PPARGCla, and PRMD16 in SCID mice. (G) Body weight of mice transplanted with human adipose organoids treated with AAV-CRISPRa or dCas-VP64 (control). (H) Representative images and fat mass of SCID mice implanted with CRISPRa treated human adipose organoids. (I) Representative images and weight of fat depots, including BAT, iWAT, and pWAT, and kidney. (J) Glucose tolerance test. (K) Insulin tolerance test. Data are represented as mean ± S.D *<0.05, **<0.01, ***<0.001.

[0058] FIG.10A-F. CRISPRa modulating Foxol, Ffarl, and Ffar4 improves glucose clearance and insulin sensitivity in mice. RT-qPCR of Foxol, Ffarl, and Ffar4 in 3T3-L1 adipocytes transfected (A) or infected with AAV-CRISPRa targeting Foxol, Ffarl, and Ffar4. (B) Representative images and body weight of mice treated with AAV-CRISPRa or dCas- VP64 (control). (C) Glucose tolerance test performed after overnight fasting and (I) insulin tolerance test of mice injected with AAV-CRISPRa targeting Foxol, Ffarl , and Ffar4 and fed with chow diet. (E) Glucose tolerance test and (F) insulin tolerance test of mice injected with AAV-CRISPRa targeting Foxol, Ffarl, and Ffar4 and fed with high fat diet. Data are represented as mean ± S.D *<0.05, **<0.01 .[0059 j FIG.l 1 A-B. CRISPRa upregulation of UCP 1 , PPARGC 1 A, and PRDM 16 in human white adipocytes. (A) qRT-PCR of UCP1, PPARGC1A, and PRDM16 in white adipocytes transfected with CRISPRa using five different gRNAs per gene. Data are represented as mean ± S.D. *<0.05, **<0.01, ***<0.001. (B) qRT-PCR of UCP1 , PPARGC 1A, and PRDM16 in human adipocytes transduced by AAV9 CRISPRa with the top two gRNAs per gene. Data are represented as mean ± S.D. *<0.05, **<0.01, ***<0.001.[0060j FIG.12A-C. Proliferation and metabolic rate of various cancer ceils co-cultured withCRISPRa-modulated human adipocytes. (A) BrdU incorporation, (B) Oxygen consumption rate (OCR) ,and (C) Fatty acid oxidation of various cancer cells (MCF-7, MDA-MB-436, SW- 1417, Pane.10.05, and Du-145) that were co-culture with CRISPRa-modulated adipocytes. Data are represented as mean ± S.D. *<0.05, **<0.01, ***<0.001.[0061 [ FIG.13A-G. CRISPRa upregulation of UCP1, PPARGC1A, and PRDM16 in human adipose organoids and proliferation and metabolic gene expression in tumors co-transplanted with CRISPRa-modulated adipose organoids. (A) Representative images of human adipose organoids transduced with UCP1, PPARGC 1 A, and PRDM16 AAV9 CRISPRa showing mCherry expression. (B) qRT-PCR of FABP4, PLIN1, and ADIPOQ in adipose organoids. Data are represented as mean ± S.D. *<0.05, **<0.01, ***<0.001. (C) qRT-PCR of UCP1, PPARGC 1 A, and PRDM16 in human adipose organoids transduced by AAV9 CRISPRa. Data are represented as mean ± S.D. **<0.01, ***<0.001. (D) Body weight of mice that were cotransplanted with UCP 1 -modulated adipose organoids and cancer cells. (E) qRT-PCR of MKI67 in xenograft tumors derived from MCF-7, MDA-MB-436, Pane 10.05, and DU-145 cancer cells that were co-transpianted with UCPl-CRISPRa modulated adipose organoids. Data are represented as mean ± S.D. **<0.01, ***<0.001. (F) qRT-PCR of GLUT4, GCK, CD36, and CTP1B in xenograft tumors. Data are represented as mean ± S.D. *<0.05, **<0.01, ***<0.001. (G) Plasma insulin levels of wild type (WT) SC1D mice and mice that were cotransplanted with UCPl-CRISPRa adipose organoids and cancer cells. Data are represented as mean ± S.D. **<0.01, ***<0.001.

[0062] FIG.14A-H. CRISPRa upregulation of Ucpl in mouse white adipocytes and phenotypic analysis of mouse genetic cancer models. (A) qRT-PCR of Ucpl, in white adipocytes transfected with CRISPRa using five different gRNAs. Data are represented as mean ± S.D. *<0.05, ***<0.001. (B) qRT-PCR of Ucpl in mouse adipocytes transduced by AAV9-CRISPRa with the top two gRNAs per gene. Data are represented as mean ± S.D.**<0.01. (C) qRT-PCR of mcherry and Ucpl in mouse adipose organoids. Data are represented as mean i S.D. ***<0.001. (D) Body weight of pancreatic cancer KPC mice implanted with control (dCas9-VP64) or Ucpl-upregulated mouse adipose organoids. (E) Immunofluorescence staining and quantification of Ki67, CA9, and CD31 in cryosections of pancreatic tumors. (F) Plasma insulin levels of pancreatic cancer genetic mice implanted with either Ucpl-CRISPRa adipose organoids or control organoids. Data are represented as mean ± S.D. *<0.05. (G) Body weight of breast cancer (MMTV-PyMT) mice implanted with control (dCas9-VP64) or Ucpl -CRISPRa mouse adipose organoids nearby mammary gland (MG) or distal (DOR). (H) Plasma insulin levels of breast cancer genetic mice implanted with either Ucpl-CRISPRa adipose organoids or control organoids nearby mammary gland (MG) or distal (DOR). Data are represented as mean ± S.D, *<0.05.

[0063] FIG.15A-B. CRISPRa upregulation of UCP1 in human mammary gland adipocytes. (A) Representative images of adipocytes isolated from mammary’ glands that were transduced with UCPl-CRISPRa AAV9. (B) qRT-PCR of dCas9, mcherry, and UCP1 in CRISPRa- modulated mammary gland adipocytes. Data are represented as mean ± S.D. *<0.05, **<0.01, ***<0.001.

[0064] FIG.16A-B depict results showing UCP 1 -o verexpressing human adipocytes suppressMCF7 cancer ceil growth. (A) Representative images of MCF7 breast cancer cells that were co-cultured with UCP1 -overexpressing human adipocytes. (B) qRT-PCR of MKI67, a proliferative marker, and metabolic genes, including GLUT4, GCK, CD36, and CTPlb.DETAILED DESCRIPTION OF THE INVENTION

[0065] The present disclosure is directed to compositions and methods to prevent and treat metabolic diseases, diabetes, and cancers through regulating expression of the genes associated with glucose and lipid metabolism. The inventors have found that upregulating or overexpressing certain gene products or downregulating other gene products in adipocytes and other cells can convert these cells to a brown fat phenotype with increased cell glucose and lipid metabolism. Implantation of these cells results in reduction of obesity, reduction of metabolic diseases (including but not limited to type II diabetes) and also reduction of cancers. As explained further herein, one or more of the gene products can be upregulated using a targeted polypeptide linked to a transcriptional activator to increase expression of the gene products in a cell from the native gene sequence or by overexpression of the gene products, forexample by introduction of one or more heterologous expression cassettes encoding the gene products. In addition, one or more of the gene products can be downregulated using a targeted polypeptide linked to a transcriptional repressor to decrease expression of the gene products or otherwise downregulate expression of the gene products (e.g., using siRNAs, antisense or other down regulation methods). Optionally, upregulation / overexpression of one or more gene products can be combined with downregulation of one or more other gene products in the same cells, to facilitate converting to a brown fat phenotyp*Genes of interest

[0066] Any of the following gene products can be upregulated or over expressed m mesenchymal stem cells, pre-adipocytes, fat cells, adipocytes, adipose organoids or fat progenitor cells as described herein to make cells having the desired metabolic phenotype.Table 1 . Representative genes and proteins associated with glucose and lipid metabolism, and promoter information.

[0067] Uncoupling protein 1 (UCP1, or SLC25A7) is responsible for thermogenic respiration and generally to the regulation of energy balance. Our study showed that upregulation of UCP1 reduces body weight, fat mass, improves insulin sensitivity, and inhibits cancer growth.

[0068] PPARG coactivator 1 alpha (PP ARGCI A, or PCG1A) is a transcriptional coactivator for steroid receptors and nuclear receptors. Greatly increases the transcriptional activity of PPARG and thyroid hormone receptor on the uncoupling protein promoter. Our study shows that upregulation of PP ARGCI A reduces body weight, fat mass, improves insulin sensitivity, and inhibits cancer growth.

[0069] PR / SET domain 16 (PRDM16) binds DNA and functions as a transcriptional regulator. Functions in the differentiation of brown adipose tissue (BAT) which is specialized in dissipating chemical energy in the form of heat in response to cold or excess feeding while white adipose tissue (WAT) is specialized in the storage of excess energy and the control of systemic metabolism. Our study shows that upregulation of PRDM16 reduces body weight, fat mass, improves insulin sensitivity, and inhibits cancer growth.

[0070] FFAR1 or GPR40 is a G-protein coupled receptor for medium and long chain saturated and unsaturated fatty acids that plays an important role in glucose homeostasis. Our study shows that upregulation of FFA1R improves insulin sensitivity.

[0071] FFAR4 or GPR120 is a G-protein-coupIed receptor for long-chain fatty acids (LCFAs) with a major role in adipogenesis, energy metabolism and inflammation. Our study show upregulation of FFA4R improves insulin sensitivity.

[0072] FOXO1 is a transcription factor that is the main target of insulin signaling and regulates metabolic homeostasis in response to oxidative stress. Our study show upregulation of FOXO1 improves insulin sensitivity.[0073 j GLUT! is a facilitative glucose transporter, which is responsible for constitutive or basal glucose uptake. Upregulation of SLC2A1 can improves insulin sensitivity and inhibits cancer growth .

[0074] GLUT2 is a facilitative hexose transporter that mediates the transport of glucose, fructose and galactose. Upregulation of SLC2A2 can improves insulin sensitivity and inhibits cancer growth.

[0075] GLUT3 is a facilitative gl ucose transporter that can also mediate the uptake of various other monosaccharides across the cell membrane. Upregulation of SLC2A3 can improves insulin sensitivity and inhibits cancer growth.

[0076] GLUT4 is an Insulin-regulated facilitative glucose transporter, which plays a key role in removal of glucose from circulation. Upregulation of SLC2A4 can improves insulin sensitivity and inhibits cancer growth.

[0077] CHREBP is a glucose sensing transcription factor. Upregulation of MLXIPL can improves insulin sensitivity and inhibits cancer growth.

[0078] CD36 is a multifunctional glycoprotein that acts as a receptor tor a broad range of ligands, including long-chain fatty acids. Upregulation of CD36 can reduce body weight, improves insulin sensitivity and inhibits cancer growth.

[0079] CPT1B is a member of the camitine / choline acetyltransferase family, is the ratecontrolling enzyme of the long-chain fatty acid beta-oxidation pathway. Upregulation of CTP1B can reduce body weight, improves insulin sensitivity and inhibits cancer growth.

[0080] AIFM2 or FSB1 has functions in the glycolysis of brown adipose tissue (BAT). Upregulation of AIFM2 can reduce body weight, fat mass, improves insulin sensitivity, and inhibits cancer growth.

[0081] GSK is a constitutively active protein kinase that acts as a negative regulator in the hormonal control of glucose homeostasis. Upregulation of GSK3B can reduce body weight, fat mass, improves insulin sensitivity, and inhibits cancer growth.

[0082] IRS1 mediates the control of various cellular processes by insulin. Upregulation of IRS1 can reduce body weight, fat mass, improves insulin sensitivity, and inhibits cancer growth.

[0083] DGAT1 and DGAT2 are fatty acid breakdown! enzymes.[0084 j ACACA and ACACB are biotin-containing enzymes that catalyze the carboxylation of acetyl-CoA to malonyl-CoA, which is the rate-limiting step in fatty acid synthesis.

[0085] NRIP1 is a transcriptional co-repressor that reduces the activity of various metabolic nuclear receptors in adipocytes by interacting with their AF2 domain. These lead to the reduction of UCPl, NRG4 and ESRRA expression and suppression of mitochondrial respiration, glucose transport and fatty acid oxidation.

[0086] CKB, creatine kinase B, is a cytoplasmic enzyme involved in energy homeostasis. It transfers phosphate between ATP and phsophgens.Upregulating Gene Expression

[0087] Compositions and methods for preventing or treating metabolic diseases, diabetes, and cancers in a subject are provided. In some embodiments, the compositions and methods upregulate expression of at least one gene associated with glucose and lipid metabolism, i.e., Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactrvator 1 alpha (PPARGC1A / PCG1A), PR / SET domain 16 (PRDM16), F 'FAR 1 / GPR40, FFAR4 / GPR120, FOXO1 , GLUT1 , GLUT2, GLUT3, GLUT4, CIIREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRS1 , DGAT1, DGAT2, UPP1, CKB and / or ACACA or as found in Table 2, in one or more cells (e.g., in mesenchymal stem cells, pre-adipocytes, fat cells, adipocytes, adipose organoids or fat progenitor cells ) in the subject. Upregulating the expression of the gene of interest can include, for example, introducing a targeted polypeptide linked to a transcriptional activator into the cell, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to the gene of interest, thereby increasing expression of the gene product. A targeted polypeptide refers to a polypeptide that specifically targets a promoter or enhancer sequence either as a function of the polypeptide’s direct affinity for the promoter or enhancer sequence or as guided by a nucleic acid sequence (for example as a gRNA-guided CRISPR nuclease). For example, catalytically-inactive C-as protein variants may be fused to transcriptional activation domains to control gene expression (Ma et al., Protein and Cell, 2(1 1):879-888, 2011: Maeder et al., Nature Methods, 10:977-979, 2013; and Konermann et al., Nature, 517:583-588, 2014).

[0088] The targeted polypeptide is covalently or non-covalently linked to a transcriptional activator that upregulates the expression of the gene of interest. The targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to the gene of interest andthus brings the transcriptional activator close to the promoter or enhancer to enhance transcription of the gene of interest.

[0089] In some embodiments, the targeted polypeptide is an inactive nuclease. Examples of nucleases include, but are not limited to, a zinc finger nuclease (ZFN), a transcription activatorlike effector nuclease (TALEN), a clustered regularly interspaced short palindromic repeats (CRISPR) nuclease, a site-specific recombinase, a transposase, a topoisomerase, and modified derivatives and variants thereof. In some embodiments, the nuclease is capable of targeting a designated nucleotide or region within the target gene. In some embodiments, the nuclease is capable of targeting a region positioned between the 5' and 3' regions of the target gene. In another embodiment, the nuclease is capable of targeting a region positioned upstream or downstream of the 5' and 3' regions of the target gene (e.g, upstream or downstream of the transcription start site (TSS)). A recognition sequence is a polynucleotide sequence that is specifically recognized and / or bound by the targeted polypeptide. The length of the recognition site sequence can vary, and includes, for example, nucleotide sequences that are at least 10, 12, 14, 16, 18, 19, 20, 21, 2.2, 23, 24, 25, 26, 27, 28, 29, 30, 35, 40, 45, 50, 55, 60, 65, 70 or more nucleotides in length. Inactivated nucleases are polypeptides that retain the DNA-binding ability'- of a nuclease while substantially lacking cleaving activity. In some embodiments, the nuclease can be identical to a native of modified nuclease but having 1, 2, 3, 4 or more amino acid changes that inactivate the nuclease (cleaving) activity.

[0090] In some embodiments, the targeted polypeptide is a catalytically inactive nuclease. In certain aspects, the catalytically inactive nuclease is derived from a zinc finger nuclease (ZFN), a transcription activator-like effector nuclease (TALEN), a clustered regularly interspaced short palindromic repeats (CRISPR) nuclease, a site-specific recombinase, a transposase, a topoisomerase, and modified derivatives and variants thereof In some embodiments, the targeted polypeptide is a catalytically inactive ZFN. In some embodiments, the targeted polypeptide is a catalytically inactive TALEN, In some embodiments, the targeted polypeptide is a TAL effector (TALE). In some embodiments, the targeted polypeptide is a catalytically inactive clustered regularly interspaced short palindromic repeats (CRISPR) nuclease. In certain embodiments, the targeted polypeptide is dCas9.Zinc Finger Nuclease (ZFN)

[0091] In some embodiments, the targeted polypeptide is a zine-finger nuclease (ZFN) or a modified derivative. ZFNs typically comprise a zinc finger DNA binding domain and anuclease domain. Generally, ZFNs include two zinc finger arrays (ZFAs), each of which is fused to a single subunit of a non-specific endonuclease, such as the nuclease domain from the FokI enzyme, which becomes active upon dimerization. Typically, a single ZFA consists of 3 or 4 zinc finger domains, each of which is designed to recognize a specific nucleotide triplet (GGC, GAT, etc.). A ZFN composed of two "3 -finger" ZFAs is therefore capable of recognizing an 18 base pair target site (i.e., recognition sequence); an 18 base pair recognition sequence is generally unique, even within large genomes such as those of humans and plants. By directing the co-localization and dimerization of the two FokI nuclease monomers, ZFNs generate a functional site-specific endonuclease that can target a particular locus (e.g., gene, promoter or enhancer).

[0092] Zinc-finger nucleases useful in the methods disclosed herein include those that are known and ZFN that are engineered to have specificity for one or more target sites described herein (e.g,, promotor or enhancer nucleotide sequence). Zinc finger domains are amenable tor designing polypeptides which specifically bind a selected polynucleotide recognition sequence within a target site of the host cell genome. ZFN can comprise an engineered DNA- binding zinc finger domain finked to a non-specific endonuclease domain, for example, a nuclease domain from a Type Ils endonuclease such as HO or FokI. In some examples, a zinc finger DNA binding domain can be fused to a site-specific recombinase, transposase, or a derivative thereof that retains DNA nicking and / or cleaving activity.|0093J Each zinc finger domain recognizes three consecutive base pairs in the target DNA. For example, a three-finger domain recognizes a sequence of nine contiguous nucleotides, with a dimerization requirement of the nuclease, two sets of zinc finger triplets are used to bind a 18 nucleotide recognition sequence. Useful zinc finger modules include those that recognize various GNN and ANN triplets (Dreier et al., (2001) J Biol Chem 276:29466-78; Dreier et al., (2000) J Mol Biol 303:489-502; Liu et al., (2002.) J Biol Chem 277:3850-6), as well as those that recognize various CNN or TNN triplets (Dreier et al., (2005) J Biol Chem 280:35588-97; Jamieson et al., (2003) Nature Rev Drug Discovery 2:361-8). See also, Durai et al., (2005) Nucleic Acids Res 33:5978-90; Segal, (2002) Methods 26:76-83; Porteus and Carroll, (2005) Nat Biotechnology 23:967-73; Pabo et al,, (2001) Ann Rev Biochem 70:313-40; Wolfe et al., (2000) Ann Rev Biophys Biomol Struct 29: 183-212; Segal and Barbas (2001) Curr Opin Biotechnol 12:632-7; Segal et ak, (2003) Biochemistry 42:2137-48; Beerli and Barbas, (2002)Nat Biotechnol 20: 135-41; Carroll et al., (2006) Nature Protocols 1: 1329; Ordiz et al., (2002)Proc Natl Acad Sci USA 99: 13290-5; Guan et al., (2002) Proc Natl Acad Sei USA 99: 13296-301 ; W02002099084; WOOO / 42219; WO02 / 42459; W02003062455; US20030059767; US Patent Application Publication Number 2003 / 0108880; U.S. Pat. Nos. 6,140,466, 6,51 1,808 and 6,453,242. Useful zinc-finger nucleases also include those described in W003 / 080809; W005 / 014791; W005 / 084190; W008 / 021207; W009 / 042186; WO09 / 054985; and WO 10 / 065123.TALENs

[0094] In some embodiments ofthe methods and compositions described herein, the targeted polypeptide is derived from a transcription activator-like effector nuclease (TALEN). In some embodiments, the targeted polypeptide is a transcription activator-like effector (TALE). TAI, effectors (TALEs) are proteins secreted by Xanthomonas bacteria and play an important role in disease or triggering defense mechanisms, by binding host DNA and activating effectorspecific host genes, see, e.g., Gu et al. (2005) Nature 435: 1122-5; Yang et al., (2006) Proc. Natl. Acad. Sci. USA 103: 10503-8; Kay et al., (2007) Science 318:648-51; Sugio et al., (2007) Proc. Natl. Acad. Sci. USA 104: 10720-5; Romer et al., (2007) Science 318:645-8; Boch et al., (2009) Science 326(5959): 1509-12; and Moscou and Bogdanove, (2009) 326(5959): 1501. A TALEN comprises a TAL effector DNA-binding domain fused to a DNA cleavage domain, and in embodiments herein, the cleavage domain can include one or more mutations such that the cleavage domain is inactive. The DNA binding domain interacts with DNA in a sequencespecific manner through one or more tandem repeat domains. The repeated sequence typically comprises 33-34 highly conserved amino acids with divergent 12th and 13th amino acids. These two positions, referred to as the Repeat Variable Diresidue (RVD) are highly variable and show a strong correlation with specific nucleotide recognition (Boch et al., (2009) Science 326(5959): 1509-12; and Moscou and Bogdanove, (2009) 326(5959): 1501). Tins relationship between amino acid sequence and DNA recognition sequence has allowed for the engineering of specific DNA-binding domains by selecting a combination of repeat segments containing the appropriate RVDs.[0095 j The TAL-effector DNA binding domain can be engineered to bind to a target DNA sequence. While not to be construed as limiting, TALENs useful for the methods provided herein include those described in W010 / 079430 and U.S. Patent Application Publication No.2011 / 0145940.

[0096] In some embodiments, the TAL effector DNA binding domain can comprise 10 or more DNA binding repeats, and preferably 15 or more DNA binding repeats. In someembodiments, each DNA binding repeat comprises a RVD that determines recognition of a base pair in the target DNA, and wherein each DNA binding repeat is responsible for recognizing one base pair in the target DNA. In some embodiments, the RVD comprises one or more of: HD tor recognizing C; NG for recognizing T; NI for recognizing A; NN for recognizing G or A; NS for recognizing A or C or G or T; N* for recognizing C or T, where * represents a gap in the second position of the RVD; HG for recognizing T; H* for recognizing T, where * represents a gap in the second position of the RVD; IG for recognizing T; NK for recognizing G; HA for recognizing C; ND for recognizing C; HI for recognizing C; HN for recognizing G; NA for recognizing G; SN for recognizing G or A; and YG for recognizing T.Cas Endonuclease

[0097] In some embodiments, the targeted polypeptide used in methods and compositions of the disclosure is a clustered regularly interspaced short palindromic repeats (CRISPR) - associated (Cas) protein or a modified derivative. A Cas protein refers to an RNA-guided double-stranded DNA-binding nuclease protein or nickase protein. Wild-type Cas nuclease has two functional domains, e.g., RuvC and HNH, that cut different DNA strands. A Cas protein can induce double-strand breaks in genomic DNA (target nucleic acid) when both functional domains are active. The Cas protein can comprise one or more catalytic domains of a Cas protein derived from bacteria belonging to the group consisting of Corynebacter, Sutterella, Legionella, Treponema, Filifactor, Eubacterium, Streptococcus, Lactobacillus, Mycoplasma, Bacteroides, Flaviivola, Flavobacterium, Sphaerochaeta, Azospirillum, Gluconacetobacter, Neisseria, Roseburia, Parvibaculum, Staphylococcus, Nrtratifractor, and Campylobacter. In some embodiments, the Cas protein can be a fusion protein, e.g., the two catalytic domains are derived from different bacteria species.

[0098] Non-limiting examples of Cas proteins include Cast, CaslB, Cas2, Cas3, Cas4, Cas5, Cas6, Cas7, Cas8, Cast) (also known as Csnl and Csxl2), Cas 10, Csyl, Csy2, Csy3, Csel, Cse2, Cscl, Csc2, Csa5, Csn2, Csm2, Csm3, Csm4, Csm5, Csm6, Cmrl, Cmr3, Cmr4, Cmr5, Cmr6, Csbl , Csb2, Csb3, Csxl7, Csxl4, CsxlO, Csxl 6, CsaX, Csx3, Csxl , Csxl5, Csfl , Csf2, Csf3, Csf4, Cpfl, homologs thereof, variants thereof, mutants thereof, and derivatives thereof. There are three main types of Cas proteins (type I, type II, and type III), and 10 subtypes including 5 type I, 3 type II, and 2 type III proteins (see, e.g., Hochstrasser and Doudna, Trends Biochem Sei, 2015:40(l):58-66). Type II Cas proteins include Casl, Cas2, Csn2, Cas9, and Cfpl. These Cas proteins are known to those skilled in the art. For example, the amino acid sequence of the Streptococcus pyogenes wild-type Cas9 polypeptide is set forth, e.g., in NBCIRef. Seq. No. NP_269215, and the amino acid sequence of Streptococcus thermophilus wildtype Cas9 polypeptide is set forth, e.g., in NBCI Ref. Seq. No. WP 011681470.

[0099] Cas proteins, e.g., Cas9 nucleases, can be derived from a variety of bacterial species including, but not limited to, Veillonella atypical, Fusobacterium nucleatum, Filifactor alocis, Solobacterium moorei, Coprococcus cates, Treponema denticola, Peptoniphilus duerdenii, Cateni bacterium mitsuokai, Streptococcus mutans. Listeria innocua, Staphylococcus pseudintermedius, Acidaminococcus intestine, Olsenella uli, Oenococcus kitaharae, Bifidobacterium bifidum. Lactobacillus rhamnosus, Lactobacillus gassen, Finegoldia magna, Mycoplasma mobile. Mycoplasma gallisepticum. Mycoplasma ovipneumoniae, Mycoplasma canis, Mycoplasma synoviae, Eubacterium rectale, Streptococcus thermophilus, Eubacterium dolichum. Lactobacillus coryniformis subsp. Torquens, Ilyobacter polytropus, Ruminococcus albus, Akkermansia muciniphila, Acidothermus celluiolyticus, Bifidobacterium longum. Bifidobacterium dentium, Corynebacterium diphtheria, Elusimicrobium minutum, Nitratifractor salsuginis, Sphaerochaeta globus, Fibrobacter succinogenes subsp. Succinogenes, Bacteroides fragilis, Capnocytophaga ochracea, Rhodopseudomonas pahistns, Prevotella micans, Prevotella ruminicola, Flavobacterium columnare, Aminomonas paucivorans, Rhodospirillum rubrum. Candidates Puniceispirillum marinum, Verminephrobacter eiseniae, Ralstonia syzygii, Dinoroseobacter shibae. Azospirillum, Nitrobacter hamburgensis, Bradyrhizobium, Wolinella succinogenes, Campylobacter jejuni subsp. Jejuni, Helicobacter mustelae. Bacillus cereus, Acidovorax ebreus, Clostridium perfringens, Parvibaculum lavamen tivorans, Roseburi a mtestinalis. Neisseria meningitidis, Pasteurella multocida subsp. Multocida, Sutterella wadsworthensis, proteobacterium, Legionella pneumophila, Parasutterella excrementihominis, Wolinella succinogenes, and Francisella novicida.

[0100] In the embodiments described herein, the Cas protein is a nuclease -inactive variant. For example, useful variants of the Cas9 nuclease can include a single inactive catalytic domain, such as a RuvC- or HNH- enzyme or a nickase. A Cas9 nickase has only one active functional domain and can cut only one strand of the target nucleic acid, thereby creating a single strand break or nick. In some embodiments, the Cas9 nuclease can be a mutant Cas9 nuclease having one or more amino acid mutations. For example, the mutant Cas9 having at least a D10A mutation is a Cas9 nickase. In other embodiments, the mutant Cas9 nuclease having at least a H840A mutation is a Cas9 nickase. Other examples of mutations present in a Cas9 nickase include, without limitation, N854A and N863A. A double-strand break can beintroduced using a Cas9 nickase if at least two DNA -targeting RNAs that target opposite DNA strands are used. A double-nicked induced double-strand break can be repaired by NHEJ or HDR (Ran et al., 2.013, Cell, 154: 1380-1389). Non-limiting examples of Cas9 nucleases or nickases are described in, for example, U.S. Patent Nos. 8,895,308; 8,889,418; and 8,865,406 and U.S. Application Publication Nos. 2014 / 0356959, 2014 / 0273226 and 2014 / 0186919. TheCas9 nuclease or nickase can be codon-optimized for the target cell or target organism.|0101] In some embodiments, a catalyticaliy-inactive Cas protein variant can be a Cas9 polypeptide that contains two silencing mutations of the RuvCl and HNH nuclease domains (D10A and H840A), which is referred to as dCas9 (Jinek et al., Science, 2012, 337:816-821; Qi et al.. Cell, 152(5): 1 173-1183). In one embodiment, the dCas9 polypeptide from Streptococcus pyogenes comprises at least one mutation at position D10, G12, G17, E762, H840, N854, N863, H982, H983, A984, D986, A987 or any combination thereof. Descriptions of such dCas9 polypeptides and variants thereof are provided in, for example, International Patent Publication No. WO 2013 / 176772. The dCas9 enzyme can contain a mutation at D10, E762, H983, or D986, as well as a mutation at H840 or N863. In some instances, the dCas9 enzyme can contain a DlOA or DI ON mutation. Also, the dCas9 enzyme can contain aH840A, H840Y, or H840N. In some embodiments, the dCas9 enzyme can contain D10A and H840A; D10 A and H840Y; D10A and H840N; DION and H840A; DION and H840Y; or DION and H840N substitutions. 'The substitutions can be conservative or non-conservative substitutions to render the Cas9 polypeptide catalytically inactive and able to bind to target nucleic acid. In methods and compositions described herein, a catalyticaliy-inactive Cas protein (e.g., dCas9) linked to a transcriptional activator domain (e.g., VP64), can be used to target a promoter or enhancer sequence of the gene of interest in order to upregulate the expression of the gene.

[0102] As described herein, the targeted polypeptide can be a catalyticaliy-inactive CRISPR nuclease. In some embodiments, the targeted polypeptide is dCas9. The CRISPR activation (CRISPRa) system utilizes a catahlicariy-inactive CRISPR nuclease (e.g. dCas9) linked to one or more transcriptional activators to upregulate expression of the genes of interest. CRISPRa further includes a gRNA targeting a portion of the promoter or enhancer sequence of the gene whose expression is to be upregulated. In some embodiments, transcriptional activators, fused to a catalyticaliy-inactive nuclease or a gRNA, can recruit transcriptional factors or RNA polymerase close to the coding sequence of the gene of interest. For example, the VP64 transcriptional activator or any other transcriptional activator can be fused to the catalyticaliy- inactive nuclease to increase transcription of the target gene,

[0103] In some embodiments, upregulating the expression of the target gene in a cell can include introducing into the ceil a catalytically-inactive nuclease (e.g., a dCas9) linked to a transcriptional activator domain (e.g., VP64) and a gRNA that targets a portion of a promoter sequence operably linked to a coding sequence of the target gene. In certain embodiments, the gRNA targets the promoter sequence comprising the nucleic acid sequence selected from SEQ ID NOs: 78-114 or 116 which operably linked to a coding sequence of the protein comprising the amino acid sequence selected from SEQ ID NOs: 57-77 or 1 15, and can comprise a sequence having at least 90%, 95%, 98%, 99% or 100% identity to a sequence selected from SEQ ID NOs: 1-55 or as shown in Table S2. For example, a promoter sequence operably linked to a coding sequence of the UCP1 protein (SEQ ID NO: 57) can comprise the sequence of SEQ ID NO: 78. In specific embodiments, the gRNA targeting the promoter sequence operably linked to a coding sequence of the UCP1 protein (SEQ ID NO: 57) can comprise a sequence having at least 90%, 95%, 98%, 99% or 100% identity to a sequence of any one of SEQ ID NOS: 1-6.

[0104] Further, upregulating the expression of the target gene in a cell can include introducing into the cell a catalytically-inactive nuclease (e.g,, a dCas9) linked to a transcriptional activator domain (e.g., VP64) and a gRNA that targets a. portion of an enhancer sequence operably linked to a coding sequence of the target gene.

[0105] A Cas protein can be guided to its target nucleic acid by a guide RNA (gRNA). A gRNA is a version of the naturally occurring two-piece guide RNA (crRNA and tracrRNA) engineered into a two-piece gRNA or a single, continuous sequence. A gRNA can contain a guide sequence (e.g., the crRNA equivalent portion of the gRNA) that targets the Cas protein to the target nucleic acid and a scaffold sequence that interacts with the Cas protein (e.g., the tracrRNAs equivalent portion of the gRNA). A gRNA can be selected using a software. As a non-limiting example, considerations for selecting a gRNA can include, e.g., the PAM sequence for the Cas protein to be used, and strategies for minimizing off-target modifications. Tools, such as NLTACK® and the CRISPR Design Tool, can provide sequences for preparing the gRN A, for assessing target modification efficiency, and / or assessing cleavage at off-target sites.

[0106] The guide sequence in the gRNA may be complementary to a specific sequence within a target nucleic acid (e.g., the UCP1 promoter sequence or the UPP1 promoter). Hie 3‘ end of the target nucleic acid sequence can be followed by a PAM sequence. Approximately20 nucleotides upstream of the PAM sequence is the target nucleic acid. In general, a Cas9 protein or a variant thereof cleaves about three nucleotides upstream of the PAM sequence. The guide sequence in the gRNA can be complementary to either strand of the target nucleic acid.

[0107] In some embodiments, the guide sequence of a gRNA comprises about 100 nucleic acids at the 5’ end of the gRNA that can direct the Cas protein to the target nucleic acid site using RNA-DNA complementarity base pairing. In some embodiments, the guide sequence comprises about 20 nucleic acids at the 5 ’ end of the gRN A that can direct tire Cas protein to the target nucleic acid site using RNA-DNA complementarity base pairing. In other embodiments, the guide sequence comprises less than 20, e.g., 19, 18, 17, 16, 15 or less, nucleic acids that are complementary to the target nucleic acid site. In some instances, the guide sequence in the gRNA contains at least one nucleic acid mismatch in the complementarity region of the target nucleic acid site. In some instances, the guide sequence contains about 1 to about 10 nucleic acid mismatches in the complementarity region of the target nucleic acid site.

[0108] Tire scaffold sequence in the gRNA can serve as a protein-binding sequence that interacts with the Cas protein or a variant thereof. In some embodiments, the scaffold sequence in the gRNA can comprise two complementary stretches of nucleotides that hybridize to one another to form a double-stranded RNA duplex (dsRNA duplex). The scaffold sequence may have structures such as lower stem, bulge, upper stem, nexus, and / or hairpin. In some embodiments, the scaffold sequence in the gRN A can be between about 90 nucleic acids to about 120 nucleic acids, e.g., about 90 nucleic acids to about 115 nucleic acids, about 90 nucleic acids to about 1 10 nucleic acids, about 90 nucleic acids to about 105 nucleic acids, about 90 nucleic acids to about 100 nucleic acids, about 90 nucleic acids to about 95 nucleic acids, about 95 nucleic acids to about 120 nucleic acids, about 100 nucleic acids to about 120 nucleic acids, about 105 nucleic acids to about 120 nucleic acids, about 110 nucleic acids to about 120 nucleic acids, or about 115 nucleic acids to about 120 nucleic acids.

[0109] In some embodiments, the gRNAs used m methods and compositions of the disclosure target a portion of a promoter or enhancer sequence operably linked to a coding sequence of the gene of interest. The catalytically-inactive nuclease (e.g., a dCas9) can be linked to a transcriptional activator domain (e.g. VP64). In certain embodiments, the gRNA targets the promoter sequence comprising the sequence of SEQ ID NO: 78- 114 or 116 and cancomprise a sequence having at least 90%, 95%, 98%, 99% or 100% identity to a sequence of any one of SEQ ID NOS: 1-55 or as shown in Table S2.[OHO] In some embodiments, the catalytically-inactive nuclease (e.g., a dCas9) linked to a transcriptional activator domain (e.g. VP64), can be guided by one gRNA and upregulate the expression of the gene of interest. In some embodiments, the catalytically-inactive nuclease (e.g., a dCas9) linked to a transcriptional activator domain (e.g. VP64), can be guided by multiple gRNAs in the same ceil and in some embodiments upregulate the expression of multiple genes of interest.Transcriptional activators

[0111] Transcriptional activators are protein domains or whole proteins linked to a targeted polypeptide to assist in the recruitment of important co-factors as well as RNA Polymerase for transcription of the genets) targeted by the system. In order for a protein to be made from the gene that encodes it, RNA polymerase must make RNA from the DNA template of the gene during a process called transcription. Transcriptional activators have a DNA binding domain and a domain for activation of transcription. The activation domain can recruit general transcription factors or RNA polymerase to the gene sequence. Activation domains can also function by facilitating transcription by stalled RNA polymerases, and in eukaryotes can act to move nucleosomes on the DNA or modify histones to increase gene expression. These activators can be introduced into the system through attachment to a targeted polypeptide (e.g., dCas9). As used herein, the term “transcriptional activator,” “transcriptional activation domain,” and “transcriptional activator domain” are used interchangeably.

[0112] Tire transcriptional activator used in methods and compositions of the disclosure is linked to a targeted polypeptide which targets a portion of a promoter or enhancer sequence operably linked to a gene of interest. Examples of transcriptional activators include, but are not limited to, HSF1, VP 16, VP48, VP64, VP 160, p53, p65, RTA, MyoDl, SET7, ESDI, CIB1, AD2, CR3, GATA4, SP1, MEF2C, TAX, SET9, VP64-p65-RTA (VPR), Histone Acetyltransferase p300, TET1 Hydroxylase Catalytic Domain, Synergistic activation mediator (SAM), SunTag, and PPAR-gamma. In some embodiments, the transcriptional activator is VP64. In one embodiment, the transcriptional activator is VP64, and the targeted polypeptide is catalytically-inactive nuclease dCas9.

[0113] The targeted polypeptide can be linked to one or more transcriptional activators. In some embodiments, the targeted polypeptide (e.g., dCas9) linked to one transcriptionalactivator (e.g., VP64). In some embodiments, the targeted polypeptide (e.g., dCas9) linked to two or more transcriptional activators (e.g., VP64-p65-RTA). The VP64-p65-RTA, or VPR, dCas9 activator was created by modifying an existing dCas9 activator, in which a Vp64 transcriptional activator is joined to the C terminus of dCas9. In the dCas9-VPR protein, the transcription factors p65 and RTA are added to the C terminus of dCas9-Vp64. Therefore, all three transcription factors are targeted to the same gene.

[0114] The targeted polypeptide can be directly, or indirectly, linked to a transcriptional activator. In some embodiments, the targeted polypeptide directly linked to a transcriptional activator as a fusion protein (e.g., dCas9-VP64). In some embodiments, the targeted polypeptide indirectly linked to a transcriptional activator through agRNA (e.g., dCas9-SAM). In the Synergistic Activation Mediator (SAM) system, dCas9-VP64 recruits more transcriptional factors (MS2, p65, and HSF1) working synergistically to activate the gene of interest. In order to assemble different transcriptional activators, the dCas9-SAM system uses a modified single guide RNA (sgRNA) that has binding sites for the MS2 protein. Hairpin aptamers are attached to the tetra loop and tire stem loop 2 of tire sgRN A to become binding sites for dimerized MS2 bacteriophage coat proteins. As the hairpins are exposed outside of the dCas9-sgRNA complex, other transcriptional factors can bind to the MS2 protein without disrupting the dCas9-sgRNA complex. Thus, the MS2 protein is engineered to include p65 and HSF1 proteins. The MS2-p65-HSFl fusion protein interacts with the dCas9-VP64 to recruit more transcriptional factors onto the promoter of the target genes.

[0115] In some embodiments, transcriptional activator domains (such as VP 16, VP48, VP64, VP160 and the like) can be fused to the zinc-finger binding domain. For example, engineered zinc finger transcriptional activator that interact with a promoter region of the gamma-globulin gene was shown to enhance fetal hemoglobin production in primer adult erythroblasts (Wilber et al., Blood, 115(15): 3033-3041). Other polydactyl zinc-finger transcription factors are also known in the art, including those disclosed in Beerli and Barbas (see. Nature Technology, (2002) 20: 135-141).

[0116] In some embodiments, the TALEN is engineered such that the TAL effector comprises one or more transcriptional activator domains (e.g., VP 16, VP48, VP64 or VP160). For example, engineered TAL effectors having a transcriptional activator domain at the c- terminus of the TAL effector were shown to modulate transcription of Sox2 and Klf4 genes in human 293FT cells (Zhang et al., Nature Biotechnology, 29(2): 149-153 (201 1). Other TALeffector transcription factors (TALE-TFs) are also known in the art, including those disclosed in Perez-Pinera et al., (Nature Methods, (2013) 10(3):239-242) that demonstrated modulation of IL1RN, KLK3, CEACAM5 and ERBB2 genes in human 293T cells using TALE-TFs. In some embodiments, the one or more transcriptional activator domains are located adjacent to the nuclear localization signal (NLS) present in the C-terminus of the TAL effector. In another embodiment, the TALE-TFs can bind nearby sites upstream or downstream of the transcriptional start site (TSS) for a target gene.Heterologous expression cassette

[0117] In other embodiments, one or more gene products as described herein can be overexpressed in a cell as described herein. Overexpression of one or more gene products in a cell means the cell expresses more than normal level of the gene products a native cell expresses under the same condition. For example, a gene product can be overexpressed by introducing a heterologous expression cassete comprising a promoter operably- linked to the gene of interest into the cell .

[0118] An expression cassette is a polynucleotide comprising at least a promoter operable linked to a coding sequence for a gene product as described herein. The expression cassette, when introduced into a cell, directs the cell's machinery to make RNA and protein(s). Some expression cassettes are designed for modular cloning of protein-encoding sequences so that the same cassette can easily be altered to make different proteins. An expression cassette is composed of one or more genes and the sequences controlling their expression. An expression cassette comprises three components: a promoter sequence, an open reading frame, and a 3’ untranslated region that, in eukaryotes, usually contains a polyadenylation site. Different expression cassettes can be transfected into different organisms including bacteria, yeast, plants, and mammalian cells as long as the correct regulatory- sequences are used.

[0119] Exemplaiy- heterologous expression cassettes used in methods and compositions of the disclosure include, for example, a promoter operably linked to a gene encoding a protein selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC2.5A7) (SEQ ID NO: 57 or a sequence having at least 90%, 95%, 98%, 99% thereto), PPARG coactivator 1 alpha (PPARGC1 A / PCG1 A) (SEQ ID NO: 58 or a sequence having at least 90%, 95%, 98%, 99%95%, 98%, 99% thereto), F0X01 (SEQ ID NO: 62 or a sequence having at least 90%, 95%, 98%, 99% thereto), GLUT1 (SEQ ID NO: 63 or a sequence having at least 90%, 95%, 98%, 99% thereto), GLUT2 (SEQ ID NO: 64 or a sequence having at least 90%, 95%, 98%, 99% thereto), GLUTS (SEQ ID NO: 65 or a sequence having at least 90%, 95%, 98%, 99% thereto), GLUT4 (SEQ ID NO: 66 or a sequence having at least 90%, 95%, 98%, 99% thereto), CHREBP (SEQ ID NO: 67 or a sequence having at least 90%, 95%, 98%, 99% thereto), CD36 (SEQ ID NO: 68 or a sequence having at least 90%, 95%, 98%, 99% thereto), CTP1B (SEQ ID NO: 69 or a sequence having at least 90%, 95%, 98%, 99% thereto), AIFM2 / FSP1 (SEQ ID NO: 70 or a sequence having at least 90%, 95%, 98%, 99% thereto), GSK (SEQ ID NO: 71 or a sequence having at least 90%, 95%, 98%, 99% thereto), IRS1 (SEQ ID NO: 72), DGAT1 (SEQ ID NO: 73 or a sequence having at least 90%, 95%, 98%, 99% thereto), DGAT2 (SEQ ID NO: 74 or a sequence having at least 90%, 95%, 98%, 99% thereto), ACACA (SEQ ID NO: 75 or a sequence having at least 90%, 95%, 98%, 99% thereto), UPP1 (SEQ ID NO: 115 or a sequence having at least 90%, 95%, 98%, 99% thereto), CKB (SEQ ID NO: 117 or a sequence having at least 90%, 95%, 98%, 99% thereto) or a polypeptide of Table 2 or a sequence having at least 90%, 95%, 98%, 99% thereto. Promoters can be selected as desired. In some embodiments, the promoters are inducible or constitutively expressed.Downregulating Gene Expression

[0120] The disclosure further provides compositions and methods for preventing and treating metabolic diseases, diabetes, and cancers through downregulating expression of the genes associated with glucose and lipid metabolism, i.e., ACACB or NRIP1 , in one or more cells (e.g., in mesenchymal stem cells, pre-adipocytes, fat cells, adipocytes, adipose organoids or fat progenitor cells) in the subject. Techniques to downregulate the expression of the gene can include, but are not limited to, e.g., CRISPR interference (CRISPRi), RNA interference (RNAi), and and sense therapy.CRISPR interference (CRISPRi)

[0121] CRISPRi utilizes a catalytically-inaetive nuclease containing one or more amino acid mutations relative to a wild-type CRISPR nuclease and sterically represses transcription byblocking either transcriptional initiation or elongation. CRISPRi further includes a gRNA targeting a promoter or enhancer sequence of the gene whose expression is to be reduced. In eukaryotes, CRISPRi can also repress transcription via an effector domain. The catalytically- inactive nuclease can be linked to a repressor domain to allow transcription to be further repressed. For example, the well-studied Kruppel associated box (KRAB) domain can be fusedto the catalytically -inactive nuclease to repress transcription of the ACACB or NRIP1 gene. In certain embodiments, the catalytically-inactive nuclease is a dead Cas9 (dCas9). Other examples of catalytically-in active nucleases are described in detail further herein.

[0122] In some embodiments, methods for downregulating expression of certain genes associated with glucose and lipid metabolism can include introducing into the one or more cells of the subject a catalytically-inactive nuclease (e.g., a dCas9) linked to a transcriptional repressor domain (e.g, KRAB) and a gRNA that targets a portion of a promoter sequence operably linked to a coding sequence of the endogenous ACACB or NR1P1 gene.

[0123] Further, methods for downregulating expression of certain genes can include introducing into the one or more cells of the subject a catalytically-inactive nuclease (e.g., a dCas9) linked to a transcriptional repressor domain (e.g., KRAB) and a gRNA that targets a portion of an enhancer sequence operably linked to a coding sequence of the ACACB or NRIP1 gene.RNA interference (RNAi)

[0124] RNA interference (RNAi) is a biological process in which RNA molecules (i.e., inhibitory RNA polynucleotides) are involved in sequence -specific suppression of gene expression. An inhibitory RNA polynucleotide can be synthesized to target the ACACB or NRIP1 gene to lower its expression level. Tire inhibitor}' RNA polynucleotide can be of various lengths, e.g., between 15 and 30 nucleotides (e.g., 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30 nucleotides). In further embodiments, the inhibitory RNA polynucleotide can be single-stranded or double-stranded. The inhibitory RNA polynucleotide can specifically hybridize to or is complementary (e.g., partially complementary') to a portion of the ACACB or NRIP1 gene, such that stable and specific binding occurs between the inhibitory RNA polynucleotide and the gene. There is a sufficient degree of complementarity' between the inhibitory' RNA polynucleotide and the ACACB or NRJPl gene to avoid non-specific binding of the inhibitory- RNA polynucleotide to non-target sequences.

[0125] The inhibitory RNA polynucleotides described herein can be a microRNA, which is a single-stranded RNA molecule of about 21 -23 nucleotides (e.g. , 21, 22, or 23 nucleotides) in length. miRNAs are encoded by genes from whose DNA they are transcribed, but miRNAs are not translated into protein (non-coding RNA); instead, each primary' transcript (a pri- miRNA) is processed into a short stem-loop structure called a pre-miRNA and finally into afunctional mature miRNA. Mature miRNA molecules are either partially or completely complementary to one or more messenger RNA (mRNA) molecules.

[0126] miRNAs are first transcribed as primary transcripts or pri-miRNA with a cap and poly-A tail and processed to short, nucleotide stern-loop structures known as pre-miRNA in the cell nucleus by a protein complex known as the Microprocessor complex, consisting of the nuclease Drosha and the double-stranded RNA binding protein Pasha (Denli et al., Nature, 432:231-235, 2004). These pre-miRNAs are then processed to mature miRNAs in the cytoplasm by interaction with the endonuclease Dicer, which also initiates the formation of the RNA-induced silencing complex (RISC) (Bernstein et al.. Nature, 409:363-366, 2001). Either the sense strand or antisense strand of DNA can function as templates to give rise to miRNA. When Dicer cleaves the pre-miRNA stern-loop, two complementary short RNA molecules are formed, but only one is integrated into the RISC complex. This strand is known as tire guide strand and is selected by the argonaute protein, which is the catalytically active RNase in the RISC complex, on the basis of the stability of the 5' end (Preall et al., Curr. Biol., 16:530-535, 2006). The remaining strand, known as the anti -guide or passenger strand, is degraded as a RISC complex substrate). After integration into the active RISC complex, miRNAs base pair with their complementary- mRNA molecules and induce target mRNA degradation and / or translational silencing.

[0127] Mammalian miRNA molecules are usually complementary to a site in the 3' UTR of the target mRNA sequence (e.g., a portion of the ACACB or NRIP1 mRNA). In some embodiments, the annealing of the miRNA to the target mRNA inhibits protein translation byblocking the protein translation machinery. In some embodiments, the annealing of the miRNA to the target mRNA facilitates the cleavage and degradation of the target mRNA.

[0128] The inhibitory- RNA polynucleotides described herein can also be a small interfering RNA (siRNA), which refers to a double stranded RNA with the two complementary- strands each having between 15 and 20 nucleotides (e.g., 15, 16, 17, 18, 19, or 20 nucleotides). In some embodiments, the two strands of an siRNA molecule can each have a 3 '-end overhang of two or three nucleotides. In an siRNA molecule, one strand (e.g., the antisense strand) is guiding and complementary- (e.g., partially complementary-) to the target gene (e.g., the ACA CB orNRIPl gene).

[0129] Suitable siRNA sequences can be identified using methods known in the art. For example, prediction algorithms that predict potential siRNA-targets based uponcomplementary DNA sequences in the target genes are available in the art. TaigetScanHuman, for example, is a comprehensive web resource for inhibitory RNA-target predictions, and uses an algorithm that incorporates current biological knowledge of inhibitory RNA-target rules including seed-match model, evolutionary' conservation, and free binding energy (Li and Zhang, Wiley Interdiscip Rev RNA 6:435-452, 2015 and Agarwal et al., Elife 4, 2015). In some embodiments, to further enhance silencing efficiency of the siRNA sequences, potential siRNA sequences may be analyzed to identify sites that do not contain regions of homology to other coding sequences, e.g., in the target cell or organism.

[0130] Once a potential siRNA sequence has been identified, a complementary' sequence (i.e., an antisense strand sequence) can be designed. A potential siRNA sequence can also be analyzed using a variety of criteria known in the art. For example, to enhance their silencing efficiency, the siRNA sequences may be analyzed by a rational design algorithm to identify sequences that have one or more of the following features: (1) G / C content of about 25% to about 60% G / C; (2) at least 3 A / Us at positions 15-19 of the sense strand; (3) no internal repeats; (4) an A at position 19 of the sense strand; (5) an A at position 3 of the sense strand; (6) a U at position 10 of the sense strand; (7) no G / C at position 19 of the sense strand; and (8) no G at position 13 of the sense strand. The siRNA design tools that incorporate algorithms that assign suitable values of each of these features and are useful for selection of the siRNA are available in the art. One of skill in the art will appreciate that sequences with one or more of the foregoing characteristics may be selected for farther analysis and testing as potential siRNA sequences.

[0131] The inhibitory’ RNA polynucleotides described herein can also be a small hairpin RNA or short hairpin RNA (shRNA), which is a short RNA sequence that makes a tight hairpin turn that can be used to silence gene expression via RNA interference. The shRNA hairpin structure is cleaved by the cellular machinery into siRNA, which is then bound to the RNA- induced silencing complex (RISC). In some embodiments, shRNAs can be between 15 to 60 nucleotides (e.g., 15, 20, 25, 30, 35, 40, 45, 50, 55, or 60 nucleotides) in length. Non-limiting examples of shRNA include a double-stranded polynucleotide molecule assembled from a single-stranded molecule, m which the sense and antisense regions are linked by a nucleic acidbased or non-nucleic acid-based linker; and a double-stranded polynucleotide molecule with a hairpin secondary structure having self-complementary sense and antisense regions.

[0132] The complementarity' between an siRNA or shRNA and its corresponding target sequence may be 100%. In some embodiments, the complementarity between the siRNA or shRNA and its corresponding target sequence is less than 100%, although 100% complementarity is desired to avoid off-target effects. In some embodiments, the complementarity between the siRNA or shRNA and its corresponding target sequence is at least 95%, at least 90%, at least 85%, or at least 80%.

[0133] In some embodiments, the siRNA or shRNA comprises one or more modified nucleotides. In some embodiments, the modified nucleotide of the siRNA or shRNA comprises a sugar modification, a nucleic acid base modification, and / or a phosphate backbone modification. Exemplary' modifications are described further below. In one particular embodiment, the siRNA or shRNA includes one or more locked nucleic acids (LNA). A locked nucleic acid is a nucleotide having a modified ribose moiety in which the ribose moiety comprises an extra bridge connecting the 2' and 4' carbons. See e.g., Elmen et al. (2005), Nucleic Acids Research 33(l):439-447; Mook et al. (2007), Mol Cane Ther 6(3):833-843; Grunweller et al. (2003), Nucleic Acids Research 31(12):3185-3193).

[0134] In some embodiments, the siRNA or shRNA comprises an overhang on either the

[0135] Antisense therapy is a gene expression suppression technique that uses antisense oligonucleotides (ASOs) to target mRNAs (e.g., ACACB orNRIPl mRNA). Antisense therapy uses a naturally occurring enzyme, RNase H, that has the activity of destroying the RN A strand of an RNA:DNA duplex. In antisense therapy, a DNA oligonucleotide of approximately 15- 30 bases in length that was complimentary to the target gene is introduced into the cells. Once inside the cell, the oligonucleotide base pairs with its targeted region in the target gene and when RNase H binds to the resulting duplex, it cleaves the RNA in multiple places, leaving theDNA oligonucleotide intact to help catalyze destruction of more target mRNAs. In this way, the production of the protein encoded by the targeted mRNA is greatly reduced.

[0136] In some embodiments, the antisense polynucleotide is 8-100, e.g., 12-50, e.g., 16-30 nucleotides in length. The complementarity between an antisense polynucleotide and its corresponding target sequence may be 100%. In some embodiments, the complementarity between the antisense polynucleotide and its corresponding target sequence is less than 100%, although 100% complementarity is desired to avoid off-target effects. In some embodiments, the complementarity between the antisense polynucleotide and its corresponding target sequence is at least 95%, at least 90%, at least 85%, or at least 80%.

[0137] In some embodiments, the antisense oligonucleotide comprises one or more modified nucleotides. In some embodiments, the modified nucleotide comprises a sugar modification, a nucleic acid base modification, and / or a phosphate backbone modification. Exemplary modifications are described further below. In one particular embodiment, the antisense polynucleotide is designed as a gapmer comprising a central stretch (gap) of nucleotides capable of inducing RNase H cleavage, and two flanking regions containing one or more modified nucleosides. Gapmer structures are well characterized and may be designed using known methods in the art, see, e.g., Monia et al. (1993), “Evaluation of 2 “-modified oligonucleotides containing 2- '’deoxy gaps as antisense inhibitors of gene expression”, J. Biol. Chem.; 268: 14514-14522; Deleavey et al. (2012), “Designing chemically modified oligonucleotides for targeted gene silencing”, Chem . Biol.; 19:937-954; and Stanley T. Crooke (2008), “Antisense Drug Technology- Principles, Strategies, and Applications”, 2nd Edition, CRC press. Accordingly, in some aspects, the antisense polynucleotide is a gapmer. In some embodiments, the antisense polynucleotide is a locked nucleic acid (LN A) gapmer, where the modified nucleotides in the flanking regions are LNA nucleotides. In some embodiments, the antisense polynucleotide is a mixmer comprising alternating stretches of LNA and unmodified nucleotides, see e.g. U.S. Pat. Nos. 5.013.830; 5, 149,797; 5, 220,007; 5,256,775, each of which is herein incorporated by reference. In one embodiment, the antisense polynucleotide is a headmer comprising only a flanking region at the 5' terminus. In another embodiment, the antisense polynucleotide is a tailmer comprising only a flanking region at the 3’ terminus.PolynucleotidesJOI 38] The present disclosure further provides a polynucleotide comprising one or more expression cassettes encoding a targeted polypeptide, wherein the targeted potypeptide linked to a transcriptional activator targets a portion of a promoter or enhancer sequence operably linked to a polynucleotide encoding a polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7) (SEQ ID NO: 57 or a sequence having at least 90%, 95%, 98%, 99% thereto), PPARG coactivator 1 alpha (PPARGC1A / PCG1 A) (SEQ ID NO: 58 or a sequence having at least 90%, 95%, 98%, 99% thereto), PR / SET domain 16 (PRDM16) (SEQ ID NO: 59 or a sequence having at least 90%, 95%, 98%, 99% thereto), FFAR1 / GPR40 (SEQ ID NO: 60 or a sequence having at least 90%, 95%, 98%, 99% thereto), FFAR4 / GPR120 (SEQ ID NO: 61 or a sequence having at least 90%, 95%, 98%, 99% thereto), FOXO1 (SEQ ID NO: 62 or a sequence having at least 90%, 95%, 98%, 99% thereto), GLUT1 (SEQ ID NO: 63 or a sequence having at least 90%, 95%, 98%, 99% thereto), GLUT2 (SEQ ID NO: 64 or a sequence having at least 90%, 95%, 98%, 99% thereto), GLUTS (SEQ ID NO: 65 or a sequence having at least 90%, 95%, 98%, 99% thereto), GLUT4 (SEQ ID NO: 66 or a sequence having at least 90%, 95%, 98%, 99% thereto), CHREBP (SEQ ID NO: 67 or a sequence having at least 90%, 95%, 98%, 99% thereto), CD36 (SEQ ID NO: 68 or a sequence having at least 90%, 95%, 98%, 99% thereto), CTP1B (SEQ ID NO: 69 or a sequence having at least 90%, 95%, 98%, 99% thereto), AIFM2 / FSP1 (SEQ ID NO: 70 or a sequence having at least 90%, 95%, 98%, 99% thereto), GSK (SEQ ID NO: 71 or a sequence having at least 90%, 95%, 98%, 99% thereto), IRS 1 (SEQ ID NO: 72 or a sequence having at least 90%, 95%, 98%, 99% thereto), DGAT 1 (SEQ ID NO: 73 or a sequence having at least 90%, 95%, 98%, 99% thereto), DGAT2 (SEQ ID NO: 74 or a sequence having at least 90%, 95%, 98%, 99% thereto), ACACA (SEQ ID NO: 75 or a sequence having at least 90%, 95%, 98%, 99% thereto), LIPPI (SEQ ID NO: 115 or a sequence having at least 90%, 95%, 98%, 99% thereto), CKB (SEQ ID NO: 1 17 or a sequence having at least 90%, 95%, 98%, 99% thereto) or any polypeptide from Table 2 or at least 90%, 95%, 98%, 99% thereto, wherein the composition upregulates expression of the at least one polypeptide when introduced to a cell. In some embodiments, the polynucleotide comprises an expression cassete comprising a promoter operably linked to a nucleic acid encoding the catalytically-inactive nuclease.

[0139] In some embodiments, the polynucleotide comprises an expression cassette comprising a promoter operably linked to a nucleic acid encoding the catalytically-inactive nuclease fused with a transcriptional activator. In certain embodiments, the polynucleotidecomprises an expression cassete comprising a promoter operably linked to a nucleic acid encoding the catalytically -inactive nuclease fused with a transcriptional activator through a linker (SEQ ID NO: 56).

[0140] In some embodiments, a polynucleotide comprising one or more expression cassettes encoding a targeted polypeptide, wherein the targeted polypeptide linked to a transcriptional repressor targets a portion of a promoter or enhancer sequence operably linked to a polynucleotide encoding a polypeptide of ACACB (e.g., SEQ ID NO: 76 or a sequence having at least 90%, 95%, 98%, 99% thereto) or NRIP 1 (e.g., SEQ ID NO: 77 or a sequence having at least 90%, 95%, 98%, 99% thereto), wherein the composition downregulates expression of the at least one polypeptide when introduced to a cell.

[0141] In some embodiments, tire polynucleotide comprises (i) a first expression cassette comprising a first promoter operably linked to a first nucleic acid encoding the gRNA and (ii) a second expression cassette comprising a second promoter operably linked to a second nucleic acid encoding the catalvtically-mactive nuclease. In some embodiments, the polynucleotide comprises (i) a first expression cassette comprising a first promoter operably linked to a first nucleic acid encoding the gRNA and (ii) a second expression cassette comprising a second promoter operably linked to a second nucleic acid encoding the catalytically-inactive nuclease the transcriptional activator.Delivery

[0142] In compositions and methods described herein, the targeted polypeptide and its associated components (e.g., gRNA, transcriptional activator), or the polynucleotides comprising expression cassettes encoding the targeted polypeptide and its associated components, or the polynucleotide comprising the heterologous expression cassette encoding the gene of interest, can be delivered into one or more cells (e.g., adipocytes, adipose stem cells or adipose progenitor cells) of the subject using a number of techniques in the art.Viral vector

[0143] In some embodiments, the targeted polypeptide (e.g., dCas9) linked to the transcriptional activator, and optionally a gRNA, can be introduced into the cell via viral delivery’ using a viral vector. For example, viral vectors can be based on vaccinia virus, poliovirus, retrovirus, lend virus, adenovirus, adeno-associated virus (AAV) (e.g., recombinant AAV (rAAV)), SV40, herpes simplex virus, human immunodeficiency virus, and the like. A retroviral vector can be based on Murine Leukemia Virus, spleen necrosis virus, and vectorsderived from retroviruses such as Rous Sarcoma Virus, Harvey Sarcoma Virus, avian leukosis virus, a lentivirus (e.g., integration deficient lentivirus), human immunodeficiency virus, myeloproliferative sarcoma virus, mammary' tumor virus, and the like. In some embodiments, a retroviral vector can be an integration deficient gamma retroviral vector. In some embodiments, viral vectors can be virus-like particles. Other useful expression vectors are known to those of skill in the art, and many are commercially available. The following exemplary vectors are provided by way' of example for eukaryotic host cells: pXTl, pSG5, pSVK3, pBPV, pMSG, and pSVLSV40. Examples of techniques that may be used to introduce a viral vector into a cell include, but not limited to, viral or bacteriophage infection, transfection, protoplast fusion, lipofection, calcium phosphate precipitation, polyethyleneimine (PEI)-mediated transfection, DEAE-dextran mediated transfection, liposome-mediated transfection, calcium phosphate precipitation, nanoparticle-mediated nucleic acid delivery, and the like.Electroporation

[0144] In some embodiments, the composition can be introduced into the cell via physical method transfection, such as electroporation, microinjection, gene gun, impalefection, hydrostatic pressure, continuous infusion, and sonication, etc. In some embodiments, a ribonucleoprotein (RNP) complex containing a Cas protein (e.g., Cas9 nuclease) and a gRNA can be formed first, then electroporated into the cell. Methods, compositions, and devices for electroporation are available in the art, e.g., those described in W02006 / 001614 or Kim, J.A. et al. Biosens. Bioelectron. 23, 1353-1360 (2008). Additional or alternative methods, compositions, and devices for electroporation can include those described in U.S. Patent Appl. Pub. Nos. 2006 / 0094095; 2005 / 0064596; or 2006 / 0087522. Additional or alternative methods, compositions, and devices for electroporation can include those described in Li, L.H. et al. Cancer Res. Treat. 1, 341-350 (2002); U.S. Patent Nos.: 6,773,669; 7,186,559; 7,771,984; 7,991,559; 6,485,961; and 7,029,916; and U.S. Patent Appl. Pub. Nos: 2014 / 0017213; and 2012 / 0088842. Additional or alternative methods, compositions, and devices for electroporation can include those described in Geng, T. et al. J. Control Release 144, 91-100 (2010); and Wang, J., et al. Lab Chip 10, 2057-2061 (2010).DNA transfection

[0145] In some embodiments, the composition can be introduced into the cell via chemical method transfection, such as calcium phosphate, cationic polymers (DEAE-dextran orpolyethylenimine (PEI)), Lipofection (or liposome transfection), Fugene, and Dendrimer, etc. Lipofection is a lipid-mediated DNA-transfection process utilizing liposome vectors.Cells

[0146] The present disclosure provides a ceil comprising a targeted polypeptide linked to a transcriptional activator, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to a gene of interest, wherein the targeted polypeptide upregulates expression of the gene of interest in the cell.

[0147] The present disclosure also provides a cell comprising a polynucleotide of one or more expression cassettes encoding a targeted polypeptide, wherein the targeted polypeptide linked to a transcriptional activator, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to a gene of interest, wherein the targeted polypeptide upregulates expression of the gene of interest in the cell .

[0148] The present disclosure also provides a cell comprising a heterologous expression cassette, wherein the heterologous expression cassette composes a promoter operably linked to a gene of interest, wherein the heterologous expression cassette overexpresses the gene of interest in the cell.

[0149] As disclosed herein, the genes of interest in present disclosure include, but not limited to. Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator 1 alpha(PPARGC1A / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120, FOXO1, GLUT1, GLUT2, GLUT3, GLUT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRS1, DGAT1, DGAT2, ACACA, ACACB, UPP1, CKB and NRIP1 and as shown in Table 2.

[0150] In compositions and methods described herein, the targeted polypeptide and its associated components (e.g., gRNA, transcriptional activator), or the polynucleotides comprising expression cassettes encoding the targeted polypeptide and its associated components, or the polynucleotide comprising the heterologous expression cassette encoding the gene of interest, can be delivered into different organisms including bacteria, yeast, plants, and mammalian cells. In some embodiments, the cell is an adipocyte. In some embodiments, the cell is an adipose stem cell. In some embodiments, the cell is an adipose progenitor cell. In some embodiments, the cell is a white adipose cell.

[0151] Also provided is an engineered adipocyte or adipose stem cell that comprises a targeted polypeptide linked to a transcriptional activator, wherein the targeted polypeptidetargets a portion of a promoter or enhancer sequence operably linked to a gene of interest, wherein the targeted polypeptide upregulates expression of the gene of interest compared to a wild-type adipocyte or adipose stem cell.

[0152] In some embodiments, the engineered adipocyte or adipose stem cell comprises a catalytically' inactive nuclease linked to a transcriptional activator, wherein a catalytically inactive nuclease targets a portion of a promoter or enhancer sequence operably linked to at least one gene of interest. In some embodiments, the catalytically inactive nuclease is (i) a clustered regularly interspaced short palindromic repeats (CRISPR) nuclease, and the engineered adipocyte or adipose stem cell further comprises a g RN A that targets the portion of the promoter or enhancer sequence; (ii) a zinc finger nuclease (ZFN); or (iii) a transcription activator-like effector nuclease (TALEN). In some embodiments, the engineered adipocyte or adipose stem cell comprising a catalytically inactive clustered regularly interspaced short palindromic repeats (CRISPR) nuclease linked to a transcriptional activator. In some embodiments, the engineered adipocyte or adipose stem cell comprising a catalytically inactive dCas9 linked to a transcriptional activator. In some embodiments, the engineered adipocyte or adipose stem cell comprising a catalytically inactive dCas9 linked to a transcriptional activator VP64.

[0153] Also provided is an engineered adipocyte or adipose stem cell comprises a heterologous expression cassette, wherein the heterologous expression cassette comprises a promoter operably linked to a gene of interest, wherein the heterologous expression cassette upregulates expression of the gene of interest compared to a wild-type adipocyte or adipose stem cell. In some embodiments, the heterologous expression cassette is inserted into the genome of the cell . In other embodiments, the heterologous expression cassette is on a plasmid.

[0154] As disclosed herein, the genes of interest in present disclosure include, but not limited to, Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator 1 alpha(PPARGCIA / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120, FOXO1, GLUT1, GLUT2, GLUT3, GLUT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRS1, DGAT1, DGAT2, UPP1, ACACA, ACACB, CKB and NRIP1 and as found in Table 2,Methods of treatment

[0155] In one aspect, the disclosure provides methods for preventing or treating a metabolic disease in a subject, the method comprising upregulatmg at least one polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator I alpha(PPARGC1A / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120, FOXO1, GLUT1, GLUT2, GLUT3, GLUT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRS1, DGAT1, DGAT2, UPP1, CKB, and ACACA or as found in Table 2, in a adipocyte of the subject, thereby preventing or treating a metabolic disease.

[0156] In another aspect, the disclosure provides methods for preventing or treating a metabolic disease in a subject, the method comprising downregulating at least one polypeptide selected from the group consisting of ACACB and NRIP1, in an adipocyte of the subject, thereby preventing or treating a metabolic disease.

[0157] As used herein, the term “metabolic disease” refers to a disease, disorder, or syndrome that is related to a subject’s metabolism, such as breaking down carbohydrates, proteins, and fats in food to release energy, and converting chemicals into other substances and transporting them inside cells for energy utilization and / or storage. Some symptoms of a metabolic disease include high serum triglycerides, high low-density cholesterol (LDL), low high-density cholesterol (HDL), and / or high fasting insulin levels, elevated fasting plasma glucose, abdominal (central) obesity, and elevated blood pressure. Metabolic diseases increase the risk of developing other diseases, such as cardiovascular disease. Examples of metabolic diseases include, but are not limited to, obesity, Type-1 diabetes, and Type-2 diabetes.

[0158] In one aspect, the disclosure provides methods for preventing or treating diabetes in a subject, the method comprising upregulating at least one polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator 1 alpha (PPARGC1A / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120, FOXO1, GLUT1, GLUT2, GLUT3, GLUT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRS1, DGAT1, DGAT2, UPP1, CKB, and ACACA or as found in Table 2, in a adipocyte of the subject, thereby preventing or treating diabetes.J 0159 ] In another aspect, the disclosure provides methods for preventing or treating diabetes in a subject, the method comprising downregulating at least one polypeptide selected from the group consisting of ACACB and NRIP1, in an adipocyte of the subject, thereby preventing or treating diabetes

[0160] In one aspect, the disclosure provides methods for preventing or treating cancers in a subject, the method comprising upregulating at least one polypeptide selected from the group consisting of Uncoupling protein I (UCP1 / SLC25A7), PPARG coactivator 1 alpha (PPARGC1A / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120,F0X01 , GLUTI , GLUT2, GLUT3, GLUT4, CHREBP, CD36, C TP I B. AIFM2 / FSP1 , GSK, IRS1, DGAT1, DGAT2, UPP1, CKB, and ACACA or as found in Table 2, in a adipocyte of the subject, thereby preventing or treating cancers.

[0161] In another aspect, the disclosure provides methods for preventing or treating cancers in a subject, the method comprising downregulating at least one polypeptide selected from the group consisting of ACACB and NRIPI , in an adipocyte of the subject, thereby preventing or treating cancers.

[0162] Examples of cancers that can be treated or prevented with the methods described herein include, but are not limited to, breast cancer, colon cancer, pancreas cancer, or prostate cancer.

[0163] In some embodiments, the method improves at least one symptom selected from the group consisting of body weight loss, cold tolerance, oxygen consumption, whole body energyexpenditure, glucose and fatty acid utilization, glucose sensitivity, and insulin sensitivity . In some embodiments, the method results in suppression of glycolysis or fatty- acid metabolism in cancer cells. In some embodiments, the method results in declining aging.

[0164] In some embodiments, the method improves at least one symptom of aging. Examples of symptoms of aging include but are not limited to skin damage, reduces muscle and physical strength, reduced sight and hearing and smell, changes in sleep patterns, changes in energy and appetite, reduction in memory and cognition, bone density loss, reduced muscle mass, blood vessels becoming stiffer that lead to increase in blood pressure, less elastic lungs, reduced immune function, smaller kidneys, menopause in women and reduced libido in men, reduction m hormone levels (such as growth hormone, aldosterone, insulin) and reduction in the production of red blood cells.Administration of constructs

[0165] In some embodiments, the upregulation of the gene expression comprises introducing to the subject a therapeutically effective amount of a composition comprising a targeted polypeptide linked to a transcriptional activator, or a nucleic acid encoding the targeted polypeptide linked to a transcriptional activator, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to a polynucleotide encoding the

[0166] In some embodiments, the upregulation of the gene expression comprises introducing to the subject a therapeutically effective amount of a composition comprising a heterologous expression cassette comprising a promoter operably linked to a coding sequence encoding the gene.

[0167] As non-limiting examples, the compositions or plurality thereof can be administered to the subject intravenously, intramuscularly, intrathecal ly, or a combination thereof. In some embodiments, the compositions are administered to a fat cell in the subject.Administration of cells

[0168] In other embodiments, the methods can comprise introducing to the subject a therapeutically effective amount of a composition comprising engineered adipocytes or adipose stem cells comprising a targeted polypeptide linked to a transcriptional activator, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to a polynucleotide encoding the polypeptide.

[0169] In certain embodiments, before introducing to the subject the engineered adipocytes or adipose stem cells, one or more adipocytes or adipose stem cells are isolated from the subject and engineered to have an upregulated expression of the gene of interest. The isolated cells (e.g., adipocytes, adipose stem cells, adipose progenitor cells) can undergo ex vivo gene therapy to upregulate the expression of the target gene, and the modified cells can be introduced into the human subject. Ex vivo gene therapy is a therapeutic approach that typically includes isolation and ex vi vo expansion and / or manipulation of cells and subsequent administration of these cells to a patient. The isolated cells may be manipulated to overexpress or upregulate the expression of the target gene in any one of the known ways, including, for example, by using RNA and DNA transfection, viral transduction, or electroporation, for example. Thereby the engineered cells have an upregulated expression of a gene of interest by the introduced targeted polypeptide linked to a transcriptional activator, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to a polynucleotide encoding the polypeptide. In some embodiments, the engineered adipocytes or adipose stem cells can be administered to the same subject (i.e., autologous cells). In other embodiments, the engineered adipocytes or adipose stem cells can be administered to a. different subject (i.e., allogenic cells).

[0170] Any cell described herein (including organoids described below) can be provided in a biocompatible matrix, optionally comprising polycaprolactone. In some embodiments, the cells are delivered into an individual (e.g., a human), for example to achieve a therapeuticeffect, and optionally at a later point can be removed from the individual. Examples of biocompatible matrices comprising polycaprolactone for delivery of cells are described in, e.g., US Patent Publication No. 2019 / 0119462.Organoids

[0171] In certain embodiments, the engineered adipocytes or adipose stem cells are cultured into an engineered adipose organoid, and the engineered adipose organoid is introduced into tiie subject to prevent or treat metabolic diseases, diabetes, or cancers. In some embodiments, the engineered adipose organoid can be administered to the same subject (i.e., autologous cells). In other embodiments, the engineered adipose organoid can be administered to a different subject (i.e. , allogenic cells).

[0172] As non-limiting examples, the engineered adipocytes, adipose stem cells, or the engineered adipose organoid can be administered to the subject by targeted implantation, or intravenously, intramuscularly, intrathecally, or a combination thereof.Engineering fat cells to consume a metabolite preferentially consumed by cancer cells

[0173] In certain embodiments, adipocytes or adipose stem cells are engineered to consume a metabolite preferentially consumed by cancer cells compared to non-cancer cells in an individual. There are a number of types of cancer that preferentially (compared to healthy noncancer cells in the individual) consume specific metabolites. It has been discovered that one can engineer adipocytes or adipose stem cells (or an organoid comprising such cells) to also consume the same metabolite and such cells can compete with the cancer cells for the metabolite, thereby reducing or preventing growth of the cancer in the individual.

[0174] A variety of cancer cells are known to preferentially consume certain metabolites. Examples of such cells and metabolites include, but are not limited to, pancreatic ductal adenocarcinoma or other cancer cells and uridine (see, e.g., Nwosu, Z. C. et al. Nature 618, 151-158 (2023)). Other metabolites used by cancer cells in general and that can be targeted byadipocytes or adipose stem cells engineered to consume the metabolite include those in the following Table 2. The metabolite or functional pathway is listed to the left under “Pathway” and examples of genes that can be expressed in the adipocytes, adipose organoids or adipose stem cells to metabolize the targeted metabolite or pathway are listed under “Function.” Table 2

[0175] The adipocytes or adipose stem cell s can be engineered to consume these metabolites, tor example, but introducing or overexpressing one or more genes to improve consumption of the metabolite by the cells. For example, expression of uridine phosphorylase (UPPl) by the cells will increase consumption by tlie cells of uridine . Expression of these genes (for example, but not limited to, UPPl) can be increased in any number of ways, including but not limited to, use of CRISPRa increasing endogenous UPPl expression, introduction of an expression cassette encoding UPPl or editing the genome of the cell to overexpress UPPl.[0176 j The cells engineered to consume the metabolites can be introduced into an individual such that the cells are in proximity to the relevant cancers such that the cells compete with the cancer cells for the metabolite, thereby reducing or stopping growth of the cancer cells in the individual.Pharmaceutical formulations

[0177] The compositions (e.g., expression cassettes, or cells having upregulated or overexpressed gene products) described herein can be formulated together with a pharmaceutically acceptable carrier. The compositions can additionally contain othertherapeutic agents that are suitable for treating or preventing a given disorder. Pharmaceutically carriers can enhance or stabilize the composition, or to facilitate preparation of the composition. Pharmaceutically acceptable carriers include solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents, and the like that are physiologically compatible.[0178 j A pharmaceutical composition as described herein can be administered by a variety of methods known in the art. The route and / or mode of administration vary depending upon the desired results. In some embodiments, the composition is sterile and fluid. Proper fluidity can be maintained, for example, by use of coating such as lecithin, by maintenance of required particle size in the case of dispersion and by use of surfactants. In many cases, it is preferable to include isotonic agents, for example, sugars, polyalcohol such as mannitol or sorbitol, and sodium chloride in the composition. Long-term absorption of the injectable compositions can be brought about by including in the composition an agent which delays absorption, for example, aluminum monostearate or gelatin.

[0179] Pharmaceutical compositions described herein can be prepared in accordance with methods well known and routinely practiced in the art. Pharmaceutically acceptable earners are determined in part by the particular composition being administered, as well as by the particular method used to administer the composition. Accordingly, there is a wide variety of suitable formulations of pharmaceutical compositions. Applicable methods for formulating the compositions and determining appropriate dosing and scheduling can be found, for example, in Remington: The Science and Practice of Pharmacy, 21stEd., University of the Sciences in Philadelphia, Eds., Lippincott Williams & Wilkins (2005); and in Martindale: The Complete Drug Reference, Sweetman, 2005, London: Pharmaceutical Press., and in Martindale, Martindale: The Extra Pharmacopoeia, 31st Edition., 1996, Amer Pharmaceutical Assn, and Sustained and Controlled Release Drug Delivery Systems, J.R. Robinson, ed., Marcel Dekker, Inc., New York, 1978, each of which are hereby incorporated herein by reference. Pharmaceutical compositions are preferably manufactured under GMP conditions. Typically, a therapeutically effective dose or efficacious dose is employed in the pharmaceutical compositions described herein. The compositions can be formulated into pharmaceutically acceptable dosage forms. Dosage regimens are adjusted to provide the desired response (e.g., a therapeutic response). In determining a therapeutically or proph ylactically effective dose, a low dose can be administered and then incrementally increased until a desired response is achieved with minimal or no undesired side effects. For example, a single bolus may beadministered, several divided doses may be administered over time or the dose may be proportionally reduced or increased as indicated by the exigencies of the therapeutic situation. It is especially advantageous to formulate parenteral compositions m dosage unit form for ease of administration and uniformity of dosage. Dosage unit form as used herein refers to physically discrete units suited as unitary dosages for die subjects to be treated; each unit contains a predetermined quantity of active compound calculated to produce the desired therapeutic effect in association with the required pharmaceutical carrier.

[0180] Actual dosage levels of the active ingredients in the pharmaceutical compositions can be varied so as to obtain an amount of the active ingredient which is effective to achieve the desired therapeutic response for a particular patient, composition, and mode of administration, without being toxic to the patient. The selected dosage level depends upon a variety of pharmacokinetic factors including the activity of the particular compositions employed, or the ester, salt or amide thereof, the route of administration, the time of administration, the rate of excretion of the particular compound being employed, the duration of the treatment, other drugs, compounds and / or materials used in combination with the particular compositions employed, the age, sex, weight, condition, general health and prior medical history of the patient being treated, and like factors.EXAMPLES

[0181] Many modifications and variations of this invention can be made without departing from its spirit and scope, as will be apparent to those skilled in the art. The specific embodiments described herein are offered by way of example only and are not meant to be limiting in any way.

[0182] All documents (for example, patents, patent applications, books, journal articles, or other publications) cited herein are incorporated by reference in their entirety and for all purposes, to the same extent as if each individual document was specifically and individually indicated to be incorporated by reference in its entirety for all purposes. To the extent such documents incorporated by reference contradict the disclosure contained in the specification, the specification is intended to supersede and / or take precedence over any contradictory material.Example 1

[0183] Here, we set out to develop a novel cancer therapeutic approach, termed adipose manipulation transplantation (AMT) that utilizes two unique abilities of white adipose tissue(WAT): 1 ) They can be readily extracted via liposuction and implanted via reconstructive surgery-; 2) they can change into a BAT-like tissue, called browning or beiging (16, 17), by upregulating essential transcriptional regulators or enzymes, such as the uncoupling protein 1 (UCP1 ), PPARG coactivator 1 alpha (PPARGC1A) or PR / SET domain 16 (PRDM16), involved in BAT development and function (18-33). Similar to BAT, beige adipocytes have the capacity to convert energy to heat and contribute to whole-body energy expenditure (34). We show that CRISPR activation (CRISPRa) of either UCP1, PRDM16 or PPARGC1A, induces browning which subsequently increases glucose and fat metabolism in human white adipocytes and adipocyte organoids. Co-culturing of these CRISPRa-modulated adipocytes with various cancer cell lines (breast, colon, pancreatic, or prostate cancer) leads to significantly suppressed cancer cell proliferation as well as decreased glucose uptake, glycolysis and fatty acid oxidation capacity in the cancer cells. Subcutaneously cotransplanting CRISPRa-modulated human adipose organoids and cancer cells (breast, colon, pancreatic, or prostate) m immune -compromised mice leads to significantly- reduced tumor size with decreased hypoxia and angiogenesis. Implantation of engineered adipose organoids in pancreatic or breast cancer genetic mouse models significantly reduces cancer progression. Furthermore, in the breast cancer model we show that their implantation both near and distal to the tumor leads to similar results. To further demonstrate the therapeutic potential of this approach, we show that adipocytes isolated from human dissected breast tissues can be similarly manipulated via CRISPRa and inhibit growth of patient-derived breast cancer organoids. Combined, our results introduce a novel cancer therapeutic approach that has the potential to treat numerous cancer types.ResultsCRISPRa browning of human white adipocytes[0184 j To induce browning in human adipocytes we utilized CRISPRa to upregulate UCP1, PPARGC1A or PRDM16, all known genes involved in BAT development and function. Using CRISPick (35), we designed five gRNAs targeting each gene’s promoter and cloned them into an adeno associated vims (AAV) based expression vector. Differentiated adipocy-tes derived from human white preadipocytes -were co-transfected with the gRNAs along with a Staphylococcus aureus (sa) endonuclease deficient Cas9 (dCas9) fused to the VP64 transcriptional activator. We used an sa dCas9 due to its smaller size and the VP64 transcriptional activator, which carries four copies of VP16, a herpes simplex virus type 1transcriptional activator (36), as it provides moderate gene upregulation and is small enough to fit into AAV, which has a 4.7 kilobase optimal packaging capacity (37). To generate mature human adipocytes, preadipocytes were subjected to adipocyte differentiation using a cocktail of 3-isobutyl-l -methylxanthine (IB MX), dexamethasone, and insulin before being subjected to CRISPRa. Following four days, we measured gene expression via qRT-PCR, finding several gRNAs to significantly increase the expression levels of UCP1, PPARGC1A, PRDM16 in the transfected cells compared to the control cells (treated with dCas9-VP64 only) (FIG.1 1 A). We selected the top two gRNA for each gene for AAV serotype 9 (AAV9) packaging. We used AAV9, as it was shown to effectively infect various adipose depots (38). We infected human differentiated adipocytes with these viruses along with AAV 9 dCas9-VP64, finding for each gene at least one gRNA that significantly increased expression levels compared to dCas9-VP64 only control (FIG.1 IB). We used the top activating gRNA AAV for all subsequent experiments.

[0185] We next examined whether our CRISPRa treatment increases browning in these human white adipocytes. Human adipocytes infected with the top gRNA for UCP1, PRDM16 orPPARGClA showed significant upregulation of their target genes compared to dCas9-VP64 only infected cells (FIG.l A). In addition, we also observed increased mRNA levels for brown fat marker genes, including TFAM, DIO2, CTPlb, and NRF1 upon upregulation of either of the three genes (FIG. IB; PROM 16 CRISPRa did not show upregulation of CTP1b, and NRF1). We examined oxygen consumption rate (OCR) in these cells using Seahorse (see Methods), by initially blocking oxygen consumption and then adding I pM oligomycin, followed by the introduction of 1 uM FCCP to measure the maximal respiratory capacity. We found that CRISPRa-AAV treatment targeting either gene increased overall OCR levels in human white adipocytes with UCP1 gRNA AAV treated cells having the largest increase (FIG. IC), In addition, these cells showed increased uncoupled respiration (under oligomycin, ATPase inhibitor) indicating a brown fat-like phenotype (FIG.1C). CRISPRa treated cells also had elevated maximal respiration following carbonyl cyanide-p-trifluoromethoxy- phenylhydrazone (FCCP) treatment (FIG. 1 C) . Furthermore, these AAV-CRISPRa engineering adipocytes showed increased glucose uptake in both basal and insulin stimulated conditions (FIG. ID). We also tested the fatty acid oxidation (FAO) capacity of these cells by performing a similar Seahorse OCR assay. In both BSA- and BSA conjugated-palmitate (saturated fatty acid complex) media, we found that our CRISPRa-treated adipocytes had an overall OCR increase in BSA conjugated-palmitate (FIG. IE). Under FCCP treatment, in which the increaseof OCR in palmitate-containing media compared to BSA-containing media is thought to be due to exogenous fatty acid oxidation, we found that upregulation of either gene increased exogenous FAO capacity' in human adipocytes (FIG. IF). Taken together, we show that AAV- based CRISPRa upregulation of UCP1, PPARGCIA or PRDM16 induces browning in human adipocytes, leading them to have increased glucose uptake and fatty acid oxidation.CRISPRa-modulated adipocytes suppress cancer cell growth in vitro

[0186] We next evaluated whether our CRISPRa ’browned’ adipocytes could inhibit cancer growth in vitro using a co-cuituring system (FIG.2A). We initially treated differentiated adipocytes with CRISPRa-AAV for either of the three genes (UCP1, PPARGCIA or PRDM16) and replated these adipocytes on the top chamber of a 12- or 24-well trans well plate, which has inserts of 0.4um membrane, so that the adipocytes don’t contact the cells on the lower chamber (FIG.2A). In the lower chamber, we grew' five different cancer cell lines: breast cancer cells MCF7 (ER+,PR+,GR+) and MDA-MB-436 (triple negative), colon cancer (SW-1417), pancreatic cancer (Pane 10.05) and prostate cancer (DU-145). As a negative control, we used adipocytes infected with dCas9-VP64 only. After three days, we observed that all five cancer cell lines that were co-cultured with UCP1, PPARGCI A or PRDM16 CRISPRa-treated human adipocytes showed significantly lower cell numbers than cells co-cultured with dCas9-VP64 treated adipocytes (FIG.2B). We found that the number of cancer cells co-cultured with CRISPRa-treated adipocytes were 3- to 5- fold lower than cells cocultured with the control adipocytes (FIG.2C). By qRT-PCR, we observed that all cancer cells co-cultured with CRISPRa-treated adipocytes had significantly decreased levels of MK167 (other than DU-145 treated with PRDM16 CRISPRa) a proliferation marker, compared to control cells, with UCP1 CRISPRa having the greatest effect (FIG.2D). We also performed a BrdU incorporation assay, finding that after 24 hours the CRISPRa co-cultured cancer cells showed significantly reduced proliferation compared to cells co-cultured with control adipocytes (FIG.12A).J0187] We next analyzed the glucose and fatty acid metabolism of the cancer cells. To measure glycolysis, we utilized the extracellular acidification rate (ECAR) assay in which tire basal glycolytic rate is measured by adding glucose and the maximal glycolytic rate is measured by oligomycin A addition. We found that all five cancer cell lines co-cultured with CRISPRa- AAV treated adipocytes showed lower overall glycolysis than those co-cultured with dCas9- VP64 only (FIG.12B). These cells also showed a significant reduction in both basal and maximal glycolytic rate (FIG.2E-F) and lower glucose uptake in both basal and insulinconditions (FIG.2G-H), other than SW-1417 treated with either PPARGC1A or PRDM16 CRISPRa. Using qRT-PCR, we also found that the expression of key glycolysis genes, such as GCK and GLUT4, a major glucose transporter, were significantly lower in the cancer cells cocultured with CRISPRa-AAV adipocytes (other than GCK for PRDMl 6 CRISPRa treated Pane 10.05 and DU-145 cells) compared to the negative control (FIG.2I). We also examined fatty acid oxidation (FAO) using Seahorse. Similar to glycolysis, we found that all five cancer cell lines that were co-cnltnred with CRISPRa-AAV adipocytes had reduced FAO compared to the negative control (FIG.2J, FIG.12C). Moreover, using qRT-PCR, we found in most CRISPRa conditions that the cancer cells have lower expression of both CPTlb, a key regulator of FAO in the mitochondria and CD36, a fatty acid transporter on the cell membrane, further confirming decreased FAO (FIG.2J), Combined, our data shows that our CRISPRa-modulated adipocytes reduce glycolysis and fatty acid metabolism in five different cancer cell lines and can significantly suppress cancer growth.CRISPRa-modulated human adipose organoids suppress xenograft growth

[0188] To examine whether CRISPRa-modulated adipocytes could inhibit cancer growth in in vivo xenograft models, we co-transplanted four cancer cell lines (MCF7 and MD A-MB-436 (breast). Pane 10.05 (pancreas) and DU-145 (prostate)) with CRISPRa-modulated human adipose organoids. While adipocytes could be used for co-transplantation, adipose organoids offer added advantages, including: 1) providing a 3D-culture that can better recapitulate the heterogeneity of adipose tissue; 2) enhanced response to endogenous stimuli; 3) the ability to form tissue microenvironments that could better integrate with cancer cells following transplantation. We initially' established culturing conditions for human adipose organoids. We utilized immortalized human preadipocytes grown using methods that combines features from three different 3D culturing protocols (39, 40). In brief, we cultured human preadipocytes in basal DMEM media supplemented with 10% fetal bovine serum in Nunc 96 well plates treated with Nunclon Delta. Organoids formed after 48 hours and were then differentiated to adipose organoids using a differentiation cocktail containing IBMX, dexamethasone, insulin, T3, and rosiglitazone. Adipocytes formed 21 -days post differentiation (FIG.13 A). Using qRT-PCR, we analyzed these organoids for various adipogenic markers, including FABP4, PLIN1, and ADIPOQ, finding all to be expressed (FIG.13B). We further tested our ability to upregulate UCP1, PPARGC1 A, and PRDM16 in these organoids using similar methods and AAV gRNAs as in the adipocytes, finding all three to show significant upregulation of the target genes(FIG.13C). With the establishment of these adipose organoid culturing and CRISPRa conditions, we next set out to test whether they can suppress xenograft cancer growth.

[0189] To generate xenografts, cancer cells were subcutaneously implanted into immunocompromised SCID mice. Following 6-8 weeks, UCPl-CRISPRa treated human adipose organoids were mixed with Matrigel and co-transplanted adjacent to palpable tumors. For all subsequent assays, we only used UCPl-CRISPRa, as it showed the most optimal results in our cell culture experiments. Due to some reports suggesting that brown fat could be linked to cancer-associated cachexia (loss of skeletal muscle and fat) (41), we measured on a weeklybasis the body weight of mice co-transplanted with cancer cells and UCP1 -modulated adipose organoids, finding no significant differences between CRISPRa treated and control mice (FIG.14D). Tumors and human adipose organoids were collected following three weeks (FIG.3A). All tumor types co-transplanted with CRISPRa-modulated human adipose organoids were significantly smaller than dCas9-VP64 only transplanted human adipose organoids (FIG.3B), having over 50% reduction in volume (FIG.3C). Gene analysis showed that tumors co-transplanted with CRISPRa-treated adipose organoids had decreased expression of the proliferation marker gene MIK67 (FIG.13E), as well as reduced marker gene expression for glycolysis (GLUT4, GCK) and fatty acid oxidation (CD36, CPT1B) (FIG.13F). Using immunofluorescence, we examined additional tumor marker genes, finding that all tumors cotransplanted with UCPl-CRISPRa modulated human adipose organoids had markedly reduced Ki67+ (FIG.3D), In addition, cancer cells showed decreased levels of hypoxia, identified by having a lower carbonic anhydrase (CA9+) area per image view (FIG.3E). These tumors also showed decreased levels of CD31+ area per image view, indicating decreased microvessel density and suggesting a corresponding lower metastatic potential (FIG.3F). Since brown fat is known to reduce insulin levels, we examined the plasma insulin m these mice. We found that plasma insulin levels of mice that were co-transplanted with UCPl-CRISPRa adipose organoids and cancers were significantly lower than those co-transplanted with the control adipose organoids and were comparable to levels in wild type SCID mice (FIG.13G). Taken together, these results show that UCPl-CRISPRa modulated human adipose organoids significantly reduce glycolysis and fatty acid oxidation, reduce hypoxia and insulin levels and inhibit tumor growth for four different cancer types in vivo.AMT suppresses cancer development in pancreatic and breast cancer genetic mouse models

[0190] To examine whether our AMT approach can prevent cancer development, we utilized pancreatic and breast cancer genetic mouse models. For pancreatic cancer, we used the KPC mouse model, that upon tamoxifen treatment develops pancreatic ductal adenocarcinoma due to conditional mutations in Kras and Trp53 (42). For breast cancer, we used MMTV-PyMT mice on an FVB background, containing a mouse mammary tumor virus (MMTV) long terminal repeat upstream of the Polyoma Virus middle T antigen (PyVmT), that develop mammary tumors with a mean latency of 53 days (43). We first designed five gRNAs targeting mouse Ucpl and transfected them into mouse 3T3-L 1 adipocytes, finding all five upregulate Ucpl (FIG.14A). We next selected the top two gRNA for AAV serotype 9 (AAV9) packaging and infected 3T3-L1 differentiated adipocytes with these viruses along with AAV 9 dCas9- VP64, finding that all of them significantly increased Ucpl gene expression levels compared to dCas9-VP64 only control (FIG.14B). We used the top activating gRNA AAV9 for all subsequent experiments. As organoids have several of the aforementioned advantages, we generated adipose organoids using mouse preadipocytes, utilizing similar techniques as described tor human adipose organoids (see Methods). We then infected them with AAV9 dCas9-VP64 and Ucpl -gRNA and observed both mCherry expression from our gRNA virus and significant Ucpl upregulation (FIG.14C).

[0191] We first set out to test whether we can suppress pancreatic cancer development using KPC mice. KPC mice were treated with tamoxifen postnatal day 0-4. At four weeks of age, Ucpl -CRISPRa or dCas9-VP64 only (negative control) adipose organoids were orthotopically implanted next to the pancreas (FIG.4A). Following six weeks, pancreases were removed and analyzed. Over these six weeks, we observed no significant difference in body weight between mice implanted with Ucp1 -CRISPRa organoids or control organoids (dCas9-VP64 only) (FIG.14D). We found that KPC mice implanted with Ucpl -CRISPRa upregulated adipose organoids had significantly smaller tumors compared to control dCas9-VP64 implanted mice (FIG.4B) and reduced pancreatic mass (FIG.4C). They also showed reduced expression of the proliferation marker, Mki67, as well as genes involved fatty' acid oxidation (Cd36, Cptlb) (FIG.4D). In addition, we found Ucpl-CRISPRa mice to have lower expression levels of the pancreas’ main glucose transporter, Glut2 (FIG.4D). Ucpl-CRISPRa mice also had a lower number of K167+ cells compared to control mice as determined by immunofluorescence (FIG.4E, 14E). Similarly, we observed lower CA9+ area per image, and CD31+ area per image view', suggesting reduced hypoxia and angiogenesis (FIG.4E, 14E). In addition, we foundUcpl-CRISPRa adipose organoids to have significantly reduced insulin levels compared to control mice (FIG.14F).

[0192] To examine whether our treatment might provide systematic therapeutic effect in suppressing breast cancer growth, we next used MMTV -PyMT female mice, implanting Ucp 1 - CRISPRa or dCas9-VP64 adipose organoids near the third nipples (MG) of four-week-old mice (FIG.4F). As cold treatment leads to widespread BAT activation causing cancer suppression (15), we also examined whether distal implantation of adipose organoids could suppress cancer development by implanting organoids in the back of 4-week-old mice (DOR). Following six weeks post implantation, tumors were collected and analyzed. Similarly, we found no difference in body weight of mice implanted with Ucp 1 -CRIPSRa organoids compared to those implanted with control organoids (FIG.14G). Remarkably, w!e found both strategies of organoid implantation resulted in significantly reduced tumor size (FIG.4G) and volume (FIG.4H) regardless of site of implantation. Tumors also had decreased expression of the Mki67 proliferation marker and metabolic genes, including Glut4, Gck, Cd36, and Cptlb (F1G.4I). The tumors of mice implanted with Ucpl-CRISPRa adipose organoids had less Ki67 ■ cells than control mice (FIG.4J). These tumors also had lower CA9+ area per image, and CD31 + area per image viewy indicating reduced hypoxia and angiogenesis (FIG.4I-K). Additionally, mice implanted with Ucpl-CRISPRa adipose organoids had significantly lower plasma insulin levels than control mice (FIG.14H). Taken together, our results indicate that our CRISPRa-modulated adipose organoids could have systematic therapeutic effects in suppressing cancer growth.UCPl-CRISPHa upregulation of adipocytes from dissected breast tumors suppresses cancer growth.

[0193] To further demonstrate the therapeutic potential of AMT, we treated adipocytes obtained from dissected human breast tissues with UCP 1 -CRIPSPRa AAV9 and tested their ability to suppress tumor progression by co-culturing them with breast cancer organoids generated from dissected breast tumors or metastatic pleural effusions (FIG.5A). Samples were obtained from patients who underwent breast surgery or thoracentesis. For the co-culture experiments, we used five different breast cancer organoids generated from patients with early- stage or metastatic triple-negative breast cancer [estrogen receptor (ER)-negative, progesterone receptor (PR)-negative / human epidermal growth factor receptor 2 (HER2)-negative] or hormone receptor-positive (ER-positive and / or PR-positive)ZHER2-negative breast cancer(Table SI ). Organoids from breast tumor tissue were generated by digesting cells for one hour in collagenase and organoids from metastatic pleural effusions were generated by isolating tumor spheroids via centrifugation, before in both cases embedding cancer cells in organoid culture using established protocols that enable long-term propagation of tumor organoids (44). In parallel, primary human adipocytes were isolated from human breast tissue using an established protocol (45). For the triple -negative breast cancer organoids derived from primary tumors, we used two different cases, including one where we generated organoids and isolated mammary gland adipose tissue from the same individual (T0R41). Adipocytes were infected with dCas9-VP64 only (negative control) or UCPl-CRISPRa AAV9. After five days, they showed strong mCherry expression, a fluorescent marker that is part of tire gRNA AAV9 (FIG. S 5 A), suggesting that they can be readily infected by our AAVs. In addition, gene analysis showed that both mCherry and UCP1 expression levels were significantly higher in the UCPl- CRISPRa treated adipose organoids compared to the control organoids (F1G.S5B).Table SI. Breast cancer organoid status.

[0194] To test whether UCPl-CRISPRa AAV9 adipocytes can suppress cancer growth, we added them to a hydrogel dome on top of the breast cancer organoids with a fully-defined organoid medium (44) and co-cultured for five days (FIG.5A). In all five cases, we observed significant reduction in cancer organoid size (FIG.5B) and in most organoids also a reduction in organoid number (TOR124 and TOR41 were not significant) upon incubation with adipocytes infected with UCPl-CRISPRa AAV9 compared to the dCas9-VP64 only treated cells (FIG.5C). All five cancer organoid cases co-cultured with UCPl-CRISPRa had significantly lower proliferation marker MKI67 expression compared to negative control (F1G.5D). We also observed significantly decreased levels of GLUT4, GCK, CD36, and CTPIb for the UCPl-CRISPRa co-cultured cancer organoids (FIG.5E), suggesting they have lower glycolysis and fatty acid metabolism. Overall, our results demonstrate that humanadipocytes from a dissected breast tissue can upregulate UCP1 via CRISPRa AAV9 and are able to reduce glycolysis and fatty acid metabolism and suppress breast cancer organoid growth. In addition, using matched mammary' gland adipose tissue and breast cancer samples, we demonstrate the potential clinical utility of an ex vivo autologous transplantation of CRISPRa-modulated adipocytes to treat cancer.Discussion

[0195] Cancer cells are fast-proliferating cells that require large amounts of nutrients, including glucose and fatty acids. They can reprogram metabolic pathways to utilize available substrates in the surrounding environment. Targeting their metabolism can be a potent cancer treatment. Here, w'e developed CRISPRa-modulated human adipocytes that have increased glucose and fatty acid utilization by upregulatmg UCP1 , PPARGC1A, and PRDM16. These CRISPRa-modulated adipocytes were able to suppress cancer growth in five different cancer cells lines, including two breast lines, colon, pancreas, and prostate. Co-transplanting CRISPRa-treated human adipose organoids and xenografts in mice led to a significant reduction in tumor growth in all five cancer types. These tumors had lower glycolysi s and fatty acid metabolism and showed decreased hypoxia and angiogenesis. Implanting CRISPRa- modulated adipose organoids into genetic mouse models of breast and pancreatic cancers also prevented tumor development in mice. Furthermore, we demonstrated that implantation of CRISPRa-modulated adipose organoids distant from the cancer tissue leads to similar results. In addition, co-culturing cancer organoids from breast tumors and CRISPRa-modulated mammary adipocytes dissected from patients resulted in lower cancer growth. Combined, our data suggests that AMT has enormous potential to treat a wide variety of cancers.

[0196] Adipocytes offer a unique ex vivo therapeutic system with many of the needed procedures already established in the clinic. Liposuction and fat transplantation are commonly used in many surgical procedures, such as aesthetic and reconstructive surgery. Due to successful engraftment, adipose tissue transplantation has progressively evolved, not only in plastic and reconstructive surgery, but also for therapeutic treatments (46). Several reports using rodent models have shown that BAT transplantation has beneficial metabolic outcomes (47-50). These also include the use of UCPl-CRISPRa modulation in human white preadipocytes to induce browning, followed by their transplantation in mice treated on a high- fat diet, leading to improved body weight, glucose tolerance and insulin sensitivity (34). Ourwork further showcases how these ‘brown’ adipocytes and adipose organoids can be utilized for cancer treatment.

[0197] There is a growing interest in carrying out human adipose tissue grafting by using adipose stem cells or progenitors due to their resistance to trauma and long-term survival following transplantation. One such example, is the use of CRISPRa to upregulate the relaxin family peptide receptor 1 (RXFP1) in adipose-derived stem cells and their transplantation in a diabetes mellitus induced erectile dysfunction rat model, showing amelioration of the erectile disfunction phenotype (51). Organoids could be advantageous for these cells as they provide a 3D-culture that can better recapitulate the heterogeneity of adipose tissue, respond better to endogenous stimuli and form tissue microenvironments that could more efficiently integrate with cancer cells following transplantation. Several groups have successfully grown adipose organoids from mouse adipose stem cells (33, 40, 52, 53). Here, wfe wfere able to culture human adipose organoids from preadipocytes using various conditions from previous studies (33, 40, 52, 53). These human adipose organoids exhibited mature adipocytes markers, including FABP4 and PL1N1. In addition, in our hands they could last up to a year after being subcutaneously implanted in mice, showing the potential for long-term treatment (data not shown). Finally, in our study we show that their CRISPRa modulation could significantly reduce tumor size, glycolysis and fatty acid metabolism and improve hypoxia and angiogenesis in cancer mouse models. Further development of these organoids and their modulation could likely improve these attributes and their therapeutic use for a wide range of diseases.

[0198] Our work builds on the recent observation that activating BAT, via cold exposure, increases adipocyte glucose uptake, lipid metabolism and significantly inhibits tumor progression (15). Here, instead of placing tumor models in cold conditions, we took advantage of CRISPRa to increase the expression of BAT key regulators, including UCP1, PP ARGCI A, PRDM16 to engineer adipocytes to have increased glucose and fatty acid uptake and metabolism, and used them to deplete resources from cancer cells. Interestingly, and in line with the BAT cold activation results (15), implanting CRISPRa-modulated adipose organoids distal from the tumors also led to suppression of cancer growth, suggesting that complex surgical procedures for tumors with limited access might not be needed for this approach. This phenomenon might be due to additional mechanisms in which CRISPRa-modulated adipose organoids can suppress cancer growth. Previous studies have shown that hyperinsulinemia can lead to cancer growth due to insulin being a powerful mitogen and survival factor (54-56). For example, administration of Dapagliflozin, a SGTL2 inhibitor that lowers blood glucose, and acontrolled-release mitochondrial protonophore (CRMP) suppress cancer growth in mice by reversing hyperinsulinemia (57). Since BAT is widely known to reduce whole-body blood glucose and insulin levels in humans (15, 49, 58), we hypothesize that the CRISPRa-modulated adipose organoids can reduce cancer progression by lowering plasma insulin levels. Indeed, our data, using both xenograft and genetic mouse models, shows that mice implanted with CRISPRa-modulated adipose organoids have reduced plasma insulin levels compared to dCas9-V64 control mice (FIG.13G, 14F,H).

[0199] Amongst BAT-activating genes, UCP1 showed the most robust effect in terms of cancer suppression. It would be interesting to further develop this AMT approach to upregulate additional genes that could aid in cancer therapy. These could include for example upregulation of GLUT1 and GLUT4, that are the main glucose transporters in adipose cells, with GLUT4 being tire most abundant and insulin responsive (59). Glucose metabolism associated genes, such as the transcription factor FOXO 1 (60) and the G-coupled receptors, GPR20 and GPR120, which were implicated in improved glucose uptake and insulin resistance (61 , 62), and AIFM2, which promotes glycolysis in BAI' (63). Fatty acid oxidation associated genes, including for example the fatty' acid transporter CD36, a key transporter for fatty' acid oxidation, CPTlb, and the fatty acid breakdown enzyme, ACC-1 . Additional modifications could also be engineered in these adipocytes / adipose organoids, including for example utilization of their endocrine capabilities to secrete chemotherapeutic drugs or other cancer therapeutic associated compounds.

[0200] In this study, we used AA V-based CRISPRa to upregulate genes. However, it is worth noting that both upregulation and delivery could also be carried out using other modalities. For example, gene upregulation could be carried out using zinc fingers, TALENS, generation of specific mutations via regular CRISPR editing or base or prime editing in promoters or enhancers or standard overexpression using a cDNA mammalian expression construct of the gene of interest. Deliver}' could also be carried out with other viruses, such as lentivirus that is widely used for CAR-T therapy, but has a major caveat of genomic integration, or various non- viral nucleic acid delivery' vehicles such as nanoparticles (64) or virus-like particles (VLPs) (65). Various drugs could also be used to upregulate specific genes in adipocytes in a global manner in cancer patients. In addition, downregulation of certain genes in adipocytes or adipose organoids, using CRISPRi, siRNA, CRISPR editing or other techniques could also be utilized for AMI'. For example, a recent study used CRISPR to deplete the nuclear receptor interactingprotein 1 (NRIP1) to make ‘brown’ adipocytes which upon implantation in mice decreased their adiposity on a high-fat diet (66).

[0201] A link between obesity, excess amount of WAT and cancer development and progression has been established, with nearly 40% of all cancer deaths in the United States being attributed to obesity' (67), There are numerous proposed mechanisms in how WAT is linked to cancer development and progression, including chronic inflammation, hyperinsulinemia, steroid hormones, and adipokines (68-74). In addition, in glucose-rich conditions, cancer cells synthesize de novo FAs from intermediates of the glycolysis-TCA cycle (lipogenesis)(75, 76). The synthesized FAs are then utilized to synthesize triglycerides and are stored as lipid droplets in cancer cells. When energy is needed, these lipid droplets undergo lipolysis to release FAs which are subjected for b-oxidation (76-78). Since BAT is highly associated with improved glucose tolerance and insulin sensitivity (79), one could envision a personalized treatment development for obese cancer patients, whereby AMT is used not only to target cancer and its unique metabolism in these patients but also treat their metabolic disease. One major hurdle in our approach that needs to be taken into account is cancer-associated cachexia (41). While we did not observe weight loss in our mouse models, a longer treatment time could possibly lead to a reduction in body weight, as was shown for UC-Pl-CRISPRamice on a high-fat diet (34). Modification of other genes than UCP1, removal of the implant after a certain time or having a molecular kill switch could all be potential solutions for cachexia if observed.

[0202] In summary, our results provide proof-of-principle results for a novel cancer therapeutic approach, termed AMT, that can be further improved and personalized for specific cancers and patients. Similar to chimeric antigen receptor (CAR)-T cell therapy, AMT can be readily used in the clinic as cells can be obtained from cancer patients via liposuction or other procedures, engineered and transplanted back into the same individual for therapeutic benefit. The utilization of adipocytes from dissected breast tissue, as performed in our study, further showcases the clinical utility of such an ex vivo approach. In particular, tor breast cancer this could be particularly straightforward as many mastectomies are followed up by reconstructive surgery with autologous tissue (80), which could be manipulated poor to this procedure. Unlike T-cells, adipocytes have a lower immune response (34, 81) which could allow7more straightforward development of ‘off-the-shelf adipocytes or adipose organoids for cancer and other treatments. Their ease of growth in culture, long lasting and robustness, and lowermultiplicity (82) along with existing clinical procedures to remove and transplant them make them an exceptional cell type for cancer and other cellular-based disease therapies.Materials and MethodsHuman and mouse adipocytes

[0203] For adipocyte differentiation of human preadipocytes, human preadipocytes or mouse 3T3-L1 preadipocytes (both kind gifts from Dr. Hei Sook Sul, UC Berkeley) were cultured to 100% confluency in DMEM, supplemented with 10% FBS and fresh media were replaced. After 48 hours, cells were subjected to adipocyte differentiation by adding a cocktail of 3- isobutyl-1 -methylxanthine (1BMX) (0.5M) (Sigma-Aldrich; 410957), dexamethasone (luM) (Sigma- Aldrich; D1756), and insulin (lOug / ml) (Sigma-Aldrich; 19278). Media was replaced every two days with insulin containing DMEM complete media (Fisher Scientific; 1 1 -965-1 18) during differentiation.Cancer cell lines

[0204] All the cancer cells were acquired from American Type Culture Collection (ATCC), MCF7 (ATCC; HTB-22) was cultured in Eagle’s minimum essential medium (ATCC; 30- 2003), supplemented with 10% FBS and lOug / ml human recombinant insulin (Sigma-Aldrich; 19278). MDB-MA-436 (ATCC; HTB-130) was cultured in Leibovitz’s L-15 medium (ATCC; 30-2008) with lOug / ml insulin, 16 ug / ml glutathione (Sigma-Aldrich; G6013) and 10% FBS. SW-1417 (ATCC; C-CL-238) was grown in Leibovitz’s L-15 medium supplemented with 10% FBS. Pane 10.05 (ATCC; CRL-2547) was cultured in RPMI-1640 medium (ATCC; 30-2001) with lOug / ml human insulin and 15% FBS. DU-145 (ATCC; HTB-81) was cultured in Eagle’s minimum essential medium with 10% FBS.CRISPRa Ari V in vitro optimization

[0205] Five gRNAs targeting the promoter of hitman UCP1, PPARGC1A, and PRDM16 or mouse Ucpl were designed using the Broad Institute CRISPick Tool (83) (Table S2). These guides were individually cloned into pAAV-U6-sasgRNA-CMV-mCherry-WPREpA (84) at the BstXI and Xhol restriction enzyme sites using the In-Fusion (Takara Bio; 638910) cloning methods as described in (84). 5xl05human preadipocytes or mouse 3T3-L1 cells were plated into 12-well plate and were then subjected to adipocyte differentiation protocol after two days of confluency. At day four of differentiation, cells were transfected with 0.5ug of dCas9-VP64 and 0.5ug of gRNA plasmid using X-tremeGene (Sigma; 6366236001) and CombiMag reagent(OZ Biosciences; CM21000) following the manufacturer’s protocol. At day eight of differentiation, cells were lysed with Trizol and RNA was collected and cDNA and qRT-PCR were performed, as mentioned in RNA Isolation and qRT-PCR section. The two gRNAs with the highest upregulation for each gene were packaged into rAAV-9 serotype virons. rAAV-9 serotype virons were produced by transfecting AAVpro 293T cell (Takara; 6322723) with pCMV-sadCas9-VP64 (Addgene; 115790) or pAAV-U6-sasgRNA-CMV-mCherry-WPREpA (84) along with packaging vectors, including PAAV2 / 9n (Addgene; 1 12865) and pHelper vectors using TransIT293 reagent (Minis; 2700). After 72 hours, AAV particles were collected and purified using AAVpro Cell & Sup. Purification Kit Maxi (Takara; 6676) and quantified by the AAVpro Titration Kit (Takara; 6233). gRNA AAV viruses (IxlO6MOI) and dCas9- VP64 AAV (lx 106MOI) were used to infect human and mouse differentiated adipocytes. After five days, RNA was collected, cDNA was made, and qRT-PCR was done as described below.Table S2. Sequences of primers for RT-qPCR, cloning, genotyping and gRNAs.RNA Isolation and qRT-PCR[0206 j Total RNA from sorted or cultured cells was extracted using Trizol reagent (ThennoFisher; 15596026). Reverse transcription was performed with Ipg of total RNA using qScript cDNA Synthesis Kit (Quantabio: 95047) following the manufacturer’s protocol. qRT- PCR was performed on QuantStudio 6 Real Time PCR system (ThennoFisher) using Sso Fast (Bio-Rad; 1705205). Statistical analysis was performed using ddct method with GAPDH or Gapdh primers as control (see primer sequences in Table S2). Gene expression results were generated using mean values for over n=4-6 biological replicates.Seahorse assay

[0207] Human preadipocyt.es (5x10’ cell / well) were plated in 12-well tissue culture plates and subjected to adipocyte differentiation protocol. Adipocytes and cancer cell lines were trypsinized and reseeded in XF96 plates (Agilent; 102.905-100) at 20K cells per well and assayed the next. day. On the day of experiments, the cells were washed two times and maintained in XF base medium (Agilent; 1033334) supplemented either with 1 mM sodium pyruvate (ThennoFisher; 11360070) and 17.5 mM glucose (Sigma-Aldrich; G7021), for tlie mitochondria stress test or with 2 mM glutamine (StemCell technologies; 07100) for the glycolysis test. For FAO tests, cells were washed and incubated with substrate-limiting medium DMEM (Corning; 17-207-CV) supplemented with 0.5 mM glucose, 1 mM glutaMAX (ThermoFisher; 3050061), 0.5 mM carnitine (Sigma- Aldrich; C0283), and 1%FBS. Cells were then incubated at 37°C in a non-CO2 incubator for 1 hour. The assay was performed using Seahorse XFe96 analyzer (Agilent; XFe96). Oxygen consumption measured under 1 .5 gM oligomycin (Sigma-Aldrich; 75351), 2 uM FCCP (Sigma- Aldrich; C2920), and 0.5 uM of Rotenone (Sigma-Aldrich; R8875) / Antimycm (Sigma-Aldrich; A8674). Extracellular acidification rate (ECAR) was measured under 10 mM glucose, 1 uM oligomycin, and 50 mM 2 -deoxyglucose (Sigma-Aklrich; D8375).Glucose uptake assay

[0208] Human preadipocytes (3 x10scell / well) were plated in 96-well tissue culture plates and subjected to adipocyte differentiation protocol. One day before the assay, media wasreplaced with serum-free media. On the day of the assay, using glucose uptake-Glo assay (Promega; J1342), ceils were incubated with 1 nM insulin (Sigma-Aldrich; 19278) for 1 hour prior to the assay following the manufacturer's protocol.Co-culturlng CRISPRa-modulated adipocytes with cancer cells[0209 j 5x10’ human preadipocytes were plated in 12-well tissue culture plates and subjected to adipocyte differentiation protocol. At day 2 of differentiation, cells were transduced with gRNA AAV viruses (IxlO6MOI) and dCas9-VP64 AAV (IxlO6MOI). After 6 days, cells were collected and replated into the upper-well of 12-well transwell plate (Fisher Scientific; 07-200-150) in which 3x103cancer cells were plated in the lower-well a day earlier. Tire cells were culture in adipocyte differentiation media, described previously, and designated media for each cancer cell line (1: 1 ratio). After three days, cancer cells were collected for imaging and seahorse assay. RNA was collected, and cDNA was made, and qRT-PCR was earned out as previously described. Differential expression was determined using the ddet method with GAPDH primers as control (primer sequences in Table S2).Human and mouse adipose organoid culture

[0210] Human or mouse 3T3-L1 preadipocytes (0.5xl06cells) were plated in 96-well Nunclon Sphera ULA U-bottom plates in (ThermoFisher; 174929). Organoids fonned after 48 hours and were then differentiated to adipose organoids using a differentiation cocktail containing 3 -isobutyl- 1 -methylxanthine (IBMX) (0.5M), dexamethasone (luM), and insulin (lOug / ml). Adipocytes formed 21 -days post differentiation. Human adipose organoids were then transduced with gRNA AAV viruses (IxlO6MOI) and dCas9-VP64 AAV (IxlO6MOI). After 5 days, organoids were collected and mixed with Matrigel (Coming; 354234) and subcutaneously injected into mice (10 organoids / mouse).Co-transplantation of CRISPRa-modulated human adipose organoids and cancer cells

[0211] All animal studies -were carried out in accordance with the University of California San Francisco Institutional Animal Care and Use Committee protocol number AN197608. Mice were housed in a 12: 12 light-dark cycle, and chow diet (Envigo; 2018S) and water were provided ad libitum. Five-week-old immune-deficient SCID mice (JAX; 001303) were anesthetized using isoflurane and subcutaneously injected with 2xl06-6xl()° cancer cells in phosphate buffered saline (PSB). After 6-12 weeks, depending on the cancer ceil lines, we subcutaneously injected CRISPRa AAV human adipocytes or adipose organoids to a siteadjacent to the tumor. Following 4-6 weeks, mice were euthanized, and tumors and adipose implants were collected. We measured tumor size with calipers and tumor volume according to standard formula (length x width?, x 0.52).Immun ofluorescen ce[0212 j A portion of isolated tumors were fixed -with 1 % paraformaldehyde for two hours and prepared for cryostat sectioning. Each sample were cut into 5 umm thick sections and blocked with 3% BSA (Miltenyi Biotech; 130-091-376) blocking solution for 30 minutes. For Ki-67 staining, slides were permeabilized with 1% triton X-100 PBS solution for 15 minutes and washed with 0.1 % Tween20 PBS solution prior to blocking. Slides were then incubated with primary antibodies (information and concentration listed in Table S3) overnight at 40C and washed 3x with 0. 1% Tween2.0 PBS. The slides were then incubated with secondary antibodies (information and concentration listed in Table S3) for 60 minutes at room temperature and then washed 3x with 0.1 % Tween20 PBS. Images were obtained using a confocal microscope (Zeiss; LSM880) and analyzed with Fiji (85).Table S3. List of antibodies.CRISPRa-modulated mouse adipose organoid implantation in pancreatic and breast cancer genetic mouse models

[0213] KPC, tamoxifen-inducible" is a KrasLSL-G12D;p53LoxP;Pdxl-CreER triple mutant model of tamoxifen-inducible pancreatic ductal adenocarcinoma (PDAC) on an C57 / BL6 background was acquired at the Jackson Laboratory (032429). To induce Cre recombination, tamoxifen was administered to pups via lactation following oral gavage of the mother with 6mg tamoxifen (suspended in com oil) at postnatal days 0. 1, 2 and 4. We orthotopically implanted mouse adipose organoids (10 organoids / mouse) mixed with Matrigel (Coming; 354234) near the pancreas in 4-week-old mice, using a similar protocol describe in (86) and dissected the pancreas 6 weeks after the implantation. The MMTV-PyMT breast cancer mice were acquired from the Jackson Laboratory (002374). Four-week-old female mice were implanted with mouse adipose organoids (10 organoids / mouse) mixed with Matrigel (Corning; 354234) and subcutaneously injected into mice either at the third nipple or the back. The tumors were collected six weeks post implantation.Cancer organoids

[0214] Organoids were generated from breast tumor tissue or tumors from malignant effusions. Patients were consented for specimen collection using IRB-approved tissue collection protocols at the University of California, San Francisco and the Brigham & Women’s Hospital. Surgical specimens were obtained from the UCSF Medical Center or Brigham & Women’s Hospital on the day of their procedure, viably frozen as tissue pieces, or used to generate formalin-fixed, paraffin-embedded (FFPE) sections or organoid cultures. Each tissue was minced using razor blades and digested in a solution containing DMEM / F12 (Gibco; 11330), 2 rnM GlutaMax (Gibco; 35050), 10 mM HEPES (Gibco; 15630), 50 U / mL Penicillm- Streptomycin (Gibco; 15070), and 1 mg / ml collagenase XI (Sigma-Aldrich; C9407). Tissue digestion was performed at 37°C with constant shaking at 150 rpm for 1-2 hours. Cells were then pelleted by centrifugation, further dissociated by sequentially pipetting with 10, 5, and 1- ml pipette tips, and recentrifuged. The resulting cell pellet was used directly to establish organoid cultures by embedding in basement membrane extract, allowing this to harden at 37°C for 20 minutes to form a hydrogel dome, and then overlaying this dome with Type 1 Organoid Medium as previously describe (87, 88). All metastatic cancer organoids were derived from malignant pleural effusions that w'ere collected from metastatic breast cancer patients undergoing thoracentesis at the UCSF Medical Center. The fluid samples were placed on ice within four hours after collection. Organoids were generated by washing malignant effusions with PBS, collecting tumor spheroids by centrifugation, and incubating with 3-5 ml RBC lysis buffer (BioLegend; 420301) for 10-15 minutes when there were visible RBCs, followed by embedding the cell pellet in organoid culture as described above.Mammary gland adipocyte isolation

[0215] For adipocyte extraction, mammary gland adipose tissues from excess tissue removed during breast surgeries were washed with PBS three times and mechanically minced into smaller pieces. The tissue mixture was incubated with PBS with 3% BSA and Collagenase I (Img / ml) for 45 minutes at 37°C, centrifuged and the top lipid layer was discarded. The remaining mixture was filtered twice through a 200um strainer and centrifuged. Mature adipocytes were isolated and washed twice with PBS and were plated in suspension in 6 well plates in high glucose DMEM media supplemented with 10% FBS. For transduction of CRISPRa, UCP1 AAV9 viruses (IxlO6MOI) and dCas9-VP64 AAV9 (1x106MOI) were mixed with 20ul of AdeoMag (OzBiosciences, AM71000) and adipocytes and incubated for 15 minutes. 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[0217] To examine whether CRISPRa-mediated upregulation of Ucpl, Ppargcla, and Prdml6 can protect, mice against obesity, we intravenously injected A AV-sad Cas9-VP64 and AAV-gRNAs targeting Ucpl, Peg la, and Prdml6 to 4 -week-old C57BL / 6J mice, which are widely used for diet-induced obesity due to having many loci implicated in regulation of bodyweight, body fat, and obesity, and being susceptible to diet-induced obesity (FIG.6A). Five weeks post injection, all Ucpl-, Ppargcla-, and Prdml6-gRNAs treated mice began to gain weight less than control only AAV-sadCas9-VP64 injected mice and their body weights continued to be significantly lower than tire control mice up to nearly one-year post-treatment (FIG. 6B). Using DEXA (dual energy X-ray absorptiometry), we found Ucpl-, Ppargcla-, and Prdml6-AAV-CRISPRa mice to have a 30-60% lower fat mass than control mice with no significant difference in lean mass (FIG. 6C).

[0218] After 45 weeks, upon tissue dissection, all AAV-CRISPRa treated mice had smaller white fat pads, such as iWAT (inguinal) and pWAT (perigonadal) compared to control mice (FIG. 6D). Gene analysis indicated that m Cherry (marker in sgRNA AAV) was increased in brown adipose tissue (BAT), iWAT, pWAT, and liver (FIG.6E). Moreover, Ucpl , Ppargcla, and Prdml6 mRNA levels were significantly higher only in adipose depots with the highest levels in BAT (FIG.6E). We next examined cold tolerance in these mice by maintaining them at 4°C for six hours after being at 30°C (thermoneutrahtv). At 2.0 weeks, mice treated withUcpl, Ppargcla, and Prdml6 gRNAs were able to maintain their body temperature, while dCas9-VP64 only control mice had a decrease of ~5°C after three hours of cold exposure (FIG.6F). Moreover, the whole-body oxygen consumption rate (OCR) of mice with CRISPRa for all three genes, compared to control mice, as measured by the Comprehensive Lab Animal Monitoring System (CLAMS; Columbus Instruments) was significantly higher during both day and night when mice were kept at thennoneutrality of 30°C and 16°C. This difference in OCR was more apparent when mice were exposed to cold at 4°C (FIG.6G), At 32 weeks, we also tested for glucose tolerance (GTT) and insulin sensitivity' (ITT) in these mice. For GTT, mice were fasted for 24 hours prior to glucose administration (2g / kg). For ITT, mice were fasted four hours prior to insulin (0.75U / kg). Blood glucose was measured at 30, 60, and 120 minutes after the injections. All AAV-CRISPRa treated mice showed significantly higher glucose clearance than negative controls (dCas9-VP64 only) at all time points (FIG.6H). Similarly, the CRISPRa treated mice had significantly higher insulin sensitivity than control mice (FIG.61). In addition, these mice showed lowered insulin levels in plasma, further indicating improved insulin response in AAV-CRISPRa treated mice (FIG.6J). Overall, the results strongly demonstrate our CRISPRa targeting Ucpl, Ppargcla, and Prdml6 reduce weigh gain and adiposity with increased energy expenditure and cold tolerance in mice.

[0219] We next examined whether CRISPRa induced browning can be an effective treatment for high fat diet-induced obesity. We intravenously injected AAV-sadCas9-VP64 and AAV- gRNAs targeting Ucpl, Pparcgla, and Prdm l6 to 4-week-old C57BL / 6J mice that were fed with high fat diet (60% fat) (FIG.7A). After ten weeks, the AAV-CRISPRa-treated mice showed significantly reduced body weight compared to the dCas-VP64 control mice (FIG.7B). These mice were also leaner (FIG.7C) and showed decreased fat mass measured by DEXA (FIG.7D), Upon dissection, we found AAV-CRISPRa mice had much smaller white fat pads, including iWAT and pWAT (FIG.7D), suggesting our treatment reduced adiposity induced by HFD. When subjecting these mice to GTT, all CRISPRa treated mice showed significantly higher glucose clearance than negative control at all time points (FIG.7E), Similarly, the CRISPRa treated mice had significantly higher insulin sensitivity than control mice (FIG.7F). In summary, our CRISPRa treatment targeting Ucpl, Peg la, and Prdml6 protected mice against HFD-induced obesity' and improved insulin sensitivity and glucose tolerance.

[0220] To further examine whether CRISPRa induced browning can be an effective obesity therapeutic, we tested its ability to rescue a commonly used obesity mouse model, ob / ob. In this model, mice are homozygous for a spontaneous loss-of-fimction mutation in the leptin(Lep) gene, leading to severe obesity, hyperphagia, hyperglycemia, glucose intolerance, and elevated plasma insulin! . We intravenously injected AAV-sadCas9-VP64 and AAV-gRNAs targeting Ucpl, Pparcgla, and Prdml6 to 4wk-old ob / ob mice (FIG.8A) or lOwk-oid ob / ob mice which were morbidly obese (FIG.8B). Following eight weeks, mice treated with AAV- CRISPRa at four weeks or 10 weeks showed significantly lower body weight than the dCas- VP64 control mice (FIG.8C,D). These mice were also leaner (FIG.8D) and showed reduced fat mass measured by DEXA (FIG.8F), They also had significantly smaller BAT, iWAT and pWAT (FIG.8F), suggesting our treatment reduced their leptin depletion associated obesity. When subjecting these mice to GTT, all AAV-CRISPRa treated mice showed significantly higher glucose clearance than negative control at ail time points (FIG.8G) and had significantly higher insulin sensitivity than control mice (FIG.8H). Ail AAV-CRISPRa-treated mice had lower insulin and free faty acid plasma levels, indicating improved metabolism. These data clearly indicate CRISPRa treatment not only prevents and alleviates obesity but also improves insulin sensitivity and glucose tolerance in ob / ob mice.

[0221] Due to its successful engraftment and long-term survival, fat transplantation is commonly used in many surgical procedures and has progressively increased the interest for therapeutic treatments2. Using the patient s own adipose tissue for fat grafting also eliminates tissue rejection. Hence, here set out to utilize CRISPRa BAT-activated fat transplantation, as a novel obesity therapeutic. We first collected fat pad from C57BL / 6J mice that were injected via tail-vein with AAV-CRISPRa targeting Ucpl, Pparcgla, or Prdml6, After six weeks, mice were sacrificed and iWAT were collected, washed with cold PBS, minced into smaller pieces and implanted subcutaneously into five-week-old C57BL / 6J mice (FIG.9A). After five weeks, mice implanted with adipose of AAV-CRISPRa mice showed lower body weight than control dCas9-VP64 implanted mice (FIG.9B). In addition, these mice had significantly reduced glucose tolerance and increased insulin response (FIG.9C,D). Moreover, these CRISPRa- treated mice had lower plasma insulin and free fatty acid (FIG.9E)10222] We next tested our CRISPRa therapy in human adipocytes. We utilized adipose organoids since they resemble human adipose tissue and recapitulate responses to endogenous stimuli providing proper tissue microenvironments that prevent, further tissue dysfunction3. To culture 3D organoids, we plated 105cells in Nunc 96 well plates treated with Nunclon Delta, in the same MSC basal (low serum) media supplemented with 5ng / ml recombinant human EGF and FGF. Organoids formed after 48 hours and were then differentiated to adipose organoids using a differentiation cocktail containing IBMX, dexamethasone, insulin, T3, androsiglitazone. Adipocytes formed 21 -days post differentiation. The organoids were then infected with AAV9-based CRISPRa targeting the UCP1, PPARGCla and PRDM16 promoters. Following 72 hours, we transplanted these human adipose organoids into immune deficient SCID mice (Jackson Lab #001303) to prevent organoid rejection. Each mouse was subcutaneously injected with 20 organoids mixed with Matrigel (FIG.9F). The mice with CRISPRa treatment showed significantly lower body weight gain compared to control mice transplanted with dCas9-VP64 only treated organoids already three weeks post injection (FIG.9G.H). Furthermore, these mice had smaller white fat pads, including iWAT and pWAT (FIG.9I). When subjecting to GTT and ITT, CRISPRa organoid transplanted mice displayed higher glucose tolerance and insulin response than control mice (FIG.9J-K). Combined, these data demonstrate our ability’ to generate human adipose organoids, manipulate their gene expression, transplant them in mice and utilize them to significantly reduce body weight in mice.REFERENCES1 . Zhang, Y. et al. Positional cloning of the mouse obese gene and its human homologue.Mature 372, 425-432 (1994).2, Shukla, L., Yuan, Y., Shayan, R., Greening, D. W. & Kamezis, T, Fat therapeutics: Tire clinical capacity of adipose-derived stem cells and exosomes for human disease and tissue regeneration. Front. Pharmacol. 11, 158 (2020).3. McCarthy, M. et al . Fat-on-A-chip models for research and discover}-’ in obesity and its metabolic comorbidities. Tissue Eng. Part B Rev. 26, 586-595 (2020).Example 3J0223] To examine whether CRISPRa-mediated upregulation of Ucpl, Ppargcla, and Prdml6 can protect mice against diabetes, we first examined the therapeutic potential of our CRISPRa treatment in mice. We used C57BL / 6J mice, widely used for diet-induced obesity' due to having many loci implicated in regulation of body weight, body fat, and obesity, and being susceptible to diet-induced obesity. We optimized gRMA targeting the promoters of these genes in mice. We designed five gRNAs for Foxol, Ffarl, and Ffar4 in mice using CRISPick, Guides along with dCas9-VP64 were transfected into differentiated 3T3-L1 adipocytes. Foxol, Ffarl , and Ffar4 mRNA expression was measured by qRT-PCR. Several guides significantly- increased the expression levels of these genes in these cells (FIG. 10A). The top two gRbJA for each gene were selected for AAV serotype 9 (AAV9) packaging and used to infect 3T3-L1adipocytes with these viruses along with AAV9 dCas9-VP64 finding gRNAs for all three genes that significantly increased expression compared to dCas9-VP64 only (FIG. 1 OB). Next, mice were tail-vein injected with AAV9-dCas9-VP64 and gRNA-AAV9 viruses targeting Foxol, Ffarl, and Ffar4 individually. Mice were then fed with either chow or high fat diet (HFD). After five weeks, w'e performed glucose tolerance test and insulin tolerance test. For GTT, mice were fasted for 24 hours prior to glucose administration (2g / kg). For ITT, mice were fasted four hours priorto insulin (0.75U / kg). Blood glucose was measured at 30, 60, and 120 minutes after the injections. For mice on chow die t, all AAV-CRISPRa treated mice on ei ther chow diet or HFD showed significantly higher glucose clearance than negative controls (dCas9-VP64 only) at all time points (FIG.10C-E). In addition, these mice showed improved insulin response on either chow diet or HFD. Overall, the results strongly demonstrate our CRTSPRa targeting Foxol, Ffarl, and Ffar4 can improve insulin signaling in mice.Example 4

[0224] It was determined that an AAV9 containing a mammalian cDNA vector expressing UCP1 can express this gene in human adipocytes and suppress MCF7 cancer cell growth. FIG.16A depicts representative images of MCF7 breast cancer cells that were co-cultured withUCP 1 -overexpressing human adipocytes. FIG. 16B depicts qRT-PCR of MKI67, a proliferative marker, and metabolic genes, including GLUT4, GCK, CD36, and CTPlb.Example 5

[0225] We show' using breast organoids from dissected breast tissue of BRCA1 / BRCA2 / RAD51D mutation carriers that our therapeutic approach can suppress proliferation of premalignant cells for this high-risk group of patients, indicating an effective preventative measure for patients that are at high risk for breast cancer.UCPl~CRISPRa adipocytes suppress proliferation in breast tissues at high risk of cancer development

[0226] To examine whether GCPf-CRISPRa mammary adipocytes might prevent cancer development in individuals at high lifetime risk of cancer, we co-cultured them alongside breast organoids from dissected patient-matched breast tissue of BRCA1 IBRCA2 / RAD5 ID mutation carriers. We obtained three samples dissected from individual donors carrying a BRCA1 mutation (ORG158), a BRCA2 mutation (ORG150), and a RAD5ID mutation (ORG164), as shown in Table S4. In all three cases, we observed that breast organoids co-cultured with donor matched t / CP7~CRISPRa adipose organoids were significantly smaller and had lower organoidnumbers compared to the negative control. In addition, we found that BRCA 1 IBRCA2 breast organoids co-cultured with UCP7 -CRISPRa adipose organoids have lower expression levels of MKI67 and MTOR, known proliferation markers compared to controls. Furthermore, these breast organoids exhibited reduced expression levels of CK5, and CK17, suggesting reduced basal-luminal phenotypes in these BRCA1 / BRCA2 / RAD51D-hsterozygous luminal progenitor- predominant breast ceils (Shalabi, S. F. et al. Nat Aging 1, 838-849, (2021); Gray, G. K. et al. Dev Cell 57, 1400-1420 el 407, (2022)). In summary, our results indicate that l7CP7-CRISPRa breast adipocytes inhibits premalignant phenotypes in breast organoids from donors with inherited cancer predisposition syndromes.Table S4. Breast organoids each carrying a gene mutation.Example 6

[0227] We generated CRISPRa tetracycline inducible vectors and showed that they can turn on UCP1 -CRISPRa by tetracyline treatment and suppress cancer growth in an inducible manner.Inducible or cell scaffold AMT systems suppress cancer progression

[0228] To further enhance the translation capabilities of AMI', we developed inducible AAV vectors designed to turn on dCas9-VP64 upon tetracycline treatment, thereby enabling to tightly regulate UCP1 expression in adipocytes or adipose organoids. We cloned the reverse tetracycline -control transactivator (rtTA) downstream of the CMV promoter into the gRNA- AAV vector and the tetracycline response element (TRE) and a minimal promoter upstream of dCas9-VP64 in the dCas9-VP64 AAV vector. Upon tetracycline treatment, rtTA binds to TRE and induces expression of dCas9-VP64. To first test this system, we infected TRE-dCas9- VP64-AAV with or without tire rtTA-t / CP7-gRNA-AAV, followed by the addition of DMSO or doxycycline to human adipocytes. We found that only cells in which both TRE-dCas9- VP64-AAV and rtTA UCP1 -gRNA-AAV were transduced and treated with doxycycline had increased expression levels of dCas9-VP64 and UCP1 . We next generated MCF7 xenograftsin SCID mice and after four weeks implanted inducible UCPZ-CRISPRa. human adipose organoids. Following adipose organoid implantation, mice were fed with doxycycline diet for 3 weeks and tumors were subsequently dissected and examined. We found that tumors coimplanted with the inducible UCP7-CRISPRa human adipose organoids were significantly smaller than ones co-implanted with dCas9-VP64-treated adipose organoids. These tumors also had lower expression of the proliferation marker, MK167, glycolytic genes (GLUT 4 and GCK) and fatty oxidation genes (CD36 and CP Tib).Example 7

[0229] We implanted l7CP7-CRISPRa adipose organoids in cell scaffolds that were generated for these organoids and show that implanting these scaffolds with breast cancer xenograft significantly suppresses tumor growth.

[0230] To further showcase the clinical applicability of AMT, we inserted l7CP / -CRISPRa human adipose organoids into a polymer microwell scaffold, generated from polycaprolactone (PCL), and implanted it alongside tumors, lire microwell scaffold organoid delivery' platform is made from biodegradable polyester polycaprolactone (PCL) and manufactured using a microfabrication process involving photolithograhy and micromolding (Nyitray, C. E., Chavez,M. G. & Desai, T. A. Tissue Eng Part A 20, 1888-1895, (2014); Jeong, G. S. et al. Nat Comrnun 7, 1 1269, (2016); Girgin, M. U. et al. Nat Comrnun 12, 5140, (2021)). We made PCL scaffolds patterned with arrays of cylindrical microwells (Wise, K. D. & Najafi, K. Science (New York,N.Y.) 254, 1335-1342, (1991); Leong, T. G„ Zaratshar, A. M. & Gracias, D. H. Small 6, 792- 806, (2010); Steedman, M. R., Tao, S. L„ Klassen, H. & Desai, T. A. Biomed Microdevices 12, 363-369 (2010); Kharbikar, B. N., Kumar, S, H,, Kr, S. & Srivastava, R. Vol. 9668 256- 272 (SPIE, 2015); Bernards, D. A. et al. ACS Materials Au 3, 255-264, (2023)). The microwells present a controlled three-dimensional (3D) microenvironment that provides a supportive niche for survival, function and enhanced integration of transplanted organoids(Girgin, M. U. et al. Nat Comrnun 12, 5140 (202.1); Kharbikar, B. N., Chendke, G. S. & Desai, T. A. Adv Drug Deliv Rev 174, 87-113, (2021 ); Kharbikar, B. N., Mohindra, P. & Desai, T. A. Cell Stem Cell 29, 692-72.1 (2.022)). Here, we manufactured microwells of 500 pm diameter, specifically designed to accommodate and spatially' organize adipose organoids for transplantation. Using scanning electron microscopy, we found that adipose organoids attached to the microwell scaffold with filopodia and lamellipodia, suggesting that the implant is stable and can be extracted after implantation without leaving residual organoids. We next generated MCF7 xenografts in SCID mice for 4 weeks, loaded UCP7 -CRISPRa and dCas9-VP64 only (negativecontrol) human adipose organoids onto the device and co-impl anted them next to the xenograft. Following three weeks, tumors were collected and examined, finding that tumors co-implanted with the scaffold-containing LOV-CRISPRa human adipose organoids were significantly smaller than tumors co-implanted with the control scaffold adipose organoids containing dCas9-VP64 only. Furthermore, these tumors had lower expression levels of the proliferation marker, MKI67, glycolytic genes (GLUT 4 and GCK) and fatty oxidation genes (CD36 and CPTlb). Combined, these data show that AMT could be used in an inducible manner or delivered via an integrated cell-scaffold delivery' platform that can be readily removed or replaced to fit the changing tumor metabolic kindscape.Example 8

[0231] To highlight the ability to customize this therapeutic approach for different cancer- associated metabolic programs, we upregulated uridine phosphorylase (UPP1) in human adipocyte / adipose organoids and show that they can suppress pancreatic ductal adenocarcinoma (PDA) cell line and xenografts growth. This cancer type is known to utilize undine-derived ribose in glucose-restricted conditions (Nwosu, volume 618, pages 151- 158 (2023). nthis experiment, we are not making ‘brown’ adipocytes / adipose organoids, but. rather making them utilize more uridine.

[0232] UPPl-CRISPRa adipose organoids suppress pancreatic ductal adenocarcinoma

[0233] To examine whether AMT can be utilized to treat other cancer-associated metabolic pathways, we upregulated uridine phosphorylase (UPP1) in human adipocyte / adipose organoids and tested whether they can suppress pancreatic ductal adenocarcinoma (PDA), which is known to utilize uridine-derived ribose in glucose-restricted conditions35. Using CRISPick36, we designed five gRNAs to upregulate UPP1 expression in human adipocytes and found all gRNAs were able to induce UPP1 expression in these cells. We next generated AAV9 vims for the top two gRNAs and transduced human adipocytes with AAV9 and found both gRNAs to significantly induced UPP1 expression. We used the top activating gRNA AAV for all subsequent experiments. We next transduced human adipocytes with UPPl-CRISPRa AAV9 and incubated these cells with 3H-labeled-uridine. We found these adipocytes to significantly uptake uridine during a 12-hour incubation and have increased lactate levels, a byproduct of uridine catabolism. We next co-cultured a PDA cell line, PANC-1, with UPPl- CRISPRa or dCas9-VP64 only (negative control) human adipocytes on top of transwell plates. Cells were cultured in low glucose-containing media with or without excess amount of uridine.We found that PANC-1 cells that were co-cultured with the UPPl-CRISPRa adipocytes had a significantly lower number of ceils compared to the ones co-cultured with dCas9-VP64 adipocytes. This growth suppression was abolished with the addition of uridine, PANC-1 cells that were co-cultured with UPPl-CRISPRa adipocytes had lower ATP levels compared to control PANC-1 cells. In contrast, with an excess amount of uridine, there was no apparent difference in ATP levels between PANC-1 cells with UPPl-CRISPRa adipocytes and control cells. Furthermore, PANC-1 cells that were co-cultured with UPPl-CRISPRa modulated adipocytes had lower lactate and NADH levels than control cells. We next carried out a similar study but growing the cells in a high-glucose-containing media, finding that the growth suppression of PANC-1 growth by UPPl-CRISPRa adipocytes was reduced. Combined, these assays indicate that UPPl-CRISPRa adipocytes have increased uridine utilization and can outcompete PDA for uridine utilization in low glucose conditions.

[0234] We next set out to test whether UPP l-CRISPRa can suppress PDA xenograft growth. We implanted PANC-1 cells in SCID mice for four weeks, followed by the implantation of UPPl-CRISPRa and dCas9-VP64 only (negative control) adipose organoids. After three weeks, tumors w’ere dissected and examined. We found that tumors co-implanted with UPPl- CRISPRa human adipose organoids were significantly smaller than ones co-implanted with dCas9-VP64 adipose organoids. In addition, these tumors had lower expression of MKI67, a proliferation marker. All the byproducts of uridine catabolism, including NADH and lactate were found to be reduced in tumors co-implanted with UPPl-CRISPRa human adipose organoids. In summary', these results suggest that CRISPRa upregulation of UPP1 in adipocytes / adipose organoids reduces uridine in the TME of PDA and leads to cancer growth suppression. Taken together, we demonstrate the clinical versatility and capacity of AMT to target various cancer metabolic pathways.

[0235] Although tire foregoing invention has been described in some detail by way of illustration and example for purposes of clarity' of understanding, one of skill in the art will appreciate that certain changes and modifications may be practiced within the scope of the appended claims. In addition, each reference provided herein is incorporated by reference in its entirety’ to the same extent as if each reference was individually incorporated by reference.Informal Sequence ListingSeq. ID. No Name SequenceSeq. ID. No: 1 UCP1 gRNA-1 CCCGAGGCACCGAGCGAGAATSeq. ID. No: 2 UCP1 gRNA-2 GCAGGGCTCCCGAGGCACCGASeq. ID. No: 3 UCP1 gRNA-3 AGGGCTCCCGAGGCACCGAGCSeq. ID. No: 4 UCP1 gRNA-4 ACC GAGCGAGAA IGGGAATGGSeq. ID. No: 5 UCP1 gRNA-5 GCACCGAGCGAGAATGGGAATSeq. ID. No: 6 PPARGCl a gRNA-1 CACTGAAGCAGAGGGCTGCCTSeq. ID. No: 7 PPARGCla gRNA-3 T I AGAGC AGC AAGC IGCAC AGSeq. ID. No: 8 PPARGCla gRNA-1' GTTAGAGCAGCAAGCTGCACASeq. ID. No: 9 PPARGCla gRNA-4 GGGC FGCCTITGAG TGACGTCSeq. ID. No: 10 PP ARGC 1 a gRNA-5 AGTTAGAGCAGCAAGCTGCACSeq. ID. No: 1 1 PRDM 16 gRNA-1 CGGCGGCGGCGGCGCGACGATSeq. ID. No: 12 PRDM 16 gRNA-2 GGCGGCGCGACGATGAGGATGSeq. ID. No: 13 PRDM16 gRNA-3 GCCGCCGCCGCCGCCTCGGCGSeq. ID. No: 14 PRDM16 gRNA-4 CGCC G( 1CGCCGCCGCC TCGGCSeq. ID, No: 15 PRDM 16 gRNA-5 GGCGGCGGCGGCGGCGCGACGSeq. ID. No: 16 FOXOI gRNA-1 CCGCCGCCTCCCCGTGGAAAASeq. ID. No: 17 FOXOI gRNA-2 ATGGGCATGCGGCACCGCCGCSeq. ID. No: 18 FOXOI gRNA-3 GGGC AGC C AGTGGGC GC C GGGSeq. ID. No: 19 FOXOI gRNA-4 GCACCGCCGCCCGGGCAGCCASeq. ID. No: 20 FOXOI gRNA-5 AGCCCGGCGCCCACTGGCTGCSeq. ID. No: 21 GPR40 gRNA-1 TGGAGAA1TACAATPCACCTGSeq. ID. No: 22 GPR40 gRNA-2 GGTGAATTGTAATTCTCCACASeq. ID. No: 23 GPR40 gRNA-3 GGAGAATTACAATTCACCTGGSeq. ID. No: 24 GPR40 gRNA-4 GC PGGAACCCGCGAGT GATCCSeq. ID. No: 25 GPR40 gRNA-5 CTGGAACCCGCGAGTGATCCCSeq. ID. No: 26 GPR120 gRNA-1 CAGTGCTGGCGCTCCTCAGAASeq. ID. No: 27 GPR120 gRNA-2 ACTGGGTGCAGGGAGCTGCACSeq. ID. No: 28 GPR120 gRN A-3 CCCTTCTGAGGAGCGCCAGCASeq. ID. No: 29 GPR120 gRNA-4 ACTTCCTGGTTCCCGCGCGCCSeq. ID. No: 30 GPR.120 gRNA-5 TGCTGGCGCTCCTCAGAAGGGSeq. ID. No: 31 GLUT4 gRNA-1 CAAACTC TAAACCCCAGGCGGSeq. ID. No: 32 GLUT4 gRNA-2 AGCCAAACTCTAAACCCCAGGSeq. ID. No: 33 GLUT4 gRN A-3 AAACTCTAAACCCCAGGCGGASeq. ID. No: 34 GLUT4 gRNA-4 CCAAACTCTAAACCCCAGGCGSeq. ID. No: 35 GLUT4 gRNA-5 TGGAGTTGGTGGGGCGGGCCASeq. ID. No: 36 GLUT4 gRNA-6 TGGCTGGCGAGACACGCCTCSeq. ID. No: 37 GLUT4 gRNA-7 CCGGGATCCTAGCTGGTGGGSeq. ID. No: 38 GLUT4 gRNA-8 GGTGGGCGGAGTCCTAACACSeq . ID . No : 39 GLUT4 gRN A-9 TITA A GATGCTTCTGCA GCCSeq. ID. No: 40 GLU 14 gRNA-10 CGAC 1GGGAAG 1 1 1 1 GAG AASeq. ID. No: 41 GLUT2 gRNA-1 GGAGTTGGGCTACX'CAGACCTSeq. ID. No: 42 GLUT2 gRNA-2 GAGGAGTTGGGCTACCCAGACSeq. ID. No: 43 GLUT2 gRNA-3 CAGCGGCAGCTGAATATTGATSeq. ID. No: 44 GLUT2 gRNA-4 CTGCCGCTGAGAAGATTAGACSeq. ID. No: 45 GLUT2 gRNA-5 GTCTAATCTTCTCAGCGGCAGSeq. ID. No: 46 GLUT2 gRNA-6 ACCGGGTTCTCACCTGGCGTSeq. ID. No: 47 GLUT2 gRNA-7 GCCCCCACACCATAGGCCGASeq. ID. No: 48 GLUT2 gRNA-8 CCCGCCAGAGCTCCAGAGCASeq. ID. No: 49 GLUT2 gRNA-9 CCGCCCCTACTTTGCTCCAASeq. ID. No: 50 GLUT2 gRNA - 10 TCTCCCTTCCCGTCTTTCCTSeq. ID, No: 51 CHREBP-gRNA-I CACCGGGTTC I CACC I GGCGTSeq. ID. No: 52 CHREBP-gRNA-2 CACCATAGGCCGA FCGGGI GGSeq. ID. No: 53 CHREBP-gRNA-3 AGCATAATCCTTACGCCAGGTHYTPGGIFAPGLPLTPSPMMDKAKPSPSLNIIASLGFNEYFPSRPHPGSLPFSTAPPTFP ALTPGFPGIFPPSLYPRPPLLPPTSLLKSPLNHTQDAKLPSPLGNPALPLVSAVSNSSQG TTAAAGPEEKFESRLEDSCVEKLKTRSSDMSIXJSDFEDVNTTTGTDLDTTTGTGSDL DSDVDSDPDKDKGKGKSAEGQPKFGGGLAPPGAPNSVAEVPVFYSQHSFFPPPDEQL LTATGAAGDSIKA1ASIAEKYFGPGFMGMQEKKLGSLPYHSAFPFQFLPNFPHSLYPF TDRALAHNLLVKAEPKSPRDALKVGGPSAECPFDLTTKPKDVKPILPMPKGPSAPAS GEEQPLDLSIGSRARASQNGGGREPRKNHVYGERKLGAGEGLPQVCPARMPQQPPL HYAKPSPFFMDPIYSRVEKRKVTDPVGALKEKYLRPSPLLFIIPQMSAIETMTEKLESF AAMKADSGSSLQPLPHHPFNFRSPPPTLSDPILRKGKERYTCRYCGKIFPRSANLTRIIL RTHTGEQPYRCKYCDRSFSISSNLQRHVRNIHNKEKPFKCHl^CNRCFGQQTNLDRHI, KKHEHENAPVSQHPGVLl’NHLGTSASSPTSESDNHALLDEKEDSYFSEIRNFIANSEAI NQASl'RTEKRADMQIVDGSAQCPGLASEKQEDVEEEDDDDLEEDDEDSLAGKSQDD TVSPAPEPQAAYEDEEDEEPAASLAVGFDHTRRCAEDHEGGLLALEPMPTFGKGLDL RRAAEEAFEVKDVLNSTLDSEALKHTLCRQAKNQAYAMMLSLSEDTPLHTPSQGSL DAWLKVTGATSESGAFIIPINIILSeq. ID. Mo: 60 FFAR1MDLPPQLSFGLYVAAFALGFPLNVLAIRGATAHARLRLTPSLVYALNLGCS DLLLTVSLPLKAVEALASGAWPLPASLCPVFAVAHFFPLYAGGGFLAALSAGRYLGA AFPLGYQAFRRPCYSWGVCAAIWALVLCHLGLVFGLEAPGGWLDHSNTSLGINTPV NGSPVCLEAWPASAGPARFSLSLLLFFLPLAITAFCWGCLRALARSGLTHRRKLRA AWVAGGALLTLLLCVGPYNASNVASFLYPNLGGSWRKLGLITGAWSVVLNPLVTG YLGRGPGLKTVCAARTQGGKSQKSeq. ID. Mo: 61 FFAR4MSPECARAAGDAPERSLEQAMRTRFPFFSDVKGDHRLVLAAVETTVLVLIF AVSLLGNVCALVLVARRRRRGATACLVLNLFCADLLFISAIPLVLAVRWTEAWLLGP VACHLLFYVMTLSGSVULTLAAVSLERMVCIVHLQRGVRGPGRRARAVLLAL1WG YSAVAALPLCVFFRVVPQRLPGADQEISICTLAVPTIPGEISWDVSFVTLNFLVPGLVIV ISYSKILQITKASRKRLTVSLAYSESHQIRVSQQDFRLFRTLFLLMVSFFim'SPIiniLL rLIQNFKQDLVIWPSLFFWVVAFTFANSALNPILYNMTLCRNEWKKIFCCFWFPEKGA ILTDTS VKRNDLSIISGSeq. ID, No: 62 FOXO1MAEAPQVVEIDPDFEPLPRPRSCTWPLPRPEFSQSNSATSSPAPSGSAAANPD AAAGLPSASAAAVSADFMSNLSLLEESEDFPQAPGSVAAAVAAAAAAAATGGLCGD FQGPEAGCLHPAPPQPPPPGPESQHPPVPPAAAGPLAGQPRKSSSSRRNAWGNLSYA DLITKAIESSAEKRLTLSQIYEWMVKSVPYFKDKGDSNSSAGWKNSIRHNLSLHSKFI RVQNEGTGKSSWWMLNPEGGKSGKSPRRRAASMDNNSKFAKSRSRAAKKKASLQS GQEGAGDSPGSQFSKWPASPGSHSNDDFDNWSTFRPRTSSNASTISGRLSPIMTEQDD LGEGDVHSM\rYPPSAAKMASTI>PSLSEISNPENMENLLDNLNLLSSPTSLTVSTQSSP GTMMQQTPCYSFA PPM TSI.NSPSPNYQKYTYGQ SSMSPLPQMPIQTLQDNKS SYGG MSQYNCAPGLLKELLTSDSPPHNDIM1TVDPGVAQPNSRVLGQMVMMGPNSVMSTY GSQASHNKMMNPSSHTHPGHAQQTSAVNGRPLPHTVSTMPHTSGMNRLTQVKTPV QVPLPHPMQMSALGGYSSVSSCNGYGRMGLLHQEKLPSDLDGMFIERLDCDMESIIR NDLMDGDTLDFNFDNVLPNQSFPHSVKTTTHSWVSGSeq. ID. No: 63 SLC2A1MEPSSKKLTGRLMLAVGGAVLGSLQFGYNTGVINAPQKVIEEFYNQTWVH RYGESILPTTLTTLWSLSVAIFSVGGMIGSFSVGLFVNRFGRRNSMLMMNLLAFVSAV LMGFSKLGKSFEMLILGRFIIGVYCGLTTGFVPMYVGEVSPTALRGALGTLHQLGIW GILIAQVFGLDSIMGNKDLWPLLLSnFIPALLQCIVLPFCPESPRFLLINRNEENRAKSVLKKLRGTADVTHDLQEMKEESRQMMREKKVTILELFRSPAYRQPILIAVVLQLSQQL SGINAVFYYSTSIFEKAGVQQPVYATIGSGIVNTAFTVVSLFVVERAGRRTLHLIGLAG MAGCAILMTIALALLEQLPWISYLSIVAIFGFVAFFEVGPGPIPWFIVAELFSQGPRPA AIAVAGFSNWTSNFIVGMCFQYVEQLCGPYVFIIFTVLLVLFFIFTYFKVPETKGRTFD E1ASGFRQGGASQSDKTPEELFHPLGADSQVSeq. ID. No: 64 SLC2A2MPSGFQQIGSEDGEPPQQRVTGTLYLAVFSAVLGSLQFGYNIGVINAPQKVI EQSYNETWLGRQGPEGPSSIPPGTLn'LWALSVAIFSVGGxMISSFLIGIISQWLGRKRA MLVNNVLAVLGGSLMGLANAAASYEMLILGRFLIGAYSGLTSGLVPMYVGEIAPTH LRGALGTLNQLAIVIGILIAQVLGLESLLGTASLWPLLLGLTVLPALLQLVLLPFCPESP RYLYIIQNLEGPARKSLKRLTGWADVSGVLAELKDEKRKLERERPLSLLQLLGSRTH RQPLIIAWLQLSQQLSGINAVFYYSTSIFETAGVGQPAYATIGAGVVNTVFTLVSVLL VERAGRRTI.HIXGLAGMCGCAILMTVALLLLERVPAMSYVSIVAIFGFVAFFEIGPGP IPWF1VAELFSQGPRPAAMAVAGFSNWTSNFIIGMGFQYVAEAMGPYVFLLFAVLLL GFFIFTFLRVPETRGRTFDQISAAFHRTPSLLEQEVKPSTELEYLGPDENDSeq. ID. No: 65 SLC2A3MGTQKVTPALlFAll'VATIGSFQFGYNTGVINAPEKllKEFINKTLTDKGNAPP SEVLLTSLWSLSVAIFSVGGMIGSFSVGLFVNRFGRRNSMLIVNLLAVTGGCFMGLC KVAKSVEMLILGRLVIGLFCGLCTGFVPMYIGEISPTALRGAFGTLNQLGIVVGILVA QIFGLEFILGSEELWPLLLGFTILPAILQSAALPFCPESPRFLLINRKEEENAKQILQRLW GTQDVSQDIQEMKDESARMSQEKQVTVLELFRVSSYRQPIIISIVLQLSQQLSGINAVF YYSTGIFKDAGVQEPIYATIGAGVVNUFTVVSLFLVERAGRRTLHMIGLGGMAFCST LMl'VSLLLKDNYNGMSFVCIGAILVFVAFFEIGPGPIPWFIVAELFSQGPRPAAMAVA GCSNWTSNFLVGLLFPSAAHYLGAYVFIIFTGFLnFLAFlTFKVPETRGRlTEDHRAF EGQAHGADRSGKDGVMEMNSIEPAKETTTNVSeq. ID. No: 66 SLC2A4MPSGFQQ1GSEDGEPPQQRVTGTLVLAVFSAVLGSLQFGYN1GV1NAPQKVI EQSYNETWLGRQGPEGPSSIPPGTLTTLWALSVAIFSVGGMISSFLIGIISQWLGRKRA ML'V’NNVLAVLGGSLMGLANAAASYEMLILGRFLIGAYSGLTSGLVPMYVGEIAPTH LRGALGTLNQLAIVIGILIAQVLGLESLLGTASLWPLLLGLWLPALLQLVLLPFCPESP RYLYIIQNLEGPARKSLKRLTGWADVSGVLAELKDEKRKLERERPLSLLQLLGSRTH RQPIJIAVVL.QLSQQLSGINAVFYYSTSIFETAGVGQPAYATIGAGVVNTVFTLVSVLL. VEIL-^GRRTLHLLGLAGAICGCAILMI'VALLLLERVPAAISYVSIVAIFGFVAFFEIGPGP IPWFIVAELFSQGPIU’AAAUVAGFSNW'rSNFIIGMGFQYVAEAAIGPYVFLLFAVLLL GFFIFTFLRVPETRGRTFDQISAAFHRTPSLLEQEVKPSTELEYLGPDENDSeq. ID. No: 67 MLXIPLMAGALAGLAAGLQVPRVAPSPDSDSDTDSEDPSLRRSAGGLLRSQVIHSGH FMVSSPHSDSLPRRRDQEGSVGPSDFGPRSIDPTLTRLFECLSLAYSGKLVSPKWKNF KGLKLLCRDKIRLNNAWRA\WIQYVKRRKSPVCGFVTPLQGPEADAHRKPEAVVL EGNYWKRRIEVVMREYHKWRIYYKKRLRKPSREDDLLAPKQAEGRWPPPEQWCKQ LJNSVVPVIA.GdlPEEEPGGRQL.LDi;NCFLSDISDTLF’lAn'QSGPSPL,QLPPEDAYVGN ADMIQPDLl'PLQPSLDDFMDISDFFTNSRLPQPPMPSNFPEPPSFSPVVDSLFSSGTLGP EVPPASSAMTHLSGHSRLQARNSCPGPLDSSAFLSSDFLLPEDPKPRLPPPPVPPPLLH YPPPAKVPGLEPCPPPPFPPMAPPTALLQEEPLFSPRFPFPTVPPAPGVSPLPAPAAFPPT PQSVPSPAPTPFPIELLPLGYSEPAFGPCFSMPRGKPPAPSPRGQKASPPTLAPATASPP TrAGSNNPCLTQLLTAAKPEQALEPPLVSSTLLRSPGSPQETVPEFPC'ITLPPTPAPTPP RPPPGPATLAPSRPLLVPKAERLSPPAPSGSERRLSGDLSSMPGPGH>SVRVSPPQPILS RGRPDSNKTENRRITHISAEQKRRFNIKLGFDTI.BGL.VSTI.SAQPSLKVSKATTLQKTAEYILMLQQERAGLQEEAQQLRDEIEELNAAINLCQQQLPATGVPITHQRFDQMRDM FDDYVRTRTLHNWKFWVFSILIRPLFESFNGMVSTASVHTLRQTSLAWLDQYCSLPA L.RPTVI.NSLRQEGTS’INrETDPGRrPEQATRAVTEGTLGKPLSeq. ID. No: 68 CD36KKWRHKSSAPKRSIPLESCFNINKRADSKNKHLVALYTRDEHFAIAADSEAEQDS\WQALLQLHNRAKGin-IDGAAALGAGGGGGSCSGSSGLGEAGEDLSYGDVPPGPAFKE VWQVILKPKGLGQTKNLIGIYRLCLTSKTISFVKLNSEAAAVVLQLMNIRRCGHSENF FFIEVGRSAVTGPGEFWMQVDDSWAQNMHETILEAMRAMSDEFRPRSKSQSSSNCS NPISVPLRRHHLNNPPPSQVGLTRRSRTES1TATSPASMVGGKPGSFRVRASSDGEGT MSRPASVDGSPVSPSTNRTHAHRHRGSARLHPPLNHSRS1PMPASRCSPSATSPVSLSS SSTSGHGSTSDCLFPRRSSASVSGSPSDGGFISSDEYGSSPCDFRSSFRSVTPDSLGHTP PARGEEELSNYICMGGKGPSTLTAPNGHYILSRGGNGHRCTPGTGLGTSPALAGDEA ASAADLDNRFRKRTHSAGTSPTITHQKTPSQSSVASIEEYTEMMPAYPPGGGSGGRLP GHRHSAFVPTRSYPEEGLEMHPLERRGGHHRPDSSTLHTDDGYMPMSPGVAPVPSG RKGSGDYMPMSPKSVSAPQQIINPIRRHPQRVDPNGYMMMSPSGGCSPDIGGGPSSSS SSSNAVPSGTSYGKLWTNGVGGHHSHVLPHPKPPVESSGGKLLPCTGDYMNMSPVGDSNTSSPSDCYYGPEDPQHKPVLSYYSLPRSFKHTQRPGEPEEGARHQHLRLSTSSGR LLYAATADDSSSSTSSDSLGGGYCGARLEPSLPHPHHQVLQPHLPRKVDTAAQTNSR LARPTRLSLGDPKASTEPRAREQQQQQQPLLHPPEPKSPGEYVNIEFGSDQSGYLSGP VAFHSSPSVRCPSQLQPAPREEETGTEEYMKMDLGPGRRAAWQESTGVEMGRLGPA PPGAASICRPTRAVPSSRGDYMTMQMSCPRQSYVDTSPAAPVSYADMRTGIAAEEVS LPRATMAAASSSSAASASPTGPQGAAELAAHSSLLGGPQGPGGMSAFTRVNLSPNRN QSAKVIRADPQGCRRRHS SETFS STPS ATRVGNTVPFGAGAA VGGGGGS SS SSED VK RHSSASFENVWLRPGELGGAPKEPAKLCGAAGGLENGLNY1DLDLVKDFKQCPQEC TPEPQPPPPPPPHQPLGSGESSSTRRSSEDLSAYASISFQKQPEDRQSeq. ID. No: 73 DGAT1MGDRGSSRRRRTGSRPSSHGGGGPAAAEEEVRDAAAGPDVGAAGDAPAPAPNKDGDAGVGSGHWELRCHRLQDSLFSSDSGFSNYRGILNWCWMLILSNARLFLENLIKYGILVDPIQVVSLFLKDPYSWPAPCLVIAANVFAVAAFQVEKRI.AVGALTEQA GLlXHVANLATIirFPAAVVLLVESITPVGSLLALMAHTILFLKLFSYRDVNSWCRRA RAKAASAGKKASSAAAPHTVSYPDNL / TYRDLYYFLJ'APTLCYELNFPRSPRIRKRFIA., RRILEMLFFTQLQVGLIQQWMVPTIQNSMKI’FKDMDYSRIIERLLKLAVPNHLIWLIF FY^'LFHSCLNAVAELMQFGDREFYRDW^NSESVTYFWQNWNIPVHKWCIRHFYKP MLRRGSSKWMARTGVFLASAFFHEYLVSVPLRMFRLWAFTGMMAQIPLAWFVGRF FQGNYGNAAVWLSLIIGQPIAVLMYVHDYYVLNYEAPAAEASeq. ID. No: 74 DGAT2MKTLIAAYSGVLRGERQAEADRSQRSHGGPALSREGSGRWGTGSSILSALQ DLFSVWLNRSKVEKQLQVISVLQWVLSFLVLGVACSAILNmFC / roCWLIAVLYFT WIAYl.WNTPKKGGRRSQWVRNWAVWRYFRDYFPIQLA'XTHNLL / TTRNYIFGYHPH GIMGLGAFCNFSTEATEVSKKFPGIRPYLATLAGNFRMPVLREYLMSGGICPVSRDTI DYLLSKNGSGNAHIWGGAAESLSSMPGKNAVTLRNRKGFVKLALRHGADLVPIYS FGENEVYKQV1FEEGSWGRWVQKKFQKYIGFAPCIFHGRGLFSSDTWGLVPYSKPIT TVVGEPrr^PKLEHPTQQDIDLYHTMYMEALVKLFDKHKTKFGLPETEVLEVNSeq. ID. No: 75 ACACAMDEPSPLAQPLELNQHSRFIIGSVSEDNSEDEISNLVKLDLLEEKEGSLSPASV GSDTLSDLGISSLQDGLALHIRSSMSGLHLVKQGRDRKKIDSQRDFTVASPAEFV'ERF GGNKVIEKVLIANNGIAAVKCMRSIRRWSYEMFRNERAIRFVVWTPEDLKANAEYI KMADirYVPVPGGPNNNNYAWELILDTAKRIPVQAWAGWGHASENPKLPELLLK NGIAFMGPPSQAMWALGDKIASSIVAQTAGIPTI>PWSGSGLRVDWQENDFSKRILNV PQELYEKGYVKDVDDGLQAAEEVGYPVMIKASEGGGGKGIRKVNNADDFPNLFRQ VQAEV PGSPIFVMRLAKQ SRHLEVQILADQYGNAISLFGRDC SVQRRHQKIIEEAPAT1 ATPAVFEHMEQCAVKLAKMVGYVSAGTVEYLYSQDGSFYFLELNPRLQVEHPCTENWADVNLPAAQLQIAMGIPLYRIKDIRMMYGVSPWGDSPIDFEDSAHVPCPRGHVIA ARITSENPDEGFKPSSGTVQELNFRSNKNVWGYFSVAAAGGLHEFADSQFGHCFSW GENREEAISNMAYALKELSIRGDFRTTVEYLIKLLETESFQAfNRIDTGWI^DRLIAEKV QAERPDTMLGWCGALHVADVSLRNSVSNFLHSLERGQVLPAHTI.LNTVDVELrYEIISLERGQVLPADSLLNLVDVELIYGGVKYILKVARQSLTMFVLIMNGCHIEIDAHRL NDGGLLLSYNGNSYTTYMKEEVDSYRmGNKTCVFEKENDPTVLRSPSAGKLTQYT VEDGGHVEAGSSYAEMEVMKMIMTLNVQERGRVKYIKRPGAVLEAGCVVARLELD DPSKVHPAEPFTGELPAQQTLPILGEKLHQVFHSVLENLTNVMSGFCLPEPVFSIKLKESRETQDKDIWREASSAESVSQVTAKEELLPTAETKASFFNLRSPYNSHMGNNASRPH SANGEVYGLLGSVLTTKKESESeq. ID. No: 78 UCP1 promoterCCAGCTGTGTGACCTTGGGCAAGTGATGAATCTGCTCTGTGTTCAGTTTTCGGCTGGGGCTTTCGGAAACCAGCACGATATCAGAGCCTTGGTGAAAGGT TCTGCCTAGCTGGAGCTCTCCCAGAAGGAAGAGCGGGGCACTCTTCCATT CCTCCAACTCCCCAGACATCTTGCAGGCACCTTGCGGCCTTCTCTGCTTC CCTTTCCTCTCCTTTAAACTTCTCATCCTCCTTCCTCCGGATTCCTTCTCGGAACGCTCACGGCTTACTTTCTTTCCCTGCGGTGAGGAACTCCTGGACC GTGTCGTAGAGGCCGATCCTGAGAGAGGCGGAGCTGATTTGCCGCTGAAG CCCCGCAGGCAGCCCGCTGTAGAGTTTCATCCGCCCTTCTGTTTTTACCA C AGCGG TGA FTGTT CCCAGGAC ACCT FT ATACCT 'AATAAC ACT GGACGTCAGCTTCCCTGAAAAAGGCAATGTTGACCTGACGGGTAGCCTCTGAAAAAA AATAGAAAGGAGAAGGAGCCAGCGAGGTTFCTCCTCTGCAAACACTTGTT GAAATAAAGATCAACTGAGGCAAAIAAGTGGCA TGCAFACAGGCAAAGA T GTIGGGGAAAGCAAGTCGCGIATA FAGAA FGCAT FCTGTTGGCC FGACTGAGGGCTCCAGCCCCGAAGGTGGAGGAAGTTCCTTTCCCTTGCTCTTCACG CCTGTCCGCCGGGCAGCAAACCCGATTTCTGTTTTTTGAACCGACCGCCG GGCAGCGGCGG FGCA GAGGC GGCGGC FGCAGACGG AGC GCGG TGI IGGGG GCCGAG TCCCCGCG FCCCC I CC TACCC ACCCT CGCGCCAGCAGGACCCT CCTTTTATTTTCAACAGTGTAAAATGTGGTTCCAGAGCTAGCCCAGGTCTG AAATCTCCCTGCTAACTTACCTATAATGATGTAATATGTGTTGGTTGTGT GGCCTTTCCTAGTTCGATCTITGTGCAAA1TITATTTTCAATGTTTATTC TTGTGAAAACTTAAGAAAACAAAAAACTTTTAAAAAAAACAGTGGGAAATCCCCGAAGAATCAAAGAAAGGAAAAAGCACCTGACTAGTAAACTCAGGAG AGGCCAATATTCTCAGCTCTTAAAATACTAAGTGCACCCTAAATTTTGGG AG A ATI FGGI AGT AG TCA I GGT CAACCCATTCT C I GTGGCCCTGG TGG FI CTTCAGCTAATCCCAGAAAAAGTTCCAGTTTCCCATCCTAAAGCACCAGCAGGGGGGTGATTTTAGGGGTAAGAAGATTAAACCAATTTTTAAAGTCTTA GAATTATTTGGAGAGAATACTGTTGATATCCAGATAGAGAGCTTAGGAAG CTGC A FI FA A CAT GC FAAA AGAGG A AG A AATAGAGGAGG I AT TTGG FAG T C A FGA I ATGGA TGCA A FGA AAGGGGCATGC I T I TCA CGGGAAAATGGGGCGCTTCAGTGAAGTAACGCTTTAAAAAAAAAAAAAAAGAAAGAAAAAGAAA AGAAAGAAAGAAAGGAAACACTTAGACTTTTGGAGGCTTCAAGCATCATG CTGTGATTAAAGCCAGCTTTGAATGCCACAGACTCTAAACGGAGCCCTGG CCATATAATAACCAAAATCCCCTGCAATCT1TITITAATTTATTTTCCTTCCCTCAATAGGGAGACCTAAAAAGATAATTGTTTGTGGACTTAGAAGTCCTCAACATCTTTATTTGAGAATTAAGAAACATCAGTCCAAAATATTTGAAATATAGAATTAGTTCTCCAGGATGTTCTTGTAATTCTTTTGTTTCTTTTTTGTTTATTTGCTTAATATTAGGTCATATCCCTAGCTCTTTTTTTGAGATCCGCAATTCATTTTATAAAACCCACAATAAAATTTTTCATTACTCAAAGAAT AGGCACATAATTATAGGGACAAATTAACCTTGTTAGATGTGAAGTCTGGG ATAGGGAATGGTGGAGGAACAATTTGGCTCTCTGCTTTAACAATGTGGTC TTTAATGTTCAGCTTTTTATCTGCTTTGTGTGTTGATTCCATCCAGAGGTTACACATATATACATATACATGAATATACAGTCTTGTATTGTTTTCGAATTGCTAAGAACTAAAAACATATGCATATACTTGTATATTTGTATACACAGCCTTGCATGGTTTCCTAA1TGTTTTACATTTGTTCATTTTGCCTCCCAAACTAGATTTAAAGTCCTrrAGGACACAGGCCTTCTTTTGTGCTTTGTATATAGTTTAAAATGACCTAATGAGAGACTAAATTAAATGAACTTCTGTTTTAGAGTGCTGAAAATAATTTTATTAGCATAGAATATGATACAGGGAGACAAAAA GGGTGGCAT GGCATArAT FA AGCACCT AC A FGT AGAT AATT AAC TAGA TG CTGAACCAAGTCTCCTGAAGGTATAA ATGCAAAGTACCTCTCACAAATACATCCAAAAGCTACCTCCAAACACATGGTAAATACCAAGCTCCACGAAGCT TTCTCTGATTCTTCCAGTTAGAAATCAACTAGATATTTTTGGACCTCTTT GTACAAAATCCTTGATACCTGTTTGATAGTTACTGCTTCCAAAGTTTTAA ACTGTCTTATAGTTAACCATAATACAAACTTGATTTTACCTTGGAAATTTGTTAAGGAGCAGACAATAAATTAGCTTAACTGCACTGATGATAATGAATC ATTATAATTAAGTATAATTCTCCATTAACCTTTTGGAGGTTTTTGTGCCA I ' EGA I GGT AAAT FT TA A AG AGAG A GAG AGAAG A AGGAGTGGAC FI GGCC A CATTAATTATATTAATGAAAAA AGAAACTGGGTTCTI A.AAAAAATTAGTTGGCCTCGCGAGGGACCGAGGGCGGCGGGTCCGAGTGCCGCCCGCCGGCCT GGGCAGTGGCGGAGCGCGGAGCTGGCGGCGCCTCCGCTGTTGTTTTTGAG CCGCGAAGCCCGAAGCAGCAGCCGTTGGGTGGGGGCGAAGGGGAGGAGGC GGG GGCCGGGAGGCGC G AGGGGGGCGG FGGGGCCCGGAGGGGG C IT C GG ATTCCCGGCCCCTGGGTGAGGCGCCCCCTTCCCGCCGCGCTCCGCTGCCGG GTGCCCTCGGCCTCGGCCTCCCGTGACCTCTGACCCCTCTTGGTGCGAAC AAGACCGGGCG IT FCGCCGCCGACGCGAAGGGGCTG TCTG TGCGCGGCGT FGCGGGCCCTCCGCGCGTGGGGTG FGCGTGTGCGI GT FCGGGTTCGGTTCCAGCCCGGACTCGCGTCCGAACTATCGGCGCGTGTGCCCCGAGATCCAAG GAAGTCGTGTGGAAAACCGCAGCCGCCGCCCCATCTTCGGCCCCGGCTGG GGCGGGAGCAGCAGCGCGACGCGCCGCGACGC AGGGGCAGGGTGGGGGGA TAGTCACCTCGCCTCCGGGGCCACCTGGGTCCTTTTAAAGTGTCCGGGGTAGGAGGGTGACCCTGCACCCTGGGAGGGAGGCGGGAGGAAAAGCTCTGTC CCGCCTGCCCTCTTTGTGCCAGGCCCATGCCAGGCACCCTGATACATGCT CTGCCT C A FT CCCACTCGGCAAC AAGCC TCTGGG FAAGGGCCAG FCTCCA GAAGTGGACCTGCTCCTTCAAGTCAGCAGCACACATGCCCAGTCCGTTCTCAATCCACTTTGTCCCTGGTTTGATTCTTGTGAGCACCATTAACTTTTCT GGAGGAAGGTGAGGCTTTAAGAACTGTTTAAAGCCCAGGCG Seq. ID. No: 84 FFAR4 promoter 1AGGAGGTTAAT GT I GGAGAAGGCC TTTTAGTGC AAAGAGCCC ACCCTGGTrCTGCGCGGACCTGCTCTTCATCAGCGCTATCCCTCTGGTGCTGGCCGT GCGCTGGACTGAGGCCTGGCTGCTGGGCCCCGTTGCCTGCCACCTGCTCT I C TA CGI GA TGACCCTGAGCGGCAGCGTCACCATCCTCACGC TGGCCGCG GTCAGCCTGGAGCGCATGGTGTGCATCGTGCACCTGCAGCGCGGCGTGCGAAATACAAAAAATTAGCCAGGCATGGTGGCACGCGCCTATAATCCCAGCT ACTCAGGAGGCTGAGGCAGGAGAATCACTTGAACCTGAGAGGCGGAGGTT GAAG FGAGC CAAGA' FI GC AC C A TTGC A TTCCA GCCT GGG CC AC AG AG CG A GACTGTCTCAAAAAAAAAAAAAGAAAAAGAAAAAAAGAAAAAAGAAAGTTTGTGTCAGATGCTAAAAAAAGTCACAAACTTACACTTCTTAAGCCCTTAC TACACTAAAGGTGTGACATTTAGTATATTATCTT'ACACAAGCCAATGAAG GAAGTATTTTATTTATTTLATTTATTTTTATTTTTTTGAGACGGAGTCTTG CTCTGTCACCCAGGCTGAAGTGCAGTAGCACAATCTCAGCTCACTGCAACGGGCTGGAGGTGGCCGAGTTGGACTGGCTAAACTCCGGCCTGGGCAGCGG CCAGGTGCACGAGCGCGGCCGGGGCAGCGGCTCGAAGTCCGGGTCGATCT CCACCACCTGAGGCGCCTCGGCCATGGTGACCCCCGCCCCTCCCCCAGCC GC AGG A GAGCC A AG AGGGGGAG A AC GC AGC AC TGGGGGC GG ACGGGGAGGTSeq. ID. No: 87 FOXO1 promoter 2CCGTCCCCGGCCGGTCGCGCCCTGCCTGTCCCCTCCACCTGCAGCCCGG TCCCGGGGCAGCGAGGCTCCGGGGCCCCTCGCCGCGCCCTCCCCCGCCGCGGAACAGGGGCTCCGGCGCGGGGAGGAGATTATCTGGCCTCCCTGAACAC ACGAATCCAAAGGCACCCGCGACCGCATGCCCTCCGTGGGAACCTCTTCC CCTGGGCGGGAATCTCCCGCTCCGTCCACTAAGTCCAGGGCCGGCAGCGA AGGGCTCAGGAGCGCAGTTAGAGAGAACCAGGTCATTTTATTACTTATCCGTTGAAAAGAAATCGCTCTGCGGACGCTACAAAGATGCCCTGCAGGACAA GCCCACTTACACAGAAAAAAAGAAATCCTATCTAGGGAGTTGTTGGTCCC CAGAGTCCCCATCCCTCATTCCCCAACCCCGTGGCGTGCGCGCTTCCCGC TAGACTTCAGCCTGGGGCTCTTTCCTGGCCCCCAGATCCCCCGCCCCTCCTGGTATTGTTGGTTTATTTATTTAGTCTGTTAGTAAATAAATAAATGCTG GTCTCAAACTCCTGGGCTCAAGTGATCCTCCCACCTTAGCCTCCGTAGTA GCTGGGAGTGCAGGCATGTGCCAC TGCACTGGTAGTGGFAT FGCTA FCAT CTGACTTCACCTTATTTCCTCTAGACCAGTGCCTTACTTGAGACACAGTGTGGTTATGCACAATTACTTGAAAAAACTTATGCAGACTAGTCAGTTAACA GAGCAAAAATCCTTAAAACCCCAATTACTGAATAAGAAACAGTTCTTCAA I ' FGGCAA AG FAA AGAGA AT ' FAA FT TTGA' FCTG FGG T AGC TACACCCA A CC TCCCCCAA ATCCTCTGTA TGACTTG A CTGTA TTCCCCTA A CTATCTCCTGAGAGAAAAAGACAGTCTCGGGTAGGATTACTAAGAATTGACCATTCTGGA AACAAATACAGTGCAGTCTGATCTGTACCCCAGACTCCACGGAAGCCCAC TGG TGG FGGIGGAGGGGGTGG T AG ITT GTG FCT T CACTGCTGGGTGGC FC TTTGAGTCTCTTATCTCTCAGGACCATGTAACCTACTGGATCTACTCACTGAGTACACAATCTTAAAGGGGAGGGAAAGACAGCCTGAGAGAAGAAAATC AGGGAAATAATTTTGCCAGTGTTCCTTTCTTCGCATAATCTCACCTGGAGCGAGAAATAGTGGGTTGAGATTCCAAGTGCAATCCACTGCGGCTCCTCGC TCGCCCTCCAGGTGGCAGCACAACCCTGCGCTTCCGAAGCCCGTTTTCTG AGCCAGACACTCTCCACGCTCTGGGTATTTCGGCTTCTCTCTCCCCACAC GCCGACCCT AGGTCGCGCACT FI C T GCC TGGCAGAA'FTTGGCCGAGGATCCTGGGCCCGGGCCCCTAGCGGAAGGAAAAAAATCATGGTTCCATGTGACA TGCTGTGTCTTTGTGTCTGCCTGTTCAGGATGGGGAACCCCCTCAGCAGC GAGTGACTGGGACCCTGGTCCTTGCTGTGTTCTCTGCGGTGCTTGGCTCC C TGCAGT TTGGGT AC A AC A ITGGGGTC ATCAATGCCCC TCAGAAGGTGAGAGCCGCCCGCGCTGCGCCGGAGACTCGGGTCCTCCGAGTCTGTGTCCGAG TCCGAGTCTGGGCTGGGCGCGACCCGCGGGACCTGCAAGCCCGCGGCCAG ACCTGCCAGCGCGCCGGCCATGGCTGTCGCCGCCGCAACCGCCTGGTCCC TGCTCCGCGCAGCGCGGGGAACAGCTCTTGGCCAGCCGGGCCTCATTAACGCTAAGCTACTCAGGAACTGTTGTCTATGGGATTGAACACTTAACAGCTG TCTCTGGGAATGTAAATTTGATTCTTTGGACTGCTCATGGGACTCTGTGA CATTTTCCTCTCCAGTGACAGCAGATTTGAATGGCATTAGGCTACTGATT AAATAATACCCAAGTAAGTTTAATGTCAACTTAGGCATCTATTTTGCATGACTGGGAATAGCAAAGTATATTACTTTTAAATAATCTGAAATTTAATTAG TGTAAATTAGTAGAATAAAAATAAAGTTAATTTTTTTTCGATTCAGGAAG CTTATGACAAATAGTACTGAATTLATTAGATGATGATGCCAAGTTGAAGTA AAGGAGAAATCAATTTGGAGGAATTAAGTAAAAGCCTCAAATTAATTATACTTCTTTTGTGGATAGTGGTTACTACTTGATACAGAATAGTTTCATTTAAAGAGTGGTAACTCTAGTCTATCATTTCCCTTTAATGTGATTCTGTAAAAGAAATTTTAATTGAAAATATTTAACTATCAGGAGAGAAATATGACTTTTCCAGTTTCTCTGTTCA CTTCGTTTTAGTATA GA ATTAGAG A TTCTTA A CA TAAATGATTGAAAAAGACTGCTTAAGGTTGTAGAGTGGGATGATTAAATGGA AGGAAATGTTTCAGAGCAAAGAAATATAAAGTTCTTGATGTGACTGCGGC TCATTTTGCTTTTGGCACAAATTACTGATTAAGATGACTACTTAAGGAAT TTAATCTGATATTCTTAGTATTTACAAACAAAGCTTCAGGTTAAATTGTTGCGTGGGGCCAGCCACTCTGGCCCGTGTCCCCACGTCCTTCAGGCCTAGC CACCCCCGCCCCGCCCTCACCAGGAACCTGACACCTACTCCCAAATCGGG GICGGGGAAAAACGTGGGGCGAGAACCAGAACCCACCCACCTTCCGCGG T GGGAATTGCAGGGCGCGGC TGGGI T T CTGIGCGGTGAAGGT FGCTCAAAGTCAGTGCAAGCTCCGCCTCCTGGGTTCACGCCATCCTCCTGCCTCAGCCT CCCAAGCAGCTAGGACTACGGGCGCCCGCCACCATGCCTGGCTAGTTTTT GTATTTTGTTTAGTAGAGACACTGTTTCACCGTGTTAGCCAGGATGGTCT CGATCTTCTGACCTCGTGATCCACCTGCCTCGGCCTCCCAAGGTGCTGGGGTGAAAACCAAAGAATGCTGCCCAGACCCCGCCAAGGGATCTGGGACCTC CCAGTTTCCCTCAGGGGGCTTATTCTCTAGATCACTCCGTCTCTCTCCAG AGGGFTC TC TAGCCT FCTGACAAGC TAGCCCATG FGAAGGTTTCTG FGGG AGACAGCTGCACTCTCTTGGATAAGTAGACTTCAGAAGCACCCAGTGCACCCCATGGCGAATCTCCCTAAGCCCCCTGTCGCAACCGAAGCCGATGGAAT CAACAAGACAAAGATGCTCCTGACCCACTGGCTAGAATCGTGAAGAAAAC GCTAATCCATGTCAAATGCACATAAGGAAATTTTTCCATGCAGAGACCAG ACAGGGGAAAAGGGGAAGGGAGAAGGAGAAAATACAGGGTTCGACCCGGGTTGTTGAGAGCCTGGCTGCACGAGGTGGAGGTGTCTGAACCACAGGATGG CTTGGGAGGCTGGGGAAGGAGGGAACATGCAGGCAGATTCTCAGAAAAGC CGCAAACTCTACTTACCTAAAGGCTTGAGCAAGTTGACGAATGCCCCAGA CC ACCA I G T ACCCA CTG TA A A A TGGG T G A A AC AGGC A TTG FI G FGCACATCCCCGCTAATTGGGAGGCCGAGGTGGGAGGATCACTTGAGCCAGGGAGGT CAAGGCTGCAGTGAGCCGTAACTATGCCACTGCACACCAGCCTGGGCCAC AGAGTGAGACCCCATCTCAAAAAAATAAAACAATAAAAATAATAAATATT GGTAGAGATGGGGGT C FCC FI FI G FT GC C CAGGC FGGT C FCAA A CTCCT GTCTTGGACATGCCGACTCTCTTTGGCTCTGCCAGTGTCGGTTCTTGCCTG GCCCCAGAAAACAGTGAACTCCCCTCTGCTTGGCCATGATCTACTTGGCC AGACACCTAAAGCAAGGGCTTAAGCCATGGAGCTGCATTTCCAGCCACAC ACCCT GTAGGAGATGAAAAT GCACGTA T GGA A TTAGTGGA T GCCC AG FT GCCTTTTCCTGGCTGAAAAACAGTCCATTACTGGTGTATGAATAGACCACA TTTTGTTTATCC ACTCATCAGCTG ACGGG CA CTTGG GTTGTTTCC ACCTT TTOACTATGTGAATAACGCCACTATGAACATTTGTGTACAGGTTTTTGTG TG A ACCA GTCTTC AGTCCTCTTTAGTATA TATTT AGGTA TGG A A TTGCTGATGTCGCCTCTCCGGCTCCTGCCAGCACCCGCGCCCCAGTCCTGCCGAGC CATTCAGACTTGGTTTAAAGTGTCCTTTCAGCATACTTTAAAGCAAAAAA GAG AG A GAGAGAGA GAGAGAGA GAGAGAGA GAGAGAGA GAGAGAGA GAGA GAGAGAGAAGGA AGGAAGGA AAACAAGCATCCCCC T G T ICC FCTGA FI FITCAAGGAATTTTTCTGATTATCACTCAATACTTTCTTGGCAACCAGAAGA CACCTCCATCCAGGAGAGGGGACATGGTCTCATGCAACCCCTCCAGGTAG CTCACTGCACACCACTCCTCTGGTCCCACTCAGCAGTGCCCATAGCTTTG GAACTGAAAATC AGGGC FCGCTGCCT AAAA A AGGGG T ITT G TCT C IGA A ASeq. ID. No: 99 GSK3B promoter 1GCCAGAACATTTAACAGGTAATGAATGCAGTAGCACTCCAAAATTGAAC TTAAATGTAATGAGCCAGTGACAACATTTAACTTAGTATTTGGCACTATGAGCCCTTACGAAGAGGCTTGAAGAGTTGAGGACGGTGAAACCCAGAGACGC TGGTGAAACTGCACGGCTGGGCGCCGCCGCCGCTTTGTGATTGGCTGGAA AACT CCGCTGGGAGCGT ACC FCC TT CGG TGATTGG TGAAGAGAAGGGGGC IT CCGAGGACAGTCT GGCCAG TCAGGAC TTCCCCTCCC TCTCCA AGG FGGGTGGAAACACTCGAGCACTTGATGAAACTGACTACCAACAGCAAGAAAAG TACAAGAAAGCAGTTTGAAATCGAATCATCCAAATAAATATCATATTATC I CAA'FT C AAGGTTAAT GAGACCGGGGGAGGGGGT ATGGGAGGAGT AA AAA GGGAGCTGCTTCATCCTTGACTGAAGATAGGTTITGCCCTTTTCCATTGCCCAGCCGGCTGCAAGCTCTCAGACGCTAAAATGGGAACAAAGCTTCCAGA AAGGCAGCGCCTTTGGGCGGCCGCGCCCCGCCCAGCCGCGGGGGCCATTG AT ACAGAGGCT FGCTGCGC TTGG FGTGCGCGGCCCGGCCGGGCCT C FGGA AACGCCCATGAGAAA FGAGC I CATGCTGGATGCGCGCGC I CC TTGGGCGCCTGCTAACTTTCATGCTGCCAAAAGCTGAAGGCTGCTGCACCGGCTTGCA GCTCTCCGCAAAGGAGGTGGTTCTGGGCCGCCCTGACATGATCACTCTCT TCGCGAATCACCTTITCCTTCCTTCCTCCTTITCTTCCTTTTGTCTTTAT GTT'GGGGT'GTTAGGTTAACGATAAATGCAGCATTAAGTTCTCCCACAGAASeq. ID. No: 102 IRS1 promoter 1GTGATGCTCTCAGTGCGTGATCGGCGGGTCAGCCCCACCTGGCTGGGCG GGGGATTGI TGAGATGGFGCCGGCGCAGGGGGACGC TGATGGGGT FAGAGCTACCTATCAGGTAAGACTGACCCACGGGAGGGAGGTTTCTAGTCAAGGCT GTTTCCCCCAGGAAATTTAAAAGCTAGATTTCGGCTTCAGGGCGATAGGC CATGGTGAGGGGATCTGTATTTTTTAAGGTTTTTCTAAAGGACTTCTGGG C C AGC CT FCC A CC FTGGG A I CCCC AG A I FT GC FGCCG FG AGGT AC CT GG AGCTCTTGCTGCGAGGGCGGAACTCATCACTCATGGCCCGCATGGCCTCCA GGATGGTCTCGTGCATGTTCTGGGCCACCACAGAGTCATCCACCTGCATC CAGAAC ICCCCGGGCCCCGTCACGGCAGAACGGCCCACC TCGATGAAGAA GAAGT FI FCCGAGTGGCCACAGCGCCTGA TGITCArCAGC TGCAGCACCACCAAGGGCAGTGACTGGGGGCAGTTATGGTCACTACAAAAGGAGAACAGG GATCCCCAGGAAGTGTCTCACGTCCGGCGCTGTGGAATTAGTTGCTGATC AAGTAGGGAGAAAATGTAAATATCACCTTTTCTCCTGCTCCCCTTGCCCA TCCGTG FGACGGGGGGAC TCACACC TAAGGC FGAGGGCATGGGGGAGGGGCCGCTGCCCACGCCGGCGTCTCCGTCCTTGTTGGGGGCCGGGGCTGGCGC GTCCCCCGCGGCTCCCACGTCGGGGCCCGCAGCGGCGTCCCGCACCTCCT CT TCC GC CGCCGC A GGCCCG CC GC CGCCGT GG C FCGAGGGC CGCG ACCCT GTCCTCCGGCGCCGGGAGCTGCCGCGGTCGCCCATGGCCTC AGCCCGCACSeq. ID. No: 105 DGAT2 promoter 1ACGAGCCACAGACTGACXTGGGATCTTCCAGGCCAGCAGGAGTCTTGCC TCCAAGAGCACCCTCTCTGAGGAGAGGATGCCAGGATTTACTGGCACCTTCTCTGGAAAGGGCCCTGTGGCAGGCTGGTGGGTACTGATGAGTCCACGTTCATTCTCCACTGTGGCACTCATCAATTFFFACGACCTCTGTTACATCGCTTI CCACCCGCCCCCCAGCTTGT FTCCCTCA T CCG FGAGG FGGGAGCGG TACCACCCACCATTCTTAGTTATTAGGGATATTCGAGAACTCCTCCCCAGCCCGCCCTGCCCCAAACATGCTGGCTTTTCTAACACTTTATGCCTATCTTTCT GCTTTGCCCTCACACCTTCCATCTGCAAAATTCCTATTCATTAATGGGCA AACCATTCTGGAATGCTTTCTATGTGCCAGACACTACCTAGGCTCTTTTT ATACCTTATCTCATTTACTTCTCAAAGTACCTCACAAAAATAATAATTATCAATAACCCACCCTGCAGCTGTACCACACTTTAACTGTGACCTAGGCATT GGCATTGCTTCTTGTGTGATTATCGCTGTGGTTATCTGCCCCTCTTGGTG TGGGTGCrGCTCGTAGCzCCTTGAAGAGGAACCCAGCTGC FGCCC FGTC FC GGGGGCGAGCAGCTTGAGCTGCCCCATGTATCCAGCCAGTAGCCTCTGACCATGTCTCTAGGGAGGGGACCTCAAGGCCTCAGAGCTGCGGGAAGGGCTG GGCTGCCCCGCACCCGATCTGGATAGTGTGGAGCCCAGGCCGCGTGCGGG TGAGCGGAGGC T GGGAGGCGGCCCCC FGCCTGCCGCCGCCCC I CCC I TGG CCCCAGTTTCTCCAGGTCCCCGGTCACAGGTTCTGGGCCGGCCCTCACCTTGATCCTTTTACAGCAAAGCTACTCCTTTGCTCTCAACCCTTCGTCATATTCTGTCACTTCCCAATAAAATCCAAACCTTACCAGATGATACATGATCTG CCTTGATTTCCATCTAATTTCTCTCATTTGCTGTGCTCCAGCCACACTGG TCTTGCCCTTTCTCCATGCCAAACAAATCCCCATTTCAGGGTCACTGCACGGCCGGTCCCACCCCGTAAGGATTTGAACGTTGGCTCCACAACTCGGGAG CCTGCGCCTTTCCTCCTCCCAACGTGGACTCCTGCCCGGCGAAGTGCCTC ACTTCCTTCTCCCGGTAACTGATTCGAATTTGGCGATTGTTAGTTTGGAG CTAGCGCCAGTGTTTCCACGGAAGTTGGTGTCAGAATGTGGTCTCTTGTGCAATGATGTAGGTACCATCCTTATCCCCATTTTGCAGATGAGGAGACTGA TGATCAGGGAGGGCATTTAACTTGCCCAAGGCTTCCCCAGCTTGTAAGTG GCA GA AC CGACA T GTGAACC CAGG FCAG T T T CC AGGGGACCAA ACA AGG f GC C CGG FG ACA GT ' FGAC T IT GGCCGC C A A' FCAT GC C T C AATA FAGCGG A ACCGCAAAGAAAAGGGAAAGGCTGTGAGGTTTTTCATGTAGGTAACCCTGG CAAGGAAGGTTTGGGGGATTAGATCCAACAGAATAACAGATTGTAAAGGA TTIGCAGAGTGAGAGAAGGGC FGAAC TGGGGAGAAGAGCTGGCCAC I GCA TTCGTCAGAGCCTCCGCTGTACAACTTGCAGCTTTACCTGCCATCCCTCTACTGCTTACGACAACATGGACTTTAGATGCCTCATGGCTTCAACAGCTAAGAATTATGAAATAAAGCGAGTTATGGGATrAAAAGGCAGATAGCAGAACTCTCCCAGGAGTAGCCAGGGCTGCACAAGTGGTTTGACGTGGGATCTTTCTCATCTTTGCCCCGGGTTOTTGCTGCTTTGAAGGTTAAGTGCTCCAGGGATACTCCGAGACATCTGGAACTCGGAAGTGAGGCCAGGGCTCCAGGAAGACT CCCTGATGACGCACTGGCCCGCAGCCCAGGCTCAGGTAGTGGGGGCTGTC AGGATGATCTGTGGGATCCCCCAGTGTCCGAAGAAAGAAGCCACAATTGT GTTTTTTTTTCTTTCTTTCT^^^GGAGATGGCCTCCTTGTTTAGAGTCCTTCTGACACTGTAATTTGGGTCTG ACAACAGGAAGTTCCTTTGTAGTTTAAGTCAATGGGAACCAATTTTTTTT TCTTTTTTTTGCGATAGAGTCTCACTCTGTTTCTTAAGATGGAGTACAGT GAC TCAGTCATGGCTCAC FGCAGCC TCAACT FCCTGGG FT CAGG TGA FCCAGACTTTCAGTGACAGATGTTGGGGTGTTTTTGCTTAGAAAGGTCCCCTT GTCTCAGCCTTGCAGGGCAGGCATGCCAGTCTCTGCCAGTTCCACTGCCCCCTTGATCTTTGAAGGAGTCCTCAGGCCCCTCGCAGCATAAGGATGTTTT GCAACTTTCCAGAATCTGGCCCAGAAATTAGGGCTCAATTTCCTGATTGTAGCGGTTGGCAAACTTTCTGTGAAGGGTCAGGTGGTAAATATTTGAGGGT TTGCAGTTACCCGTTCTCCGTGGGAACTGCTCAACAACTCACTGCAGAGA AAGCAGC CG T GGGCA AA ACG TA CAGGA ACGGGCGAGGCTG FGT ' FCCAATA AA \( i 'F i A F L\ F I F AC i (,:AAA i 'FACT AT I'H XA FAKiA i 'iT 'K'A SCATGATTATTTGGAATCACTGGGAAAGAATTTTTTTTTCATGAAGTTAGA AGCCTAAGAATTTTTTTCAATGGAATTTTATAAAAATGTCCTTGAATCAC AGATGGCTCTCCCTGGAAACATAGGTTTGTTTGAGAGTCACCTCTTTTAT TGT C FT AATAAATAGAC T AAGAGCCATCACAAGGGCTAC TGTGGC FA G AGACCAGAAACAAACTCCAACTCAGTTCCACCAACTGGGTTTTTAAAAATCC TTGTGCCTAAGAACGTCTnTTTCCCCAAAGTAAAATGTGCCATTAAAAA ATATTTTTAAAACGCAAAAGTGCTTATCATTCCGTACTTCTTTTACTACC TI C AGC AGCC AA'FT A' FT GACGTGA FAAAAGG TAGAAAC TCCTGGAATGC IGTCAGGTTTCTTTTTGACTTGAGCATCTAGCATTTAGTAATTCGCCATGA AAAAAATTACCAGGGGAAGCGAGTGTTGTTGCTGAAATTGTTTTTGCTTG ACACAAAAAAGC TAAAGTACAGCT TAGTCz TCACCCGAAATFCTGAAACGG CATGCCCGTGTTAAAACACTTATTACATAAGACAAATGAGCCGATGAGGCAACACGCGCTCTCTGGGCCCCCTTTCACCCACCCACCCCCAATTTCTATC TCCTTGTAATCTGTGTGTCCTGCTTTAATGTTGGGGGGCACGGGCGCGAA CTCT GGGT C AC TT T GACCCCACGCCCAGCACGTAGTAGGCGCCCAGCACT CG FGTGGAGCGACTC I GGGAGGAAAA CTAGGAAGGAGACC I GAGGAGCGCSeq. ID. No: 115 UPP1MAATGANAEKAESHNDCPVRLLNPNIAKMKEDILYHFNLTTSRHNFPALFGDVKFV CVGGSPSRMKAFIRCVGAELGLDCPGRDYPNICAGTDRYAMYKVGPVLSVSHGMGI PSISIXn .Di'i JKi .i.VYARCSXV'HIRKj'i'St’iCiGAGGATGGCGCCGCGGGTGTAGCGGCTCTCTGCGCAGGCCGAGTGGTGAG TCGCCCGCGGCCCGGCTCCCGCCGTTCTCTCTTCCCAGGGGTCTAGCCCG I CCCCTGCCT ' FGGCCA CGT GC CCAT ' FI ACC TGI AGGGGCGG T GACGGAGG C TCTGGTGCACC FIGGC TGTGAGCTGCAGAGGAGCAGAGAGCGGCCCGGC GCGGCTGCGCGGGGAGGCGGGCGCGCGGCCGGGAGGT I’CTGGGGCTGG I G TGTGCGGAGCGAGGTGGGCGTGGGGGAAGCGCGCGGGCGGGATGTGCTTC CTCGGGTCCACCCCGTGCCTACCTCTCCCACGTCCCGGCGACGGAGCGCG CGGGGCTCTGGGCGGGGAGCCCACCGGGCCGAGGCGCAGCGAGGGTGAAG CCAGAGCCGGCAGGGTCAGGTCCCGCAGGGCGCAGGCGGGCGCTTCTCGC AGCCCAAACCCGGGCGGGGAGTGCGGGAACCCCTAGAACTATGCTGGGAG AAGAGGAAGGAGA FGGT GACTT AAGTGAC GAAGT GATGTTTTCGCCrnTAAAGGGAGAAGGGGGTAAAA'riTCATITGGAGGA TGATTGTTACGCGAGCTTTCAGAGTTCAGATGGCGTCAAGTGGCCATCGA GTCAACATTTAACAAAATGTTACCGCATAAAATATTGTCATCGAGTTATC TGGCAGCTCCGCAGAGAAACTTCACAGGCATATGCGTTATATGACATAAT ' FI GCA' FGGGGAAGGGGG FCC C TTCACGA TTCT FI FA TATGGC AACC TGT F CT TGGACCTGGC AGGGSEQ ID NO: 117 CKB protein sequenceMl’FSNSHNALKLRETAEDEFPDLSAHNxNHMAKVLTPELYAELRAKSTPSGFTLDDVIQTGVDNPGHPYIMTVGCVAGDEESYEVFKDLFDPnEDRHGGYKPSDEHKTDLNPDNLQGGDDLDPNYATSSRVRTGRSIRGFCLPPHCSRGERRAIEKLAVEALSSLDGDLAGRYYALKSMTEAEQQQLIDDHFLFDKPVSPLLLASGMARDWPDARGIWHNDNKTFLVWVNEEDHI.RVISMQKGGNMKEVFTRFCTGLTQIETLFKSKDYEFM>7NPHI.GYILTCPSNLGTGLRAGVHIKLPNLGKHEKFSEVLKRLRLQKRGTGGVDTAAVGGVFDVSNADRLGFSEVELVQMWDGVKLLIEMEQRLEQGQAIDDLMPAQKSEQ ID NO: 118 CKB PromoterAAGACCCCGGCCCCXICCCGCCCGGCCCGCCCGCAGCX'CX'GCACX'TGCAGGTTGTCGGGGTTGAGGTCGGTCTTGTGCTCATCGCTGGGCTTGTAGCCGCX'GTGCCGGTCCTCGATGATGGGGTCGAAGAGATCCTTGAACACTTCGTAGGACTCCTCGTCGCCCGCCACGCAGCCCACGGTCATGATGTACGGGTGGCCTGGGGGAGGGGGCGCGGGACGGGGACAGTGACGTCACTGCCGGGCCCGAGCGCGCTGCTGAGGACCCTGCGGCTGCGCGGGGGGAGGGGGGGCCGGGACCCCGGCCCCGAGGGGTCGCGTACCCGGGTTGTCCACGCCTGTCTGGATGACGTCGTCCAGCGTGAAGCCGCTCGGCGTGCTCTTGGCGCGCAGCTCCGCGTACAGCTCGGGGGTCAGCACCTTGGCCATGTGGTTGTTGTGGGCGCTCAGGTCGGGGAACTCGTCCTCGGCCGGGAAGCGCAGCTTCAGTGCGTTGTGGCTGTTGGAGAAGGGCATGGCGGCGGCGGGCTGCGGGGAGACGCGGGGTCAGAGGGGACCGGCACGCCGGGGTTCCCGGGCTCCCGCGTACCACTCAGGCCCCCGCCGCCGGGCCCCCCGGCGCCCCCCGGGACGCGGCCAAGGTCAGCGGGGTCCGCAGCGCGCGCGGGGAGCGCCATCATCGCCGGGGACCCCCGGCCGGTCCGGCGCGCGCTCCAGGCGACGCGCCCCCTITGCACGCAGCGCCCCTAGCCCGGGCGCGGACGCCCCCGGCCCCCGGGCCCACTCACCGGGCGGCCGGGCGGGGGCGGGGGCGCTCCGTCCGTCGGCAGCTCCCGGAGCGACGCAGGCGAACAGCGGCCXJCTCXGCGCTCCCGCXJGCTCTTAAGGGGCACAACGCGGGCCGCCCATTGGCGGCTATTTATAGCCCATTCATTCX3ATTGGCCCGCGCCGCGGGGTGGTGCCGCCGCTTTGTCX'GCCGCCX'GCAGCCCXX7AACACCCTGGCCGCCCACCCGAGCTGTCCCCTCGCTGGGACCCCGCGCAGCCTGCCCAGTCCX'CCGCCCAAGACCTCGAGGCCGAAACCTCAGGTCCTTGGATATCTGGATCCCCTCGCACGCCCTTGCCTCTGGGCGGGAAACTGAGGCGGAGAGCCTCCGGGCACTCGAGGACGCTTGGGTTCATCCGCATCCTCGAGCCTGCCCGCCTAGTCCAGCCAGCCCCCGCGGCGGCGGCGAGGGGCCGGGCGAAAGCTTTCGGGGCTTCCGCAGCAGGTACGGCCCCCGCCCCACCCCCGGCCAGTGCGAGCTGGCCCGGAGCCGCCGACCTTCCTCAAGGTGCCCGCAGGCGTTTCCTGGGCGATCCTGGTGCAAAGCGAAGGCGCGCGGGAAGCGCAGTCTGGCTGCGGCCCAGCCCGGGGGCACCCGCGGTGCCCTGACCTTGGACAAGTCCTGGGTCTCGGGGGGCTGCGAGCCAGAAACCACGGGGACGCTGTGGCCTTAAGAGGCCGCTGGCAAGTGCAGCCTCGGAGTTTCCAGACCCCAACCCTGGGCCCTCTTCGCAGGGGACAAGnTACCCGACCCCCAAAGGCAGTCCCCGGAGACTTCAGGCAAAGATGGGAGGAAACGCTAATAAACAAl'AAGCATAAGTGCGATTAAAAAAAAAAACTGATCTCACGAATAACCAGAATCATGCAAATTAAGCAGTGACTCCACCTGCCCCTACCCCCAACACTCCCAGATCGACCCCAGCCAr'rGCTGGCTTTGAGCTGGAATGC.GGGAAGACAGGCGTCCACACGCTGCCTGCAACTTAAATTGCTGCATGC

Claims

WHAT IS CLAIMED IS:

1. A composition comprising a targeted polypeptide linked to a transcriptional activator, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to a polynucleotide encoding a polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator 1 alpha (PPARGC1A / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120, FOXO1, GLUT1, GLUT2, GLUT3, GLUT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRS1, DGAT1, DGAT2, UPP1, CKB, and ACACA or as found in Table 2, wherein the composition upregulat.es expression of the at least one polypeptide when introduced to a cell.

2. The composition of claim 1, wherein the targeted polypeptide is a catalytically-inactive nuclease .The composition of claim 2, wherein the catalytically-inactive nuclease is derived from (i) a zinc finger nuclease (ZFN); a transcription activator-like effector nuclease (TALEN); (lii) a clustered regularly interspaced short palindromic repeats (CRISPR) nuclease.

4. The composition of claim 2 or 3, catalytically inactive nuclease is derived from a clustered regularly interspaced short palindromic repeats (CRISPR) nuclease, wherein the composition further comprises a gRNA that targets the portion of the promoter or enhancer sequence.

5. The composition of claim 4, wherein the gRNA comprises a sequence having at least 90%, 95%, 98%, 99% or 100% identity to a sequence of any one of SEQ ID Nos: 1-55.

6. The composition of any one of claims 1-5, wherein the targeted polypeptide is a catalytically-inactive nuclease dCas9.

7. lire composition of any one of claims 1-6, wherein the transcriptional activator is selected from the group consisting of HSF1, VP 16, VP48, VP64, VP160, p53, p65,RTA, MyoDl, SET7, LSD1, CIB1, AD2, CR3, GATA4, SPl , MEF2C, TAX, SET9, VP64- p65-RTA (VPR), Histone Acetyltransferase p300, TET1 Hydroxylase Catalytic Domain,Synergistic activation mediator (SAM), SunTag, and PPAR-gamma.

8. The composition of any one of claims 1-7, wherein the transcriptional activator is VP64.

9. The composition of any one of claims 1-8, wherein the transcriptional activator is VP64, and the targeted polypeptide is catalytically-inactive nuclease dCa.s9.

10. A composition comprising a targeted polypeptide linked to a transcriptional repressor, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to a polynucleotide encoding a polypeptide selected from the group consisting of ACACB and NRIP1, wherein the composition downregulates expression of the at least one polypeptide when introduced to a cell.11 . A cell comprising the targeted polypeptide of any one of claims 1-10.

12. A polynucleotide comprising one or more expression cassettes encoding the targeted polypeptide of any one of claims 1-10.

13. The polynucleotide of claim 12, wherein the targeted polypeptide is a catalytically inactive nuclease and the expression cassettes comprise (i) a first expression cassette comprising a first promoter operably linked to a first nucleic acid encoding a gRNA and (ii) a second expression cassette comprising a second promoter operably linked to a second nucleic acid encoding the catalytically-inactive nuclease and the transcriptional activator.

14. A cell comprising the polynucleotide of any one of claims 12-13.

15. The cell of claim 14, wherein the cell is an adipocyte.

16. An engineered adipocyte or adipose stem cell comprising a targeted polypeptide linked to a transcriptional activator, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to at least one polynucleotide encoding a polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator 1 alpha (PPARGCIA / PCGIA), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120, FOXO1, GLUT1, GLUT2, GLUT3, GLUT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRS1, DGAT1, DGAT2, UPP1,CKB, and ACACA or as found in Table 2, wherein the targeted polypeptide upregulates expression of the at least one polypeptide compared to a wild-type adipocyte or adipose stem cell.

17. An engineered adipocyte or adipose stem cell composing:(i) a targeted polypeptide linked to a transcriptional repressor, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to at least one polynucleotide encoding a polypeptide selected from the group consisting of ACACB and NRIP 1 , wherein the targeted polypeptide downregulates expression of the at least one polypeptide compared to a wild-type adipocyte or adipose stem cell; or(ii) an siRNA or antisense molecule that comprises a sequence complementary to ACACB and NRIP1 and downregulates expression of the at least one polypeptide compared to a wild-type adipocyte or adipose stem cell.

18. The engineered adipocyte or adipose stem ceil of claim 16, wherein the targeted polypeptide is a catalytically inactive nuclease.

19. The engineered adipocyte or adipose stem cell of claim 18, wherein the catalytically inactive nuclease is derived from (i) a clustered regularly interspaced short palindromic repeats (CR1SPR) nuclease, and the engineered adipocyte or adipose stem cell further comprises a gRNA that targets the portion of the promoter or enhancer sequence; (ii) a zinc finger nuclease (ZFN); or (iii) a transcription activator-like effector nuclease (TALEN).

20. An engineered adipocyte or adipose stem cell comprising a heterologous expression cassette, wherein the heterologous expression cassette comprises a promoter operably linked to at least one polynucleotide encoding a polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator 1 alpha (PPARGC1A / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120, F0X01, GLUT1, GLUT2, GLUT3, GLUT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRS1, DGAT1, DGAT2, UPP1, CKB and ACACA or as found in Table 2, wherein the heterologous expression cassette overexpresses the at least one polypeptide compared to a wild-type adipocyte or adipose stem cell.21 . An engineered adipose organoid composed of engineered adipocytes or adipose stem ceil of any one of claims 16-20.

22. A method for preventing or treating a metabolic disease in a subject, wherein the method comprising:upregulating or overexpressing at least one polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator 1 alpha (PPARGC1A / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120, F0X01, GLUT1, GLUT2, GLUT3, GLUT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK, IRS1, DGAT1, DGAT2, UPP1, CRB, and ACACA or as found in Table 2, or downregulating ACACB or NRIP1, in an adipocyte of the subject, thereby preventing or treating a metabolic disease.

23. The method of claim 22, wherein upregulating the polypeptide comprises introducing to the subject a therapeutically effective amount of a composition comprising a targeted polypeptide linked to a transcriptional activator, wherein the targeted polypeptide targets a portion of a promoter or enhancer sequence operably linked to a polynucleotide encoding the polypeptide.

24. lire method of claim 23, wherein the targeted polypeptide is a catalytically inactive nuclease, wherein the catalytically inactive nuclease is (i) a clustered regularly interspaced short, palindromic repeats (CRISPR) nuclease, and the engineered adipocyte or adipose stem cell further comprises a gRNA that targets the portion of the promoter or enhancer sequence; (ii) a zinc finger nuclease (ZFN); or (iii) a transcription activator-like effector nuclease (TALEN).

25. The method of claim 22, wherein overexpressing the polypeptide comprises introducing to the subject a therapeutically effective amount of a composition comprising a heterologous expression cassette comprising a promoter operably linked to a coding sequence encoding the polypeptide.

26. Tire method of any one of claims 23-25, wherein the introducing comprises introducing the composition intravenously, intramuscularly, or a combination thereof.

27. The method of claim 22, wherein downregulating the polypeptide comprises CRISPR interference (CRISPRi), RNA interference (RNAi), or antisense therapy.

28. A method for preventing or treating a metabolic disease or a symptom of aging in a subject, wherein the method comprising:introducing to the subject a therapeutically effective amount of the engineered adipocytes or adipose stem cells of any one of claims 16-20 or the engineered adipose organoids of claim 2129. The method of claim 28, wherein before the introducing, isolating adipocytes or adipose stem cells from the subject and engineering the cells to have the upregulated expression or the overexpression.

30. The method of claim 29, further comprising: culturing the engineered cells into an engineered adipose organoid, and introducing the engineered adipose organoid to the subject.

31. The method of any one of claims 28-30, wherein the introducing engineered adipocytes, or adipose stem cells, or the engineered adipose organoid are autologous.

32. Tire method of any one of claims 28-30, wherein the introducing engineered adipocytes, or adipose stem cells, or the engineered adipose organoid are allogeneic.

33. The method of any one of claims 28-32, wherein the introducing comprises introducing the engineered adipocytes, adipose stem cells, or the engineered adipose organoid intravenously, intramuscularly, or a combination thereof.

34. The method of any one of claims 22-33, wherein the subject is a. human.

35. The method of any one of claims 2.2-34, wherein the method improves at least one symptom selected from the group consisting of body weight loss, cold tolerance, oxygen consumption, whole body energy expenditure, glucose and fatty acid utilization, glucose sensitivity, and insulin sensitivity.

36. A method for preventing or treating diabetes in a subject, the method comprising: introducing to the subject a therapeutically effective amount of (i) the composition of any one of claims 1-10, or (ii) a heterologous expression cassette comprising a promoter operably linked to at least one polynucleotide encoding a polypeptide selected from the group consisting of Uncoupling protein 1 (UCP1 / SLC25A7), PPARG coactivator 1 alpha7 (PPARGC1A / PCG1A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120,8 FOXO1, GLUT1, GLUT2, GLUT3, GLUT4, CHREBP, CD36, CTP1B, AIFM2 / FSP1, GSK,9 IRS1, DGAT1, DGAT2, UPP1, CKB, and ACACA or as found in Table 2, or (iii) the0 engineered adipocytes or adipose stem cells of any one of claims 16-20 or (iv) the engineered1 adipose organoid of claim 21 .

37. The method of claim 36, wherein the subject is a human .1 38. The method of any one of claims 36-37, wherein the introducing2 engineered adipocytes, or adipose stem cells, or the engineered adipose organoid are3 autologous.

39. The method of any one of claims 36-37, wherein the introducing2 engineered adipocytes, or adipose stem ceils, or the engineered adipose organoid are3 allogeneic.

40. The method of any one of claims 36-39, wherein the introducing comprises introducing the composition, or the heterologous expression cassette, or the3 engineered adipocytes or adipose stem cells, or the engineered adipose organoid intravenously,4 intramuscularly, or a combination thereof.1 41. A method for preventing or treating cancer in a subject, wherein the2. method composing:3 introducing to the subject a therapeutically effective amount of (i) the4 composition of any one of claims 1-10, or (ii) a heterologous expression cassette comprising a5 promoter operably linked to at least one polynucleotide encoding a polypeptide selected from6 the group consisting of Uncoupling protein 1 (UCP1 / SL.C25A7), PP ARG coactivator 1 alpha7 (PPARGC1 A / PCG1 A), PR / SET domain 16 (PRDM16), FFAR1 / GPR40, FFAR4 / GPR120,8 FOXO1, GLUT1, GLUT2, GLUT3, GLUT4, CHREBP, CD36, CTP1B. AIFM2 / FSP1, GSK,9 IRS1, DGAT1, DGAT2, UPP1, CKB, and ACACA or as found in Table 2, or (iii) the0 engineered adipocytes or adipose stem cells of any one of claims 16-20 or (iv) the engineered1 adipose organoid of claim 21.1 42. Tire method of claim 41, wherein the subject is a human.

43. The method of any one of claims 41-42, wherein the introducing engineered adipocytes, or adipose stem cells, or the engineered adipose organoid are autologous.

44. The method of any one of claims 41 -42, wherein the introducing engineered adipocytes, or adipose stem cells, or the engineered adipose organoid are allogeneic.

45. The method of any one of claims 41-44, wherein the introducing comprises introducing the composition, or the heterologous expression cassette, or the engineered adipocytes or adipose stem cells, or the engineered adipose organoid is intravenously, intramuscularly, or a combination thereof.

46. Tire method of any one of claims 41-45, wherein the method results in suppression of glycolysis or fatty acid metabolism in cancer cells.

47. An adipocyte or adipose stem cell engineered to consume a metabolite preferentially consumed by cancer cells compared to non-cancer cells m an individual.

48. The adipocyte or adipose stem cell of claim 47, wherein the engineered adipocyte or adipose stem cell is engineered to express uridine phosphorylase (UPP1).

49. A method of treating or preventing cancer in an individual, the method comprising introducing into the indi vidual the adipocyte or adipose stem cell of any one of claims 47-48 in proximity to cancer cells that preferentially consume the metabolite engineered adipocyte or adipose stem cells, thereby inhibiting growth of the cancer cells.

50. The method of claim 49, wherein the cancer cells are pancreatic ductal adenocarcinoma cells and the adipocyte or adipose stem cells are introduced into the breast of the individual.

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