Leptin: Regulation and Clinical Applications

by MD, Sam Dagogo-Jack Sam (Editor)

Beginning with a succinct synthesis of the vast amount of work that has been carried out in experimental animals, in vitro models, and other avenues that has enriched our understanding of leptin’s biology, the focus of Leptin shifts to a fuller consideration of the regulation and role of leptin in humans. The emphasis on human-level data is a unique feature of this book. The results of numerous studies indicate that leptin is indeed a regulated human hormone: The physiological factors that influence leptin secretion include gender, adiposity, physical exercise, feeding, and caloric restriction. Several hormones, including insulin, glucocorticoids, estradiol, growth hormone, testosterone, somatostatin, and insulin-like growth factor-I also modulate leptin secretion. The glucocorticoid-leptin-adipocyte axis appears to be a well- established system that is sensitive to acute nutrient fluxes and predictive of future adiposity; that axis is considered in detail together with other pathways that link leptin to human metabolic pathophysiology. Next follows a comprehensive presentation of the therapeutic trials of recombinant leptin replacement in human subjects with congenital leptin deficiency, leptin supplementation in lean and obese leptin-replete subjects, and leptin therapy in patients with lipodystrophy and other emerging areas, including treatment of hypothalamic amenorrhea and prevention of weight regain in post-obese subjects. The book concludes with a detailed consideration of future directions in human leptin research that could deepen understanding of the complex regulation of leptin under physiological and pathological conditions, a critical prerequisite to its rational deployment in the treatment of human disorders.

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