The discovery of leptin, the product of the ob gene [1], has broadened the horizons of research in the regulation of body adiposity and energy balance. This hormone, produced exclusively by the adipose tissue, conveys to the brain information on the size of energy stores and activates hypothalamic centers that regulate energy intake and expenditure [2]. In addition, leptin affects several neuroendocrine mechanisms and regulates multiple hypothalamic-pituitary axes [2]. The realization that the adipose tissue is not merely a storage depot, but also an important endocrine gland, has revived the interest in the ªlipostatic theoryº of body fat regulation [3] and has opened new opportunities in the investigation and treatment of disorders such as obesity and anorexia nervosa.In this review, both the biology of leptin secretion and regulation as well as our progress in elucidating the role of leptin in various physiologic and pathophysiologic states are discussed. More specifically, particular emphasis is placed on our current thinking for the role of leptin in physiologic processes, such as control of body adiposity, adaptation to starvation and the onset of puberty as well as the pathogenesis of disorders such as obesity and anorexia nervosa. Finally, some of the important unanswered questions about leptin physiology are discussed and future directions for leptin research are suggested.
Historic backgroundKennedy [3] first introduced the lipostatic theory of body weight control, according to which the adipose tissue produces a hormone that regulates body size. The elegant work of Hervey [4], based on parabiosis experiments using rats with hypothalamic lesions, suggested almost four decades ago the existence of such a factor that might act on the hypothalamus. Further work by Hausberger [5], and later by Coleman and Hummel [6], also employing the parabiosis paradigm between genetically obese and wild type animals, confirmed and extended Hervey's observations. In these studies, the circulatory systems of two animals were connected, allowing exchange of circulating hormones. Using genetically obese mice, such as the ob/ob and the db/db mice, in parabiosis with wild type animals, these investigators postulated the existence of a circulating factor in the wild type mice. They proposed that this substance was absent in ob/ob mice, since ob/ob mice would lose weight when connected to wild type mice. Furthermore, they speculated that db/db mice were resistant to the action of the unknown factor, since, on one hand, db/db mice in parabiosis with wild type animals fail to lose weight, and, on the other, wild type mice connected to db/db mice die of starvation. These findings were interpreted to result from the actions of large amounts of the unknown factor that was appropriately overproduced in response to tissue resistance in db/ db mice.All these predictions turned out to be correct when the ob gene was identified by positional cloning using the ob/ob animal model of obesity [1]. Thus, ob/ ob animals are obese because they ...