In this study we set out to explain the differing effects of parabiosis with genetically diabetic (db) mice versus administration of recombinant leptin. Parabiosis of db mutant, which overexpress leptin, to wildtype (WT) or genetically obese (ob) mice has been reported to cause death by starvation, whereas leptin infusions do not produce lethality at any dose or mode of delivery tested. Leptin is not posttranslationally modified other than a single disulphide bond, raising the possibility that it might require additional factor(s) to exert the maximal appetite-suppressing effect. We reconfirmed the lethal effect of parabiosis of db mutant on WT mice and further showed that this lethality could not be rescued by administration of ghrelin or growth hormone. We then initiated a biochemical fractionation of a high-molecular-weight leptin complex from human plasma and identified clusterin as a major component of this leptin-containing complex. However, in contrast to previous reports, we failed to observe a leptin-potentiating effect of either exogenous or endogenous clusterin, and parabiosis of db clusterin −/− double-mutant to WT mice still caused lethality. Intriguingly, in parabiotic pairs of two WT mice, leptin infusion into one of the mice led to an enhanced starvation response during calorie restriction as evidenced by increased plasma ghrelin and growth-hormone levels. Moreover, leptin treatment resulted in death of the parabiotic pairs. These data suggest that the appetite suppression in WT mice after parabiosis to db mutants is the result of induced hyperleptinemia combined with the stress or other aspect(s) of the parabiosis procedure.eptin functions as an afferent signal in a negative feedback loop that maintains constancy of adipose tissue mass. Leptin acts on its receptors located in the hypothalamus and elsewhere to regulate the neuroendocrine axis, food intake, metabolism, and body weight. The existence of an appetite-suppressing hormone was first suggested by the results from a set of parabiosis experiments between genetically obese (ob) and diabetic (db) mice as well as in studies of the rats with electrolytic lesions of the ventromedial hypothalamus (VMH) that also causes obesity (1-3). The ob and db loci are fully penetrant autosomal-recessive mutations that cause extreme obesity and encode leptin and the leptin receptor, respectively (4, 5).A key finding in these classic parabiosis experiments has been the observation that parabiosis of db mice or VMH-lesioned rats completely suppressed the appetite of wildtype (WT) or ob animals, leading to death by apparent starvation. The parabiotic partners of db mice were reported to be lean and hypoglycemic with little or no food in the stomach (1, 2). These studies suggested that db mice overproduce an endogenous appetite suppressant, and based on these studies, Coleman correctly predicted that the mouse ob gene encoded a novel hormone regulating body weight. The fact that db mice overproduce an appetite suppressant but were obese suggested that this gene ...