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Reviews: M A Kelly, M L Rayner, C H Mijovic, and A H Barnett Molecular aspects of type 1 diabetes Mol Pathol 2003; 56: 1-10 [Abstract] [Full text] [PDF]

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Does leptin resistance contribute to infections in patients with diabetes?

G.N. Malavige   (28 February 2003)

Does leptin resistance contribute to infections in patients with diabetes? 28 February 2003
G.N. Malavige, Lecturer in Microbiology University of Sri Jayawardenapura, Sri Lanka Send letter to journal: Re: Does leptin resistance contribute to infections in patients with diabetes? neelika{at}lassana.com G.N. Malavige	Dear Editor Leptin is a protein hormone structurally similar to IL-2, which regulates food intake and metabolic and endocrine function.[1] It has an important role in regulatory role in the immune response mainly acting as a T cell growth factor.[2] Moreover, it also effects cytokine production, monocyte/macrophage activation, wound healing, angiogenesis and hamatopoiesis.[1] Leptin concentrations rapidly increase during infection and inflammation. Low levels of leptin which may occur in starvation or malnutrition is associated with impaired cellular immunity, impaired delayed type hypersensitive responses and thymic atrophy contributing to increased susceptibility to infection.[2] High leptin concentrations are seen in obese and diabetic individuals, the concentrations of leptin rising with increasing insulin resistance.[3] However, despite high leptin levels there is leptin resistance or defective leptin in these individuals.[4] Therefore, leptin resistance, along with many other factors may also contribute to the increase incidence of infection seen among diabetic patients. Diabetic patients are more susceptible to infections such as tuberculosis and candidiasis, which require a good cellular immune response to overcome infection. Since, leptin is important in the regulation of the cellular immune responses leptin resistance may be a contributing factor for th high incidence of such infections. Therefore, the role of leptin in infections in diabetic patients should be further examined. Reference (1) Fantuzzi G, Faggioni R. Leptin in the regulation of immunity, inflammation, and hematopoiesis. J Leukoc Biol 2000 Oct;68(4):437-46 (2) Matarese G. Leptin and the immune system: how nutritional status influences the immune response. Eur Cytokine Netw 2000 Mar;11(1):7-14 (3) Fischer S, Hanefeld M, Haffner SM, Fusch C, Schwanebeck U, Kohler C, Fucker K, Julius U. Insulin-resistant patients with type 2 diabetes mellitus have higher serum leptin levels independently of body fat mass. Acta Diabetol 2002 Sep;39(3):105-10 (4) Lee JH, Reed DR, Price RA. Leptin resistance is associated with extreme obesity and aggregates in families. Int J Obes Relat Metab Disord 2001 Oct;25(10):1471-3.