Leptin exacerbates sepsis-mediated morbidity and mortality.
The adipose-derived hormone leptin is well known for its contribution to energy metabolism and satiety signaling in the hypothalamus. Previous studies suggested that obesity is an independent risk factor for sepsis morbidity and mortality, and it is associated with elevated baseline levels of circulating leptin in normal, nonseptic patients. In mouse endotoxemia and cecal ligation puncture models of sepsis, we observed elevated levels of leptin and soluble leptin receptor (sLR). Exogenously administered leptin increased mortality in endotoxemia and cecal ligation puncture models and was associated with increased expression of adhesion and coagulation molecules, macrophage infiltration into the liver and kidney, and endothelial barrier dysfunction. Conversely, longform leptin receptor-deficient mice were protected from sepsis morbidity and mortality and had less endothelial dysfunction. Furthermore, an in vitro study revealed that leptin-induced endothelial dysfunction is likely mediated, at least in part, by monocytes. Moreover, administration of an sLR conferred a survival benefit. Human septic patients have increased circulating sLR concentrations, which were correlated with disease severity indices. Together, these data support a pathogenic role for leptin signaling during sepsis.
Center for Vascular Biology Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Nathan I
NI
Shapiro
Eliyahu V
EV
Khankin
Matijs
M
Van Meurs
Shou-Ching
SC
Shih
Shulin
S
Lu
Midori
M
Yano
Pedro R
PR
Castro
Eleftheria
E
Maratos-Flier
Samir M
SM
Parikh
S Ananth
SA
Karumanchi
Kiichiro
K
Yano
D000818:Animals; D045744:Cell Line, Tumor; D002478:Cells, Cultured; D004730:Endothelium, Vascular / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D019446:Endotoxemia / Q000276:immunology* / Q000378:metabolism / Q000401:mortality*; D006801:Humans; D020738:Leptin / Q000009:adverse effects* / Q000097:blood; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D008820:Mice, Obese; D009000:Monocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D009017:Morbidity; D011446:Prospective Studies; D020033:Protein Isoforms / Q000008:administration & dosage / Q000097:blood; D054411:Receptors, Leptin / Q000097:blood / Q000172:deficiency / Q000502:physiology; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000097:blood; D012720:Severity of Illness Index
D020738:Leptin; D020033:Protein Isoforms; D054411:Receptors, Leptin; D011994:Recombinant Proteins; C515447:leptin receptor, mouse