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Summary

The elucidation of the ob/ob gene product, leptin, not only closed a gap in the understanding of the regulation of feeding but also offered a rationale for the humoral link between metabolic function and the regulation of hypothalamo-pituitary secretions. Absence of leptin production as seen in ob/ob mice or in some rare cases of human obesity not only leads to hyperphagia, reduced energy expenditure, and hypercorticism, but also, most importantly, to sterility. Partial or total leptin resistance by mutation of the leptin receptor leads to a similar phenotype, as seen in db/db mice, fa/fa Zucker rats and again in rare cases of human obesity. Common human obesity is characterized by partial resistance to clearly elevated circulating leptin levels. A key finding was the demonstration that treatment of sterile ob/ob mice with leptin could quickly restore fertility, implying that a minimum level of circulating leptin is necessary for positive stimulation of the gonadotropic axis, at least as a permissive factor. A similar situation was seen with the treatment of two patients with leptin deficiency. Furthermore, leptin was shown to modulate other hypothalamo-pituitary axes. A general finding has been that leptin administration to animals undergoing severe reduction in energetic supply could reverse the negative effects of such a metabolic insult on most endocrine axes, with striking effects on pulsatile growth hormone (GH) and LH secretions in the rat. Ingestive behavior is controlled by multiple interacting neuroendocrine circuits that are leptin-dependent, involving neuropeptides such as Neuropeptide Y (NPY), Melanocortins (MCs), AGRP, CART, GLP-1, Orexin, etc. Generally speaking, a deficit in feeding corresponds to centrally induced reduction in sexual function. NPY is primarily known to stimulate feeding but also to modulate sexual behavior and gonadotropin secretion. Apparently reproductive function is not dependent on hypothalamic α-MSH or CART action. The recently described natural ligand of the GHRP receptor, ghrelin, which is synthesized and release by the stomach, not only stimulates GH secretion, as predicted, but also regulates feeding by acting on hypothalamic neuropeptides such as NPY. Ghrelin action seems to represent a counterbalance of leptin action. Whereas leptin decreases feeding and can produce anorexia, ghrelin stimulates feeding and eventu- ally produces obesity. Thus a trend for coordinated neuroendocrine regulation of ingestive and reproductive behavior in response to metabolic and environmental changes is expected, with a clear integrative role for leptin and possibly insulin. Still, much remains to be learned about the mode of action of leptin to activate GnRH secretion and reproduction in mammals.

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Aubert, M.L., Sudre, B., Raposinho, P.D., Vauthay, D., Pierroz, D.D., Pralong, F.P. (2002). Leptin, Growth and Reproduction. In: Kordon, C., Robinson, I., Hanoune, J., Dantzer, R., Christen, Y. (eds) Brain Somatic Cross-Talk and the Central Control of Metabolism. Research and Perspectives in Endocrine Interactions. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18999-9_10

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