Benefits of leptin therapy in HIV patients

Abstract

Leptin therapy in human recombinant form has recently been used in HIV-associated lipodystrophy syndrome on experimental basis in some small short-term clinical trials. It has shown its beneficial effects only in hypoleptinemic HIV-infected patients by causing definite improvement in their insulin sensitivity, glucose tolerance, lipid status, and truncal obesity. Leptin prevents lipotoxicity and activates insulin signaling pathways through several postulated mechanisms. Central leptin insufficiency with peripheral hyperleptinemia has come out to be a significant contributor to the development of obesity and metabolic syndrome. In this article, we will review the basis of leptin therapy in HIV patients, with its promises. However, further larger clinical trials are needed to prove its long-term efficacy in the control of metabolic complications related to HIV therapy.

Metabolomics in Nutrition Research: Biomarkers Predicting Mortality in Children with Severe Acute Malnutrition

“…Finally, leptin has been used to treat children and adults with congenital and HIV-associated lipodystrophy [20,21]. Future studies might explore the use of leptin as an adjunct to nutritional therapy in malnourished children or adults, particularly if leptin is found to have a critical role in the defense against, or response to, severe infection.…”

Leptin Functions in Infectious Diseases

“…Human immunodeficiency virus (HIV)-infected patients have an exaggerated expression of leptin receptor on their blood mononuclear cells while low leptin levels in their serum leads to an immune deficiency in these patients ( 127 , 128 ). Importantly, leptin therapy, a novel strategy now in clinical trials, and its beneficial positive role in HIV patients in correction of metabolic complications related to HIV-associated lipodystrophy syndrome (HALS) has been reported recently ( 129 ). Leptin also diminishes the oxidative status of monocytes suggesting that leptin can alter the redox status of monocytes, which leads to immunological alterations in HIV infection ( 35 ).…”

Visceral fat is associated with brain structure independent of human immunodeficiency virus infection status

“…In HIV-infected persons, visceral adiposity is associated with decreased growth hormone and adiponectin levels. (Diaz-Delfin et al , 2013) Leptin levels are suppressed in HIV-associated lipodystrophy but elevated in generalized obesity,(Paruthi et al , 2013; Sinha et al , 2012) and both growth hormone and leptin replacement therapy decrease VAT in HIV-infected persons. (Diaz-Delfin et al , 2013; Mulligan et al , 2009) Adiponectin is preferentially produced by VAT, whereas leptin is preferentially produced by subcutaneous adipose tissue.…”