Inoue W, Luheshi GN. Acute starvation alters lipopolysaccharideinduced fever in leptin-dependent and -independent mechanisms in rats. Am J Physiol Regul Integr Comp Physiol 299: R1709 -R1719, 2010. First published October 13, 2010; doi:10.1152/ajpregu.00567.2010.-A decrease in leptin levels with the onset of starvation triggers a myriad of physiological responses including immunosuppression and hypometabolism/hypothermia, both of which can counteract the fever response to pathogens. Here we examined the role of leptin in LPSinduced fever in rats that were fasted for 48 h prior to inflammation with or without leptin replacement (12 g/day). The preinflammation fasting alone caused a progressive hypothermia that was almost completely reversed by leptin replacement. The LPS (100 g/kg)-induced elevation in core body temperature (Tcore) was attenuated in the fasted animals at 2-6 h after the injection, an effect that was not reversed by leptin replacement. Increasing the LPS dose to 1,000 g/kg caused a long-lasting fever that remained unabated for up to 36 h after the injection in the fed rats. This sustained response was strongly attenuated in the fasted rats whose T core started to decrease by 18 h after the injection. Leptin replacement almost completely restored the prolonged fever. The attenuation of the prolonged fever in the fasted animals was accompanied by the diminution of proinflammatory PGE 2 in the cerebrospinal fluid and mRNA of proopiomelanocortin (POMC) in the hypothalamus. Leptin replacement prevented the fasting-induced reduction of POMC but not PGE 2 . Moreover, the leptin-dependent fever maintenance correlated closely with hypothalamic POMC levels (r ϭ 0.77, P Ͻ 0.001). These results suggest that reduced leptin levels during starvation attenuate the sustained fever response by lowering hypothalamic POMC tone but not PGE 2 synthesis. fasting; energy balance; prostaglandin; proopiomelanocortin FEVER IS A COMMON RESPONSE to various types of infection and constitutes an important component of an adaptive strategy for fighting disease (18,29). The development of fever is a finely tuned, complex event that involves both the immune and the central nervous systems through which a series of inflammatory, thermoregulatory, and metabolic processes are regulated (46). The sum of the changes required to mount an effective fever response is an energy-demanding process that can be influenced by the energy status of the host. This was clearly shown by a number of studies reporting that malnutrition prior to the induction of inflammation compromises the fever response in various species of experimental animals (20,21,24,28,30,53,54,60). The suggested explanations for this observation include suppression of inflammatory responses (20,21,53), an alteration of the thermoregulatory response (24, 30), and an attenuation of thermogenic effecter activity (28, 54). However, it remains unclear how the signal relating to the reduced energy status of the host is relayed to the aforementioned fever-related functions and subseq...