2015年瘦素的应用：我们对瘦素和肥胖有了哪些了解？
Leptin applications in 2015: what have we learned about leptin and obesity?
作者信息
Farr Olivia M, Gavrieli Anna, Mantzoros Christos S
机构信息
Division of Endocrinology, Boston VA Healthcare System/Harvard Medical School Section of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts, USA *Olivia M. Farr and Anna Gavrieli authors have contributed equally to the writing of this article.
出版信息
Curr Opin Endocrinol Diabetes Obes. 2015 Oct;22(5):353-9. doi: 10.1097/MED.0000000000000184.
PURPOSE OF REVIEW
To summarize previous and current advancements for leptin therapeutics, we described how leptin may be useful in leptin deficient states such as lipodystrophy, for which leptin was recently approved, and how it may be useful in the future for typical obesity.
RECENT FINDINGS
The discovery of leptin in 1994 built the foundation for understanding the pathophysiology and treatment of obesity. Leptin therapy reverses morbid obesity related to congenital leptin deficiency and appears to possibly treat lipodystrophy, a finding which has led to the approval of leptin for the treatment of lipodystrophy in the USA and Japan. Typical obesity, on the other hand, is characterized by hyperleptinemia and leptin tolerance. Thus, leptin administration has proven ineffective for inducing weight loss on its own but could possibly be useful in combination with other therapies or for weight loss maintenance.
SUMMARY
Leptin is not able to treat typical obesity; however, it is effective for reversing leptin deficiency-induced obesity and is possibly useful in lipodystrophy. New mechanisms and pathways involved in leptin resistance are continuously discovered, whereas the development of new techniques and drug combinations which may improve leptin's efficacy and safety regenerate the hope for its use as an effective treatment for typical obesity.
综述目的
为总结瘦素疗法的既往及当前进展，我们阐述了瘦素在诸如脂肪营养不良等瘦素缺乏状态（瘦素最近已获批用于该病症）中的作用，以及其未来在典型肥胖症治疗中可能发挥的作用。
最新发现
1994年瘦素的发现为理解肥胖症的病理生理学及治疗奠定了基础。瘦素疗法可逆转与先天性瘦素缺乏相关的病态肥胖，且似乎有可能治疗脂肪营养不良，这一发现促使美国和日本批准瘦素用于治疗脂肪营养不良。另一方面，典型肥胖症的特征是高瘦素血症和瘦素耐受性。因此，单独使用瘦素已被证明无法有效诱导体重减轻，但与其他疗法联合使用或用于维持体重减轻可能会有效果。
总结
瘦素无法治疗典型肥胖症；然而，它对逆转瘦素缺乏所致肥胖有效，且可能对脂肪营养不良有用。与瘦素抵抗相关的新机制和途径不断被发现，同时，可能提高瘦素疗效和安全性的新技术及药物组合的研发，为其作为典型肥胖症的有效治疗方法带来了新希望。
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