Document Detail


Leptin promotes fibroproliferative acute respiratory distress syndrome by inhibiting peroxisome proliferator-activated receptor-γ.
MedLine Citation:
PMID:  21317313     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RATIONALE: Diabetic patients have a lower incidence of acute respiratory distress syndrome (ARDS), and those who develop ARDS are less likely to die. The mechanisms that underlie this protection are unknown.
OBJECTIVES: To determine whether leptin resistance, a feature of diabetes, prevents fibroproliferation after lung injury.
METHODS: We examined lung injury and fibroproliferation after the intratracheal instillation of bleomycin in wild-type and leptin-resistant (db/db) diabetic mice. We examined the effect of leptin on transforming growth factor (TGF)-β(1)-mediated transcription in primary normal human lung fibroblasts. Bronchoalveolar lavage fluid (BAL) samples from patients with ARDS and ventilated control subjects were obtained for measurement of leptin and active TGF-β(1) levels.
MEASUREMENTS AND MAIN RESULTS: Diabetic mice (db/db) were resistant to lung fibrosis. The db/db mice had higher levels of peroxisome proliferator-activated receptor-γ (PPARγ), an inhibitor of the transcriptional response to TGF-β(1), a cytokine critical in the pathogenesis of fibroproliferative ARDS. In normal human lung fibroblasts, leptin augmented the transcription of profibrotic genes in response to TGF-β(1) through a mechanism that required PPARγ. In patients with ARDS, BAL leptin levels were elevated and correlated with TGF-β(1) levels. Overall, there was no significant relationship between BAL leptin levels and clinical outcomes; however, in nonobese patients, higher BAL leptin levels were associated with fewer intensive care unit- and ventilator-free days and higher mortality.
CONCLUSIONS: Leptin signaling is required for bleomycin-induced lung fibrosis. Leptin augments TGF-β(1) signaling in lung fibroblasts by inhibiting PPARγ. These findings provide a mechanism for the observed protection against ARDS observed in diabetic patients.
Authors:
Manu Jain; G R Scott Budinger; Amy Lo; Daniela Urich; Stephanie E Rivera; Asish K Ghosh; Angel Gonzalez; Sergio E Chiarella; Katie Marks; Helen K Donnelly; Saul Soberanes; John Varga; Kathryn A Radigan; Navdeep S Chandel; Gökhan M Mutlu
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-02-11
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  183     ISSN:  1535-4970     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-06     Completed Date:  2011-08-15     Revised Date:  2012-01-26    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1490-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Bronchoalveolar Lavage Fluid
Disease Models, Animal
Female
Humans
Leptin / metabolism*,  pharmacology*
Lung / metabolism
Male
Mice
Middle Aged
PPAR gamma / metabolism*
Respiratory Distress Syndrome, Adult / metabolism*
Transforming Growth Factor beta / metabolism
Grant Support
ID/Acronym/Agency:
ES013995/ES/NIEHS NIH HHS; ES015024/ES/NIEHS NIH HHS; HL071643/HL/NHLBI NIH HHS; UL1 RR025741/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Leptin; 0/PPAR gamma; 0/Transforming Growth Factor beta

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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