REVIEW: Adipose Tissue as an Endocrine Organ Regulating Growth, Puberty,
and Other Physiological Functions
Yu. A. Pankov
Endocrinology Research Center, Russian Academy of Medical Sciences, ul.
Moskvorech'e 1, Moscow, 115478 Russia; fax: (095) 112-3547; E-mail:
yuri-pankov@mtu-net.ru
Received December 11, 1998; Revision received February 5, 1999
There are reports on some patients with clearly manifested specific
features of genotype and phenotype similar to those of ob/ob and db/db
mice. Three patients from Turkey were described who had a homozygous
mutation in the gene of leptin identical to the mutation in C57BL6J
ob/ob mice. This mutation is a C --> T substitution in codon 105 of
the amino acid sequence of leptin. In mice this mutation generates a
stop-codon; in humans it substitutes Arg-105 with Trp. The mutant human
leptin cannot be secreted by the cells and thus has no effect on the
hypothalamus. Patients with a homozygous mutation of the leptin
receptor resulting in the G --> T substitution in the splice donor
site of exon 16 were studied in a family of Kabilian origin. Exon 16
was not included in the mature mRNA molecule, and a truncated leptin
receptor was synthesized which lacked the transmembrane and
intracellular domains; this receptor was unable to transduce the
hormonal signal. Both groups of patients suffered from obesity, delayed
linear growth, infertility, increased blood insulin level, and other
disorders. Leptin influences lipid metabolism by stimulating the
expression of the proopiomelanocortin (POMC) gene in melanocortinergic
neurons of the hypothalamus. POMC is the precursor of
alpha-melanocyte-stimulating hormone (alpha-MSH), which
binds to the melanocortin receptor MC4-R in the brain, decreases
appetite, and activates lipid metabolism. Patients with mutations in
MC4-R suffered only from obesity, but their growth and puberty were not
affected. Thus, leptin apparently stimulates growth and puberty not
through its binding to the receptors on melanocortinergic neurons, but
through its binding to receptors on other hypothalamic neurons; this
effect of leptin is not affected by mutations in the MC4-R gene.
KEY WORDS: leptin, gene, mutation, splicing, puberty, obesity