Leptin Therapy Improves Metabolic Dysfunction in Immune Checkpoint Inhibitor-induced Lipodystrophy
Mona Vahidi Rad1, Suhail Saad-Omer1, Bharath Nair Suresh Kumar Bindu1
1Department of Endocrinology, Mayo Clinic, Rochester, MN 55905, USA.
JCEM Case Reports
|February 17, 2026
Summary
Immune checkpoint inhibitors can cause acquired generalized lipodystrophy (AGL). Leptin therapy improved metabolic issues in a patient with AGL and lung cancer, showing potential safety and efficacy.
Area of Science:
- Endocrinology
- Oncology
- Metabolic Disorders
Background:
- Immune checkpoint inhibitors (ICI) are crucial cancer therapies but can cause endocrine complications.
- Acquired generalized lipodystrophy (AGL) is a rare ICI adverse effect, leading to severe metabolic derangements like insulin-resistant diabetes and hepatic steatosis.
- Leptin deficiency in AGL causes metabolic issues, and leptin therapy is beneficial in other AGL forms, but its use in ICI-induced AGL with cancer history is unclear due to cancer concerns.
Related Concept Videos
01:23Dipeptidyl Peptidase 4 Inhibitors
729
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
729
01:24Glucagon-like Receptor Agonists
1.0K
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
1.0K
01:24Overview of Lipid Metabolism
5.7K
Lipid metabolism is a crucial process in the human body that involves the synthesis and degradation of lipids. This process is essential for energy production, cell membrane formation, and hormone production, among other functions.
Lipolysis: The Breakdown of Lipids:
Lipolysis is the process of breaking down lipids, particularly triglycerides, into glycerol and fatty acids. This process typically occurs in the adipose tissue and is triggered by various hormones, including glucagon and...
Lipolysis: The Breakdown of Lipids:
Lipolysis is the process of breaking down lipids, particularly triglycerides, into glycerol and fatty acids. This process typically occurs in the adipose tissue and is triggered by various hormones, including glucagon and...
5.7K
01:20Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion
197
Drug metabolism, a critical process in the liver, involves two primary phases: Phase I reactions and Phase II conjugation. Obesity introduces significant alterations in this metabolic process, primarily due to fatty infiltration of the liver, leading to conditions such as nonalcoholic fatty liver disease (NAFLD). This condition can modify the activities of both Phase I and II enzymes, impacting how drugs are metabolized in obese patients.Phase I metabolism sees variable effects across...
197
01:25Pharmacokinetics in Obese Patients: Drug Absorption and Distribution
301
Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...
301