The adipokine leptin is a potential new mediator for bronchial epithelial homeostasis. TGF-beta is a tissue growth factor the dysregulation of which is associated with airway remodeling.
TGF-beta decreased leptin receptor expression (inhaled steroid fluticasone reverses that). Leptin decreased the spontaneous release of TGF-beta and increased cell proliferation.
Severe asthma was associated with a reduced expression of leptin and its receptor and an increased RBM thickness with unaltered TGF-beta expression.
The authors concluded that decreased expression of leptin/leptin receptor characterizes severe asthma and is associated with airway remodeling.
Severe asthma - differential diagnosis and management (click to enlarge the image).
Leptin and leptin receptor expression in asthma. Bruno A, Pace E, Chanez P, Gras D, Vachier I, Chiappara G, La Guardia M, Gerbino S, Profita M, Gjomarkaj M. J Allergy Clin Immunol. 2009 Jun 17.