Role of leptin in the pathogenesis of breast cancer

Leptin is a small polypeptide codified by the Obese Gene (OB), deeply related with the body fat mass and energetic balance. Due to its diverse biological effects and downstream signal transducers, multiple classifications have been attributed to leptin, as hormone, cytokine, adypokine, growth factor, and developmental factor, among others. This scenario gives us an idea of the size of the potential biological effects generated by this molecule. The concentration of leptin in the body is determined by the amount of adipose tissue; therefore, hyperleptinemia is a common finding in obese individuals. In addition, high levels of circulating leptin may confer a poor prognosis for any pathological condition. Although leptin history has been reported for more than 20 years, its relationship with cancer has gained notoriety in the past ten years, where studies focused on discussing the issue of obesity as a strong risk factor for cancer developing. Further, growing evidences have pointed leptin as a pivotal mediator of immune response, which aggravates the scenario of cancer occurrence in the presence of obesity. Therefore, leptin can present at least two faces in the pathogenesis of breast cancer, acting by immune and non-immune mechanisms. In this paper we review the dynamic of the leptin axis in breast cancer and further discuss its role in disease, immunopathogenesis and prognosis.