Published online Mar 26, 2016. doi: 10.5662/wjm.v6.i1.43
Peer-review started: September 7, 2015
First decision: October 8, 2015
Revised: January 30, 2016
Accepted: March 7, 2016
Article in press: March 9, 2016
Published online: March 26, 2016
Processing time: 202 Days and 8.4 Hours
Obesity is a global pandemic characterized by high levels of body fat (adiposity) and derived-cytokines (i.e., leptin). Research shows that adiposity and leptin provide insight on the link between obesity and cancer progression. Leptin’s main function is to regulate energy balance. However, obese individuals routinely develop leptin resistance, which is the consequence of the breakdown in the signaling mechanism controlling satiety resulting in the accumulation of leptin. Therefore, leptin levels are often chronically elevated in human obesity. Elevated leptin levels are related to higher incidence, increased progression and poor prognosis of several human cancers. In addition to adipose tissue, cancer cells can also secrete leptin and overexpress leptin receptors. Leptin is known to act as a mitogen, inflammatory and pro-angiogenic factor that induces cancer cell proliferation and tumor angiogenesis. Moreover, leptin signaling induces cancer stem cells, which are involved in cancer recurrence and drug resistance. A novel and complex signaling crosstalk between leptin, Notch and interleukin-1 (IL-1) [Notch, IL-1 and leptin crosstalk outcome (NILCO)] seems to be an important driver of leptin-induced oncogenic actions. Leptin and NILCO signaling mediate the activation of cancer stem cells that can affect drug resistance. Thus, leptin and NILCO signaling are key links between obesity and cancer progression. This review presents updated data suggesting that adiposity affects cancer incidence, progression, and response to treatment. Here we show data supporting the oncogenic role of leptin in breast, endometrial, and pancreatic cancers.
Core tip: Obesity is a global pandemic and a risk factor for a number of cancers. Obesity is characterized by high levels of body fat (adiposity) and leptin. Research shows that leptin and its oncogenic crosstalk Notch, interleukin-1 and leptin crosstalk outcome (NILCO) provide insight on the link between obesity and cancer progression. Thus, leptin and NILCO can act as mitogenic, inflammatory, and angiogenic cues promoting the progression of cancer, cancer stem cells, and drug resistance. This review shows updated information on leptin and NILCO’s oncogenic roles in breast, endometrial, and pancreatic cancers.