igure 2. Model of immune effects of leptin in leanness and obesity.

In lean subjects, the normal secretion

of adipocyte-derived leptin associates with a balance between the number of Th1 cells and Treg cells,
which are functionally capable of suppressing immune and autoimmune responses. Conversely, in
obesity a high frequency of Th1 cells and a low proportion of Treg cells infiltrate adipose tissue, possibly
attracted by increased leptin secretion by adipocytes, which increases Th1 cell expansion and reduces
Treg cell proliferation. In addition to the increased numbers of Th1 cells in adipose tissue, higher numbers
of CD8+ T cells, macrophages and mast cells have been reported. These phenomena could reflect
adipose tissue autoimmunity.