Alteration of brain insulin and leptin signaling promotes energy homeostasis impairment and neurodegenerative diseases

The central nervous system (CNS) controls vital functions, by efficiently coordinating peripheral and central cascades of signals and networks in a coordinated manner. Historically, the brain was considered to be an insulin-insensitive tissue. But, new findings demonstrating that insulin is present in different regions of themammalian brain, in particular the hypothalamus and the hippocampus. Insulin acts through specific receptors and dialogues with numerous peptides, neurotransmitters and adipokines such as leptin. The cross-talk between leptin and insulin signaling pathways at the hypothalamic level is clearly involved in the control of energy homeostasis. Both hormones are anorexigenic through their action on hypothalamic arcuate nucleus by inducing the expression of anorexigenic neuropetides such as POMC (pro-opiomelanocortin, the precursor of aMSH) and reducing the expression of orexigenic neuropeptide such as NPY (Neuropeptide Y). Central defect of insulin and leptin signaling predispose to obesity (leptin-resistant state) and type-2 diabetes (insulin resistant state). Obesity and type-2 diabetes are associated to deep alterations in energy homeostasis control but also to other alterations of CNS functions as the predisposition to neurodegenerative diseases such as Alzheimer’s disease (AD). AD is a neurodegenerative disorder characterized by distinct hallmarks within the brain. Postmortem observation of AD brains showed the presence of parenchymal plaques due to the accumulation of the amyloid beta (AB) peptide and neurofibrillary tangles. These accumulations result from the hyperphosphorylation of tau (a mictrotubule-interacting protein). Both insulin and leptin have been described to modulate tau phosphorylation and therefore in leptin and insulin resistant states may contribute to AD. The concentrations of leptin and insulin cerebrospinal fluid are decreased type2 diabetes and obese patients. In addition, the concentration of insulin in the cerebrospinal fluid of AD patients is diminished. Taken together, these data clearly links deficiency of leptin and insulin signaling to both alterations of energy homeostasis control and predisposition to AD. Furthermore, environment changes leading to insulin and leptin-resistance may promote these defects, such as high fat diet.