Resistin, also known as adipose tissue-specific secretory factor (ADSF) or C/EBP-epsilon-regulated myeloid-specific secreted cysteine-rich protein (XCP1), is a cysteine-rich peptide hormone that is derived from adipose tissue and, in humans, is encoded by the RETN gene.
In primates, pigs, and dogs, resistin is secreted primarily by immune and epithelial cells, whereas in rodents, it is mainly secreted by adipose tissue. The human resistin pre-peptide consists of 108 amino acid residues, while in mice and rats it is 114 amino acids in length; the molecular weight is approximately 12.5 kDa. Resistin is classified as an adipose-derived hormone (similar to a cytokine), and its physiological role has been widely debated, particularly regarding its involvement in obesity and type II diabetes mellitus (T2DM).
Discovery and structure
Resistin was discovered in 2001 and identified as a hormone produced by adipose tissue, with a role in promoting insulin resistance. Specifically, elevated resistin levels appear to interfere with the action of insulin on adipose cells. Subsequent studies noted a link between resistin and activation of pro-inflammatory cytokines.
Resistin is a cysteine-rich, secreted peptide hormone characterized by a unique multimeric structure. Each resistin monomer consists of a C-terminal, disulfide-rich beta-sandwich "head" domain and an N-terminal alpha-helical "tail" segment. The head domain adopts a six-stranded jelly-roll topology, forming two three-stranded antiparallel beta-sheets, while the tail segments associate to create three-stranded coiled coils.
Beyond its pro-inflammatory effects, resistin also demonstrates direct antimicrobial activity by damaging bacterial membranes, and it modulates immune responses by recruiting and activating immune cells, promoting chemokine production, and enhancing the formation of neutrophil extracellular traps (NETs). Conversely, serum resistin levels decline with decreased adiposity following medical treatment. Specifically, central obesity (waistline adipose tissue) is the region of adipose tissue that contributes most to rising levels of serum resistin. This is significant, considering the link between central obesity and insulin resistance, two marked peculiarities of T2DM. On the other hand, at least one study has found no correlation between resistin levels and obesity or insulin resistance in humans, so the resistin–insulin resistance connection may be regarded as somewhat unsettled.
Although resistin levels increase with obesity, it is questioned whether this increase is responsible for the insulin resistance associated with increased adiposity. Several reports have shown a positive correlation between resistin levels and insulin resistance. This is supported by reports of correlation between resistin levels and subjects with T2DM. If resistin contributes to the pathogenesis of insulin resistance in T2DM, then designing drugs to promote decreased serum resistin in T2DM subjects may deliver therapeutic benefits.
Resistin can increase levels of circulating low-density lipoprotein (LDL) and accelerates LDL accumulation in arteries, increasing risk of heart disease has an adverse impact on the efficacy of statins, the primary drug used to reduce cholesterol in fighting of cardiovascular disease. In the liver, resistin increases LDL production and degrades LDL receptors, impairing the ability to process LDL.
Inflammation
Beyond its role as a hormone, resistin also contributes to inflammation. Interleukin-12 (IL-12) and tumor necrosis factor-α (TNF-α) are up-regulated by resistin in an NF-κB-mediated fashion. Likewise, in vitro studies show Toll-like receptor 2 expression is increased by resistin. Resistin itself can be upregulated by interleukins and also by microbial antigens such as lipopolysaccharide, which are recognized by leukocytes. Together, these findings suggest resistin may be a link in the well-known association between inflammation and insulin resistance.
Resistin also seems to be a marker of inflammation in semen. Resistin levels correlate positively with those of proinflammatory mediators such as interleukin-6 (IL-6), elastase and tumor necrosis factor-α (TNF-α) in seminal plasma. During inflammation, the concentrations of cytokines and ROS increase, and this may have a deleterious effect on the male reproductive function. One study showed that there was a negative correlation between the concentrations of seminal resistin and spermatic motility and vitality.
References
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This was reference 12, couldn't find any reference to it, although there were two references to ref. 22 so perhaps one of them should be to this one
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