{"title":"Leptin: 30 Years Later.","authors":"Rexford S Ahima, Jeffrey S Flier","doi":"10.1146/annurev-physiol-042324-100259","DOIUrl":"https://doi.org/10.1146/annurev-physiol-042324-100259","url":null,"abstract":"<p><p>The discovery of leptin as an adipocyte-secreted hormone encoded by the <i>ob</i> gene whose absence produces severe obesity that is corrected by leptin repletion in both mice and humans was a transformative event in metabolic science. Leptin's discovery in 1994 accelerated the identification of central neuronal circuitry responsive to peripheral signals that regulate energy balance as well as metabolic, neuroendocrine, and other vital functions. Leptin's primary physiological role was initially viewed as preventing obesity by its levels rising, but subsequent research has emphasized the key role of falling levels to signal starvation. Resistance to leptin action, though partial, characterizes common forms of obesity. Despite much being learned about leptin signal transduction over 30 years, the precise molecular mechanisms for leptin resistance and common obesity remain unclear. Leptin therapy is effective in rare patients with congenital leptin deficiency and other low leptin conditions but not common obesity. Interestingly, reducing hyperleptinemia may prove useful in treating common obesity.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":""},"PeriodicalIF":19.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amit Grover, Evgenii N Tcyganov, Dmitry I Gabrilovich
{"title":"Myeloid Cell Reprogramming and Immune Suppression.","authors":"Amit Grover, Evgenii N Tcyganov, Dmitry I Gabrilovich","doi":"10.1146/annurev-physiol-050824-111031","DOIUrl":"https://doi.org/10.1146/annurev-physiol-050824-111031","url":null,"abstract":"<p><p>Plasticity of myeloid cells, characterized by their ability to undergo reprogramming in response to environmental cues, is a fundamental feature enabling their versatile functions during immune responses. Macrophages and neutrophils, the primary myeloid cell types, exhibit distinct polarization states. Classical polarization states of macrophages and neutrophils are associated with antimicrobial activity, inflammation promotion, and tissue remodeling. Pathological polarization, observed in chronic inflammation, cancer, and other conditions, is marked by enhanced immune-suppressive activity, aberrant enzymatic activity, and atypical cytokine production, diverging from their classical functions. This review delves into the most up-to-date characterization of those polarization states, the transcriptional and epigenetic factors, and the metabolic pathways governing myeloid cell reprogramming, highlighting the influence of cytokines and tissue-specific conditions, such as hypoxia in tumors, on this process. Understanding the mechanisms underlying the pathological polarization of myeloid cells offers a promising avenue to modulate their activity for targeted therapeutic interventions.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":""},"PeriodicalIF":19.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Developmental Origins of Asthma and COPD.","authors":"Francesca Polverino, Don D Sin","doi":"10.1146/annurev-physiol-042924-084007","DOIUrl":"https://doi.org/10.1146/annurev-physiol-042924-084007","url":null,"abstract":"<p><p>Approximately two-thirds of cases of chronic obstructive pulmonary disease (COPD) and adult asthma are in part driven by impaired lung development related to early-life events. Many children who suffer insults to their lungs during the first few years of life experience abnormal lung development, growth, and/or maturation, leading to impaired lung function, which may persist throughout their lifespan. This abnormal lung trajectory may be exacerbated by lung dysanapsis, genetic and epigenetic alterations, oxidative stress and/or inflammation in the airways related to environmental factors including exposure to active or secondhand smoke, air pollution, poor nutrition and social deprivation, and repeated childhood respiratory tract infections. Children with asthma may transition to COPD in adulthood if their asthma is poorly controlled or in the presence of other risk factors such as smoking. As many of these factors are modifiable, prompt diagnosis and implementation of preventive measures should be considered as early as possible in children at risk for abnormal lung development. This review provides an update on the interplay between genetic, environmental, and socioeconomic factors, their cumulative impact on lung development, and its implication for the risk and burden of asthma and COPD in the global population.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":""},"PeriodicalIF":19.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Managing Glucose Homeostasis Through the Gut Microbiome.","authors":"Savanna N Weninger, Andrew Manley, Frank A Duca","doi":"10.1146/annurev-physiol-051524-094728","DOIUrl":"https://doi.org/10.1146/annurev-physiol-051524-094728","url":null,"abstract":"<p><p>The gut microbiota is a salient contributor to the development of type 2 diabetes mellitus (T2D) as a vast and complex metabolic cross talk that exists between the bacteria residing in the gastrointestinal tract and the host. This cross talk is largely influenced by external factors including diet, highlighting a potential avenue to effectively manipulate the gut microbiota to treat metabolic diseases such as diabetes. In this review, we discuss the influence of the gut microbiota on T2D development and targeting gut microbiota in both current and novel treatments for T2D, highlighting potential alternative therapies including fecal microbiota transplant, prebiotics, probiotics, synbiotics, or xenobiotics. A better understanding of both the impact of the gut microbiota in the etiology of diabetes and the therapeutic potential for manipulating the gut microbiota in metabolic disease could usher in a new approach to targeted treatment options to ameliorate T2D.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":""},"PeriodicalIF":19.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel Q Muir, Jiaojiao Xu, Alexandra D Medcalf, Jennifer L Pluznick
{"title":"Novel Advances in Our Understanding of Sex-Dependent Control of Blood Pressure.","authors":"Rachel Q Muir, Jiaojiao Xu, Alexandra D Medcalf, Jennifer L Pluznick","doi":"10.1146/annurev-physiol-050724-022450","DOIUrl":"https://doi.org/10.1146/annurev-physiol-050724-022450","url":null,"abstract":"<p><p>Sex differences in blood pressure are evident from puberty through menopause, with premenopausal females exhibiting lower blood pressure than males. This review discusses key factors contributing to sex differences in blood pressure, focusing on the normotensive state. Key contributions from a number of systems are discussed, including cardiovascular and renal function, oxidative stress, immune cell involvement, the microbiome, and the roles of the nervous system and renin-angiotensin-aldosterone system. Additionally, we highlight novel advances in the field, including findings related to the G protein-coupled estrogen receptor (GPER), Klotho, olfactory receptor 558 (OLFR558), and the four-core genotype (FCG) model. Insights from clinical data and their implications for hypertension management are also considered. In sum, this review aims to integrate current knowledge on sex differences in blood pressure regulation to inform future research and clinical care.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":""},"PeriodicalIF":19.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annual review of physiologyPub Date : 2025-02-01Epub Date: 2025-02-03DOI: 10.1146/annurev-physiol-042022-014322
Dawn L DeMeo
{"title":"Sex, Gender, and COPD.","authors":"Dawn L DeMeo","doi":"10.1146/annurev-physiol-042022-014322","DOIUrl":"10.1146/annurev-physiol-042022-014322","url":null,"abstract":"<p><p>Sex and gender have emerged as critical considerations relevant to chronic obstructive pulmonary disease (COPD). Sex differences in lung development and physiologic response to hormones and environmental exposures influence COPD susceptibility, progression, severity, morbidity, and mortality. Gender has been poorly measured in the context of COPD, and gendered exposures further impact biology. The hormonal milieu is critical to study across the life course. Differences in immunity and inflammation likely impact sex- and gender-related features of COPD. Emerging evidence from multiple types of omics data is revealing new genes and pathways to consider as relevant to sex- and gender-divergent features of COPD. Much research to date has focused on autosomes, but the growing awareness of a role for allosomes is highlighting knowledge gaps. Reproductive aging impacts lung function and requires more investigation. Network medicine holds promise as an approach to sex and gender omics to uncover drivers of COPD in men and women.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":"471-490"},"PeriodicalIF":15.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annual review of physiologyPub Date : 2025-02-01Epub Date: 2025-02-03DOI: 10.1146/annurev-physiol-022724-104938
Charlotte E R Smith, Haibo Ni, Eleonora Grandi
{"title":"Sex Differences in Electrophysiology and Calcium Handling in Atrial Health and Fibrillation.","authors":"Charlotte E R Smith, Haibo Ni, Eleonora Grandi","doi":"10.1146/annurev-physiol-022724-104938","DOIUrl":"10.1146/annurev-physiol-022724-104938","url":null,"abstract":"<p><p>The importance of biological sex on disease etiology and outcomes has long been underinvestigated. While recent focus on characterizing sex differences in cardiac pathophysiology has led to improved inclusion of both sexes in scientific studies and clinical trials, much is still unknown about underlying differences in normal cardiac physiology. This is particularly true for the atria, where the most common arrhythmia, atrial fibrillation (AF), occurs. AF is associated with adverse structural, electrophysiological, and calcium handling remodeling that leads to patient morbidity and mortality. Differences in the onset, prevalence, presentation, and prognosis of AF are known to differ between males and females, yet the sex-specific baseline phenotypes from which AF arises are not well characterized. This review examines what is currently known about sex differences in atrial physiology, the alterations that occur in AF, potential mechanisms underlying sex divergence, and the need for sex-targeted therapeutic strategies.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":"1-24"},"PeriodicalIF":19.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annual review of physiologyPub Date : 2025-02-01Epub Date: 2025-02-03DOI: 10.1146/annurev-physiol-022724-105119
Virgilio L Lew
{"title":"The Calcium Homeostasis of Human Red Blood Cells in Health and Disease: Interactions of PIEZO1, the Plasma Membrane Calcium Pump, and Gardos Channels.","authors":"Virgilio L Lew","doi":"10.1146/annurev-physiol-022724-105119","DOIUrl":"10.1146/annurev-physiol-022724-105119","url":null,"abstract":"<p><p>Calcium ions mediate the volume homeostasis of human red blood cells (RBCs) in the circulation. The mechanism by which calcium ions affect RBC hydration states always follows the same sequence. Deformation of RBCs traversing capillaries briefly activates mechanosensitive PIEZO1 channels, allowing Ca2+ influx down its steep inward gradient transiently overcoming the calcium pump and elevating [Ca2+]<sub>i</sub>. Elevated [Ca2+]<sub>i</sub> activates the Ca2+-sensitive Gardos channels, inducing KCl loss and cell dehydration, a sequence operated with infinite variations in vivo and under experimental conditions. The selected health and disease themes for this review focus on landmark experimental results that led to the development of highly constrained models of the circulatory changes in RBC homeostasis. Based on model predictions, a new perspective emerged, pointing to PIEZO1 dysfunction as the main trigger in the formation of the profoundly dehydrated irreversible sickle cells, the main pathogenic participants in vaso-occlusion, the root cause of sickle cell disease.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":"257-277"},"PeriodicalIF":15.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mechanisms and Implications of Electrical Heterogeneity in Cardiac Function in Ischemic Heart Disease.","authors":"Hector Martinez-Navarro, Xin Zhou, Blanca Rodriguez","doi":"10.1146/annurev-physiol-042022-020541","DOIUrl":"10.1146/annurev-physiol-042022-020541","url":null,"abstract":"<p><p>A healthy heart shows intrinsic electrical heterogeneities that play a significant role in cardiac activation and repolarization. However, cardiac diseases may perturb the baseline electrical properties of the healthy cardiac tissue, leading to increased arrhythmic risk and compromised cardiac functions. Moreover, biological variability among patients produces a wide range of clinical symptoms, which complicates the treatment and diagnosis of cardiac diseases. Ischemic heart disease is usually caused by a partial or complete blockage of a coronary artery. The onset of the disease begins with myocardial ischemia, which can develop into myocardial infarction if it persists for an extended period. The progressive regional tissue remodeling leads to increased electrical heterogeneities, with adverse consequences on arrhythmic risk, cardiac mechanics, and mortality. This review aims to summarize the key role of electrical heterogeneities in the heart on cardiac function and diseases. Ischemic heart disease has been chosen as an example to show how adverse electrical remodeling at different stages may lead to variable manifestations in patients. For this, we have reviewed the dynamic electrophysiological and structural remodeling from the onset of acute myocardial ischemia and reperfusion to acute and chronic stages post-myocardial infarction. The arrhythmic mechanisms, patient phenotypes, risk stratification at different stages, and patient management strategies are also discussed. Finally, we provide a brief review on how computational approaches incorporate human electrophysiological heterogeneity to facilitate basic and translational research.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":"25-51"},"PeriodicalIF":15.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annual review of physiologyPub Date : 2025-02-01Epub Date: 2025-02-03DOI: 10.1146/annurev-physiol-022724-105443
Ricardo J Samms, Christine M Kusminski
{"title":"A Mechanistic Rationale for Incretin-Based Therapeutics in the Management of Obesity.","authors":"Ricardo J Samms, Christine M Kusminski","doi":"10.1146/annurev-physiol-022724-105443","DOIUrl":"10.1146/annurev-physiol-022724-105443","url":null,"abstract":"<p><p>Driven by increased caloric intake relative to expenditure, obesity is a major health concern placing economic and operational strain on healthcare and social care worldwide. Pharmacologically, one of the most effective avenues for the management of excess adiposity is the suppression of appetite. However, owing to the body's natural physiological defense to weight loss and tolerability issues that typically accompany anorectic agents, leveraging this approach to induce sustained weight loss is often easier said than done. As such, to address these challenges, researchers have coupled a thorough understanding of the gut-brain axis with advancements in peptide engineering to design therapeutics mimicking the actions of endocrine hormones to promote a negative energy balance. Indeed, multireceptor agonists targeting the GLP-1, GIP, and glucagon receptors produce meaningful weight loss in people with obesity. Herein, we provide a rationale for how activation of the GIP receptor in the brain and the glucagon receptor in the liver and adipose tissue functions to synergize with GLP-1 receptor agonism to curb the drive to feed and ignite the combustion of excess calories for providing next-generation weight loss.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":"279-299"},"PeriodicalIF":15.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}