An update on visfatin/pre-B cell colony-enhancing factor, an ubiquitously expressed, illusive cytokine that is regulated in obesity

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Abstract
The aim of this article is to summarize all of the recent studies on pre-B cell colony-enhancing factor visfatin, a ubiquitously expressed secreted protein that has been implicated in obesity and insulin resistance. Although pre-B-cell colony-enhancing factor was discovered over 10 years ago, there are many remaining questions about the regulation and function of this protein. Studies in the last decade have revealed the endocrine properties of fat cells. One of the most recent proteins shown to be highly expressed in adipose tissue is visfatin, originally identified as pre-B-cell colony-enhancing factor. Visfatin/pre-B-cell colony-enhancing factor appears to be preferentially produced by the visceral adipose tissue and has insulin mimetic actions. Studies by many groups indicate that obesity-related diabetes and accompanying metabolic disorders in humans have been specifically linked to increased visceral adipose tissue mass. The different roles of various adipocyte depots, however, are still poorly understood. It has been hypothesized that understanding the differences in the biology of visceral and subcutaneous human adipose tissue may hold the key to therapeutic strategies aimed at reducing obesity-induced insulin resistance and alleviating symptoms of the metabolic syndrome. Interestingly, some observed actions of visfatin indicate that this secreted protein may be an interesting therapeutic target. Several recent studies, however, indicate that our understanding of visfatin is still speculative. This review summarizes all of the papers in the last year on the expression and function of visfatin/pre-B-cell colony-enhancing factor and highlights inconsistent observations from various investigators studying this protein. It also highlights previous observations on the role of pre-B-cell colony-enhancing factor. We suggest that the pathophysiologic role of visfatin/pre-B-cell colony-enhancing factor in humans remains largely unknown.

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