Adiponectin in health and disease: evaluation of adiponectin-targeted drug development strategies

Adiponectin is a secretory protein predominantly expressed by adipocytes and released at a high rate into circulation. The ease with which the levels of adiponectin can be measured owing to its high abundance, small diurnal variation and high stability in plasma have made it a popular target for measurements in many clinical studies. It has emerged as a valuable biomarker for insulin sensitivity, cardiovascular risk and inflammation. However, adiponectin levels have been measured in many additional disease states. Preclinical studies not only have implicated adiponectin as an outstanding biomarker but also have demonstrated direct cardioprotective and insulin-sensitizing properties to be associated with the protein. Adiponectin might, therefore, be a viable protein therapeutic that could be supplied in a recombinant form in the context of type 2 diabetes and cardiovascular disease. However, the high abundance, complex tertiary and quaternary structure and rapid turnover might make chronic administration of the protein rather challenging.