In our opinion, leptin thereby does not directly trigger inflammation (otherwise rLeptin replacement should cause autoimmunity in all forms of lipodystrophy, which is not the case), but is instead enhancing autoimmunity by facilitating the production of pro-inflammatory cytokines such as TNFα and by regulating immune cell differentiation and cellular expansion of auto-reactive lymphocytes. This evidence concerns the gene LEP and lipodystrophy.