Assessment of ghrelin

Four years ago Kojima and coworkers discovered ghrelin. Within this short lifespan ghrelin has become one of the "hottest topics" in metabolic research, and today more than 300 papers have emerged (PubMed search). The huge interest in ghrelin is partly due to its involvement in appetite regulation. Over-nutrition, obesity and type 2 diabetes are major burdens of health services in all Western countries, and the discovery of ghrelin opens for the development of antagonists that may make it possible to control appetite and food intake. At the other end of the nutritional scale, ghrelin agonists may be used in cachexia in e.g. anorexia nervosa and cancer. Thus, the potential clinical value of ghrelin research appears to be enormous. At the time of writing several in-house as well as commercial ghrelin assays have been developed. However, we still need to come to a consensus on measurement of circulating ghrelin levels. Up till now, blood ghrelin has been estimated by use of serum as well as various types of plasma, with or without extraction prior to assay. This may affect both results and conclusions. In the present paper we shall review the current literature on ghrelin, with special focus on measurements in human blood specimens.