Novel connections between the neuroendocrine and immune systems: the ghrelin immunoregulatory network

There appears to be bidirectional communication between the neuroendocrine and immune systems. This communication is mediated by way of an array of cytokines, hormones, and neuropeptides. Inflammatory cytokines released by immune cells have been shown to act on the central nervous system to control food intake and energy homeostasis. Decrease in food intake or anorexia is one of the most common symptoms of illness, injury, or inflammation. The adipocyte-derived hormone, leptin, is considered a critical sensory anorexigenic mediator that signals to the brain changes in stored energy, determined by an altered balance between food intake and energy expenditure and has been shown to exert certain proinflammatory effects on immune cells. In contrast, ghrelin, the endogenous ligand for growth hormone secretagogue receptors (GHSRs), is produced primarily from stomach serving as a potent circulating orexigen controlling energy expenditure, adiposity, and GH secretion. However, the functional role of ghrelin and GHS in immune cell function remains unclear. Here, we review the current literature supporting a role for ghrelin in controlling inflammation and immunity and the potential therapeutic use of ghrelin and GHSR agonists in the management of inflammation and in restoration of thymic function in immunocompromised individuals.