Clinical review: The human experience with ghrelin administration

Area of Science:

• Endocrinology
• Pharmacology
• Clinical Medicine

Background:

• Ghrelin is an endogenous growth hormone (GH) stimulator involved in numerous physiological processes.
• Previous clinical trials have explored ghrelin administration, but a comprehensive review of its human effects is lacking.

Purpose of the Study:

• To comprehensively review the beneficial and adverse consequences of ghrelin administration in humans.
• To synthesize evidence from published studies on ghrelin's effects across diverse patient populations.

Main Methods:

• A systematic literature search was conducted using PubMed.
• The reference lists of identified articles were screened for relevant studies.
• A total of 121 published articles involving human ghrelin administration were included.

Main Results:

• Ghrelin administration (infusion or bolus) in 1850 participants showed it stimulates appetite and increases GH, ACTH, cortisol, prolactin, and glucose.
• Evidence is limited regarding ghrelin's effects on reproductive hormones (LH, FSH), thyroid hormones (TSH), insulin, lipolysis, body composition, cardiac/pulmonary function, vasculature, and sleep.
• Adverse effects (flushing, gastric rumbles) occurred in 20% of participants, generally mild; serious events were rare and not clearly linked to ghrelin.

Conclusions:

• Current literature supports the short-term safety of ghrelin administration.
• Ghrelin is effective as an appetite stimulant in diverse patient populations.
• Wider therapeutic effects of ghrelin are suggested but require further investigation.