Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA 22908, USA.
Mol Cell Endocrinol. 2011 Jun 20;340(1):97-105. doi: 10.1016/j.mce.2011.02.012. Epub 2011 Feb 25.
Cachexia is a syndrome of wasting and anorexia that worsens the prognosis of many chronic diseases including cancer, chronic kidney disease, chronic heart disease and chronic obstructive pulmonary disease. Properties of the orexigenic hormone ghrelin-including appetite-stimulation, weight-gain production and increased cardiac output make it a logical treatment for cachexia. While endogenous ghrelin levels are increased in the setting of cachexia, treatment with ghrelin and other GHSR-1a agonists in animal models of cachexia and in humans with cachexia has demonstrated consistent effects of increased appetite and improved weight gain. These positive effects occur in multiple underlying diseases associated with cachexia and appear to be sustained over treatment duration of up to 12 weeks. The mechanism of action in producing these effects is likely related to stimulation of central appetite centers such as the central melanocortin system and to increased growth hormone release, though ghrelin's effects may also relate to decreased systemic inflammation and other direct and indirect actions. Questions regarding the long-term safety of ghrelin treatment are still unanswered, as is the important question of whether successful treatment of cachexia will improve the prognosis of the underlying disease itself.
恶病质是一种消耗和厌食的综合征，会使许多慢性疾病（包括癌症、慢性肾病、慢性心脏病和慢性阻塞性肺疾病）的预后恶化。促食欲激素胃饥饿素具有刺激食欲、增加体重和增加心输出量等特性，使其成为治疗恶病质的合理选择。虽然恶病质患者体内的内源性胃饥饿素水平升高，但在恶病质动物模型和恶病质患者中使用胃饥饿素和其他 GHSR-1a 激动剂治疗，均显示出食欲增加和体重增加改善的一致效果。这些积极影响出现在与恶病质相关的多种基础疾病中，并且似乎在长达 12 周的治疗期间持续存在。产生这些效果的作用机制可能与刺激中枢食欲中心（如中枢黑色素皮质系统）和增加生长激素释放有关，尽管胃饥饿素的作用也可能与降低全身炎症和其他直接和间接作用有关。关于胃饥饿素治疗的长期安全性问题仍未得到解答，同样重要的问题是成功治疗恶病质是否会改善基础疾病本身的预后。
