Division of Diabetes, Endocrinology and Metabolism, Michael E DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas, USA.
Vitam Horm. 2013;92:61-106. doi: 10.1016/B978-0-12-410473-0.00003-9.
Anorexia, sarcopenia, and cachexia are common complications of many chronic conditions including cancer, rheumatoid arthritis, HIV infection, aging, and chronic lung, heart, or kidney disease. Currently, there is no effective treatment for muscle atrophy or wasting conditions although they typically take a significant toll on the quality of life of patients and are associated with poor prognosis and decreased survival. Ghrelin affects multiple key pathways in the regulation of body weight, body composition, and appetite in the setting of cachexia that may lead to an increase in appetite and growth hormone secretion and a reduction in energy expenditure and inflammation. The net effect is increased lean body mass and fat mass preservation. In this chapter, we review the mechanisms of action of ghrelin and present the available data in animal models and human trials using ghrelin or ghrelin mimetics in different settings of cachexia.
厌食症、肌肉减少症和恶病质是许多慢性疾病的常见并发症，包括癌症、类风湿性关节炎、HIV 感染、衰老以及慢性肺部、心脏或肾脏疾病。目前，尽管肌肉萎缩或消耗性疾病通常会显著降低患者的生活质量，并与不良预后和生存率降低相关，但还没有针对这些疾病的有效治疗方法。Ghrelin 在恶病质的情况下影响调节体重、身体成分和食欲的多个关键途径，可能导致食欲增加和生长激素分泌增加，同时减少能量消耗和炎症。其净效应是增加瘦体重和脂肪量的保留。在本章中，我们回顾了 ghrelin 的作用机制，并介绍了在不同恶病质情况下使用 ghrelin 或 ghrelin 类似物的动物模型和人体试验中的现有数据。
