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The ghrelin system
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This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.
Ghrelin is now a well known hormone that has actions both in the hypothalamo-pituitary system as well as the gut, and also has a regulatory role in metabolism. Current evidence suggests that ghrelin has a plethora of actions on several systems that have been well outlined and discussed in this book. There are 16 chapters in the book written by experts principally devoted to decipher the action of ghrelin in their respective areas of research.
Starting from the discovery of ghrelin and its actions on the G-coupled receptors, various authors have outlined the role of ghrelin in the functions of the gut; its neuroendocrine actions; possible actions on the cardiovascular system including its ability to lower peripheral resistance, cardioprotective actions; and in the release of insulin. Its regulatory role in glucose metabolism and thus its involvement in the pathobiology of obesity and type 2 diabetes mellitus has also been discussed. All the chapters are well written outlining not only the authors’ own work but also current advances in the respective areas of work done by others.
The only criticism about this book is the lack of any reference to the role of ghrelin in sepsis and a detailed discussion about its anti-inflammatory action. There is a brief mention about the anti-inflammatory role/action of ghrelin and a passing mention about its usefulness in ischaemia/reperfusion injury. The cytoprotective actions of ghrelin especially against ischaemic injury imply that it may play a role in cardiovascular diseases especially in myocardial infarction. The anti-inflammatory action of ghrelin is particularly relevant to its suggested role in the management of sepsis/septic shock.
Thus, ghrelin is not only a growth hormone secretagogue produced by the gut, but it may also have an important role in some inflammatory conditions. Ghrelin not only plays an important role in the regulation of appetite, energy balance and glucose homeostasis, but also shows antibacterial activity, suppresses pro-inflammatory cytokine production and restores gut-barrier function. In experimental animals, ghrelin showed significant beneficial actions in preventing mortality from sepsis. In the critically ill, corticosteroid insufficiency as a result of dysfunction of the hypothalamic-pituitary-adrenal axis is known to occur. It is, therefore, possible that both gut and hypothalamus play an important role in the pathogenesis of sepsis by virtue of their ability to produce ghrelin, which, in turn, could be a protective phenomenon to suppress inflammation. However, it remains to be seen whether ghrelin and its analogues are of benefit in treating patients with sepsis and other inflammatory conditions.
Despite some limitations, this book is a comprehensive guide for those who wish to update themselves about ghrelin. This book is especially useful to those who are new entrants in this area. Reading this book will not only give a comprehensive knowledge of ghrelin but also provides what is not known about it. The references provided are also comprehensive and useful.
