title: Clinical review: The human experience with ghrelin administration.
abstract: BACKGROUND
  Ghrelin is an endogenous stimulator of GH and is implicated in a number of physiological processes. Clinical trials have been performed in a variety of patient populations, but there is no comprehensive review of the beneficial and adverse consequences of ghrelin administration to humans.
  
  
  METHODS
  PubMed was utilized, and the reference list of each article was screened. We included 121 published articles in which ghrelin was administered to humans.
  
  
  RESULTS
  Ghrelin has been administered as an infusion or a bolus in a variety of doses to 1850 study participants, including healthy participants and patients with obesity, prior gastrectomy, cancer, pituitary disease, diabetes mellitus, eating disorders, and other conditions. There is strong evidence that ghrelin stimulates appetite and increases circulating GH, ACTH, cortisol, prolactin, and glucose across varied patient populations. There is a paucity of evidence regarding the effects of ghrelin on LH, FSH, TSH, insulin, lipolysis, body composition, cardiac function, pulmonary function, the vasculature, and sleep. Adverse effects occurred in 20% of participants, with a predominance of flushing and gastric rumbles and a mild degree of severity. The few serious adverse events occurred in patients with advanced illness and were not clearly attributable to ghrelin. Route of administration may affect the pattern of adverse effects.
  
  
  CONCLUSIONS
  Existing literature supports the short-term safety of ghrelin administration and its efficacy as an appetite stimulant in diverse patient populations. There is some evidence to suggest that ghrelin has wider ranging therapeutic effects, although these areas require further investigation.
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, Pennsylvania 19104-5160, USA.
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Garin
authors.forename: Carrie M
authors.initials: CM
authors.lastname: Burns
authors.forename: Shailja
authors.initials: S
authors.lastname: Kaul
authors.forename: Anne R
authors.initials: AR
authors.lastname: Cappola
mesh_terms: D019167:Appetite Stimulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002149:Energy Intake / Q000187:drug effects; D005483:Flushing / Q000139:chemically induced / Q000503:physiopathology; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000503:physiopathology; D054439:Ghrelin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000819:agonists*; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012720:Severity of Illness Index
chemical_list: D019167:Appetite Stimulants; C515349:GHRL protein, human; D054439:Ghrelin; D011994:Recombinant Proteins; D019382:Human Growth Hormone