Review Article

The Prokinetic Face of Ghrelin

Table 1

Prokinetic effects of exogenous ghrelin on gastric motility in healthy human volunteers (D-Lys). GHRP-6: GHRP receptor antagonist; GE: gastric emptying; GHRP-6: ghrelin secretagogue receptor 6 (non-synthetic ghrelin receptor agonist); GHS-R: growth hormone secretagogue receptor; IV: intravenous; MI; motility index; MMC: migrating motor complex; SPECT: single photon emission computed tomography; VAS: visual analogue scale.

AuthorSubjectsStudy designGhrelin typeEffective doseMethodsResults

Levin F., [39]Healthy volunteers (5M, 3F)Randomized, double-blind, placebo-controlled, crossoverGhrelin10 pmol/Kg/min for 180 min after mealAssessment of solid GE by scintigraphyGhrelin accelerated the rate of GE

Tack J., [35]Healthy fasting volunteers (4F, 5M)Cross-sectionalGhrelin (Clinalfa, Switzerland)40  𝜇 g IV infusion over 30 min given 20 min after the end of phase III of MMCsAssessment of antroduodenal motility and gastric tone by manometry
and barostat
Ghrelin induced premature phase III contractions and increased the tone of the proximal stomach

Cremonini F., [37]Healthy volunteers: obese (5M, 20F) andRandomized, parallel-group, one dose, double-blind, placebo-controlledGhrelin (Clinalfa, Switzerland)0.33  𝜇 g/Kg IV given 10 minutes after IV injection of 9 9 m Tc-pertechnetateAssessment of gastric volume and emptying by SPECTGhrelin marginally decreased fasting gastric volumes, but not GE or symptoms
normal weight (13F)Assessment of symptoms by VAS

Bisschops R., [36]Healthy volunteers ( 𝑛 = 9 )No information( i ) Ghrelin40  𝜇 g IV infusion over 30 min given 20 min after the end of phase III of MMCsAssessment of antroduodenal pressures by manometry and gastric tone by barostat( i ) Ghrelin induced phase III contractions of gastric origin; those were of increased amplitude and duration.
( i i ) GHRP-6(Clinalfa, Switzerland)( i i ) Ghrelin increased proximal gastric tone

Ang D., [38]Healthy volunteers (4M, 6F)Randomized, placebo-controlled, double-blind, cross overGhrelin40  𝜇 g IV infusion over 30 min given10 min before mealAssessment of gastric accommodation by barostat( i ) Ghrelin inhibited gastric accommodation and decreased postprandial gastric volumes
( i i ) Ghrelin had no effects on postprandial symptoms