Pharmacological Modulation of Ghrelin to Induce Weight Loss: Successes and Challenges

Curr Diab Rep. 2019 Sep 10;19(10):102. doi: 10.1007/s11892-019-1211-9.

Abstract

Purpose of review: Obesity is affecting over 600 million adults worldwide and has numerous negative effects on health. Since ghrelin positively regulates food intake and body weight, targeting its signaling to induce weight loss under conditions of obesity seems promising. Thus, the present work reviews and discusses different possibilities to alter ghrelin signaling.

Recent findings: Ghrelin signaling can be altered by RNA Spiegelmers, GHSR/Fc, ghrelin-O-acyltransferase inhibitors as well as antagonists, and inverse agonists of the ghrelin receptor. PF-05190457 is the first inverse agonist of the ghrelin receptor tested in humans shown to inhibit growth hormone secretion, gastric emptying, and reduce postprandial glucose levels. Effects on body weight were not examined. Although various highly promising agents targeting ghrelin signaling exist, so far, they were mostly only tested in vitro or in animal models. Further research in humans is thus needed to further assess the effects of ghrelin antagonism on body weight especially under conditions of obesity.

Keywords: Antagonist; GOAT; Ghrelin-O-acyl transferase; Growth hormone; Inverse agonist; Obesity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Obesity Agents / pharmacology
  • Anti-Obesity Agents / therapeutic use
  • Body Weight / drug effects
  • Disease Models, Animal
  • Ghrelin / antagonists & inhibitors
  • Ghrelin / metabolism*
  • Humans
  • Obesity / drug therapy*
  • Obesity / metabolism
  • Receptors, Ghrelin / agonists
  • Receptors, Ghrelin / antagonists & inhibitors
  • Receptors, Ghrelin / metabolism*
  • Weight Loss / physiology*

Substances

  • Anti-Obesity Agents
  • Ghrelin
  • Receptors, Ghrelin