Abstract
Ghrelin is an endogenous ligand for the growth hormone secretagogue receptor. Findings from the past decade indicate that ghrelin induces a positive energy balance and weight gain by stimulating food intake and adiposity, controlling fat utilization and thermogenesis, increasing cardiac output, and attenuating sympathetic nerve activity. In small studies, repeated ghrelin administration leads to improvements in symptoms, muscle wasting and exercise tolerance in cachectic patients with pulmonary disease.
In this randomized, dose-comparison study, 44 weight loosing patients with COPD or IPF or pulmonary tuberculosis sequelae were randomly assigned exercise training with intravenous twice-daily administration of 1 or 2 μg/kg ghrelin for 3 weeks. The primary outcome was improvement in 6-min walking distance (6MWD). The secondary outcome was change in peak VO2.
Of the enrolled 44 patients, 35 cases were COPD, 4 cases were IPF and 5 cases were pulmonary tuberculosis sequelae. Twenty-one patients were assigned to the 1 μg/kg ghrelin group and 23 to the 2 μg/kg ghrelin group. Improvements from the pre-intervention 6MWD after the treatment were similar between groups. Mean increases in peak VO2 were significantly greater in the 2 μg/kg group (63.1ml/min) than in the 1 μg/kg group (-63.8ml/min). No treatment-related serious adverse events were reported.
Increase in the oxygen uptake capacity was greater in patients receiving 2 μg/kg ghrelin than in those receiving 1 μg/kg. Ghrelin treatment was well tolerated.
- Copyright ©ERS 2015
