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Ghrelin and Blood Pressure Regulation

  • Hypertension and Metabolic Syndrome (J Sperati, Section Editor)
  • Published:
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Abstract

Ghrelin is a growth hormone-releasing polypeptide that was first isolated from the rat stomach in 1999. High expression of growth hormone secretagogue receptor, the ghrelin receptor, in the heart, kidney, and blood vessels provides evidence of ghrelin activity in blood pressure regulation. Circulating ghrelin concentrations are reported to be inversely correlated with blood pressure, and the acute and chronic effects of ghrelin in decreasing blood pressure have been reported in animals with normal blood pressure, healthy individuals, animals and patients with heart failure, and animals with hypertension. The mechanism by which ghrelin regulates blood pressure appears to be related to modulation of the autonomic nervous system, direct vasodilatory activities, and kidney diuresis. Thus, modulation of the signaling pathway through ghrelin may provide a novel concept for treating hypertension. In this review, we discuss the current evidence and potential mechanisms of ghrelin activity in blood pressure regulation.

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References

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  1. Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature. 1999;402(6762):656–60.

    Article  CAS  PubMed  Google Scholar 

  2. Müller TD, Nogueiras R, Andermann ML, Andrews ZB, Anker SD, Argente J, et al. Ghrelin. Mol Metab. 2015;4(6):437–60.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Pöykkö SM, Kellokoski E, Hörkkö S, Kauma H, Kesäniemi YA, Ukkola O. Low plasma ghrelin is associated with insulin resistance, hypertension, and the prevalence of type 2 diabetes. Diabetes. 2003;52(10):2546–53.

    Article  PubMed  Google Scholar 

  4. Matsumura K, Tsuchihashi T, Fujii K, Abe I, Iida M. Central ghrelin modulates sympathetic activity in conscious rabbits. Hypertension. 2002;40(5):694–9.

    Article  CAS  PubMed  Google Scholar 

  5. Nagaya N, Kojima M, Uematsu M, Yamagishi M, Hosoda H, Oya H, et al. Hemodynamic and hormonal effects of human ghrelin in healthy volunteers. Am J Physiol Regul Integr Comp Physiol. 2001;280(5):1483–7.

    Google Scholar 

  6. Nagaya N, Miyatake K, Uematsu M, Oya H, Shimizu W, Hosoda H, et al. Hemodynamic, renal, and hormonal effects of ghrelin infusion in patients with chronic heart failure. J Clin Endocrinol Metab. 2001;86(12):5854–9.

    Article  CAS  PubMed  Google Scholar 

  7. Nagaya N, Uematsu M, Kojima M, Ikeda Y, Yoshihara F, Shimizu W, et al. Chronic administration of ghrelin improves left ventricular dysfunction and attenuates development of cardiac cachexia in rats with heart failure. Circulation. 2001;104(12):1430–5.

    Article  CAS  PubMed  Google Scholar 

  8. Aoki H, Nakata M, Dezaki K, Lu M, Gantulga D, Yamamoto K, et al. Ghrelin counteracts salt-induced hypertension via promoting diuresis and renal nitric oxide production in Dahl rats. Endocr J. 2013;60(5):571–81. Demonstrated the long term effects of ghrelin in promoting diuresis and blood pressure regulation.

    Article  CAS  PubMed  Google Scholar 

  9. Li ZF, Guo ZF, Yang SG, Zheng X, Cao J, Qin YW. Circulating ghrelin and ghrelin to obestatin ratio are low in patients with untreated mild-to-moderate hypertension. Regul Pept. 2010;165(2–3):206–9.

    Article  CAS  PubMed  Google Scholar 

  10. Chang L, Ren Y, Liu X, Li WG, Yang J, Geng B, et al. Protective effects of ghrelin on ischemia/reperfusion injury in isolated rat heart. J Cardiovasc Pharmacol. 2004;43(2):165–70.

    Article  CAS  PubMed  Google Scholar 

  11. Karcz-Socha I, Zwirska-Korczala K, Zembala M, Borgiel-Marek H, Karcz K. Ghrelin PYY 3-36 serum changes in left ventricular hypertrophic, insulin-resistant, hypertensive obese patients. Obes Facts. 2011;4(5):386–92.

    Article  CAS  PubMed  Google Scholar 

  12. Greenman Y, Rouach V, Limor R, Gilad S, Stern N. Testosterone is a strong correlate of ghrelin levels in men and postmenopausal women. Neuroendocrinology. 2009;89(1):79–85.

    Article  CAS  PubMed  Google Scholar 

  13. Shiiya T, Nakazato M, Mizuta M, Matsukara S, Mondal MS, Tanaka M, et al. Plasma ghrelin levels in lean and obese humans and the effect of glucose on ghrelin secretion. J Clin Endocrinol Metab. 2002;87(1):240–4.

    Article  CAS  PubMed  Google Scholar 

  14. David E, David S, Frayo RS, Breen PA, Marina K, Dellinger EP, et al. Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med. 2002;346(21):1623–30.

    Article  Google Scholar 

  15. Monti V, Carlson JJ, Hunt SC, Adams TD. Relationship of ghrelin and leptin hormones with body mass index and waist circumference in random sample of adults. J Am Diet Assoc. 2006;106(6):822–8.

    Article  CAS  PubMed  Google Scholar 

  16. Sondergaard E, Gormsen LC, Nellemann B. Visceral fat mass is a strong predictor of circulating ghrelin levels in premenopausal women. Eur J Endocrinol. 2009;160(3):375–9.

    Article  CAS  PubMed  Google Scholar 

  17. Tschöp M, Weyer CW, Tataranni PA, Devanarayan V, Ravussin E, Heiman M. Circulating ghrelin levels are decreased in human obesity. Diabetes. 2001;50(4):707–9.

    Article  PubMed  Google Scholar 

  18. Vendrell J, Broch M, Vilarrasa N, Molina A, Gómez JM, Gutiérrez C, et al. Resistin, adiponectin, ghrelin, leptin and proinflammatory cytokines: relationships in obesity. Obes Res. 2004;12(6):962–71.

    Article  CAS  PubMed  Google Scholar 

  19. Skoczylas A, Adamczak M, Chudek J, Wiecek A. Cilazapril increases plasma ghrelin concentration in obese patients with arterial hypertension. Endokrynol Pol. 2010;61(1):21–7.

    CAS  PubMed  Google Scholar 

  20. Oner-Iyidoğan Y, Koçak H, Gürdöl F, Oner P, Issever H, Esin D. Circulating ghrelin levels in obese women: a possible association with hypertension. Scand J Clin Lab Invest. 2007;67(5):568–76.

    Article  PubMed  Google Scholar 

  21. Stępień M, Wlazeł RN, Paradowski M, Banach M, Rysz M, Misztal M, et al. Serum concentrations of adiponectin, leptin, resistin, ghrelin and insulin and their association with obesity indices in obese normo- and hypertensive patients—pilot study. Arch Med Sci. 2012;8(3):431–6. Suggested that obesity could be a stronger determinant of ghrelin secretion than hypertension.

    PubMed Central  PubMed  Google Scholar 

  22. Hamada N, Nishi Y, Tajiri Y, Setoyama K, Kamimura R, Miyahara K, et al. Disrupted regulation of ghrelin production under antihypertensive treatment in spontaneously hypertensive rats. Circ J. 2012;76(6):1423–9. Indicated that the circulating levels of ghrelin are controlled by the ambient vascular tone and vice versa.

    Article  CAS  PubMed  Google Scholar 

  23. Mundinger TO, Cummings DE, Taborsky Jr GJ. Direct stimulation of ghrelin secretion by sympathetic nerves. Endocrinology. 2006;147(6):2893–901.

    Article  CAS  PubMed  Google Scholar 

  24. Zhao TJ, Sakata I, Li RL, Liang G, Richardson JA, Brown MS, et al. Ghrelin secretion stimulated by {beta}1-adrenergic receptors in cultured ghrelinoma cells and in fasted mice. Proc Natl Acad Sci U S A. 2010;107(36):15868–73.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. Engelstoft MS, Park WM, Sakata I, Kristensen LV, Husted AS, Osborne-Lawrence S, et al. Seven transmembrane G protein-coupled receptor repertoire of gastric ghrelin cells. Mol Metab. 2013;2(4):376–92.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Gagnon J, Anini Y. Insulin and norepinephrine regulate ghrelin secretion from a rat primary stomach cell culture. Endocrinology. 2012;153(8):3646–56.

    Article  CAS  PubMed  Google Scholar 

  27. Gagnon J, Anini Y. Glucagon stimulates ghrelin secretion through the activation of MAPK and EPAC and potentiates the effect of norepinephrine. Endocrinology. 2013;154(2):666–74.

    Article  CAS  PubMed  Google Scholar 

  28. Hosoda H, Kangawa K. The autonomic nervous system regulates gastric ghrelin secretion in rats. Regul Pept. 2008;146(1–3):12–8.

    Article  CAS  PubMed  Google Scholar 

  29. Broglio F, Gottero C, Van Koetsveld P, Prodam F, Destefanis S, Benso A, et al. Acetylcholine regulates ghrelin secretion in humans. J Clin Endocrinol Metab. 2004;89(5):2429–33.

    Article  CAS  PubMed  Google Scholar 

  30. Cummings DE, Purnell JQ, Frayo RS, Schmidova K, Wisse BE, Weigle DS. A preprandial rise in plasma ghrelin levels suggests a role in meal initiation in humans. Diabetes. 2001;50(8):1714–9.

    Article  CAS  PubMed  Google Scholar 

  31. Griffen SC, Oostema K, Stanhope KL, Graham J, Styne DM, Glaser N, et al. Administration of Lispro insulin with meals improves glycemic control, increases circulating leptin, and suppresses ghrelin, compared with regular/NPH insulin in female patients with type 1 diabetes. J Clin Endocrinol Metab. 2006;91(2):485–91.

    Article  CAS  PubMed  Google Scholar 

  32. Ryber L, Obrink K, Houe N, Frystyk J, Jørgensen JO. Serum ghrelin levels are suppressed in hypopituitary patients following insulin-induced hypoglycaemia irrespective of GH status. Clin Endocrinol (Oxf). 2006;65(2):210–4.

    Article  CAS  Google Scholar 

  33. Iwakura H, Akamizu T, Ariyasu H, Irako T, Hosoda K, Nakao K, et al. Effects of ghrelin administration on decreased growth hormone status in obese animals. Am J Physiol Endocrinol Metab. 2007;293(3):E819–25.

    Article  CAS  PubMed  Google Scholar 

  34. Enomoto M, Nagaya N, Uematsu M, Okumura H, Nakagawa E, Ono F, et al. Cardiovascular and hormonal effects of subcutaneous administration of ghrelin, a novel growth hormone-releasing peptide, in healthy humans. Clin Sci. 2003;105(4):431–5.

    Article  CAS  PubMed  Google Scholar 

  35. Nagaya N, Moriya J, Yasumura Y, Uematsu M, Ono F, Shimizu W, et al. Effects of ghrelin administration on left ventricular function, exercise capacity, and muscle wasting in patients with chronic heart failure. Circulation. 2004;110(24):3674–9.

    Article  CAS  PubMed  Google Scholar 

  36. Shimizu Y, Nagaya N, Teranishi Y, Imazu M, Yamamoto H, Shokawa T, et al. Ghrelin improves endothelial dysfunction through growth hormone-independent mechanisms in rats. Biochem Biophys Res Commun. 2003;310(3):830–5.

    Article  CAS  PubMed  Google Scholar 

  37. Okumura H, Nagaya N, Enomoto M, Nakagawa E, Oya H, Kangawa K. Vasodilatory effect of ghrelin, an endogenous peptide from the stomach. J Cardiovasc Pharmacol. 2002;39(6):779–83.

    Article  CAS  PubMed  Google Scholar 

  38. Wiley KE, Davenport AP. Comparison of vasodilators in human internal mammary artery: ghrelin is a potent physiological antagonist of endothelin-1. Br J Pharmacol. 2002;136(8):1146–52.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  39. Iantorno M, Chen H, Kim JA, Tesauro M, Lauro D, Cardillo C, et al. Ghrelin has novel vascular actions that mimic PI 3-kinase-dependent actions of insulin to stimulate production of NO from endothelial cells. Am J Physiol Endocrinol Metab. 2007;292(3):E756–64.

    Article  CAS  PubMed  Google Scholar 

  40. Lin Y, Matsumura K, Fukuhara M, Kagiyama S, Fujii K, Iida M. Ghrelin acts at the nucleus of the solitary tract to decrease arterial pressure in rats. Hypertension. 2004;43(5):977–82.

    Article  CAS  PubMed  Google Scholar 

  41. Mao Y, Tokudome T, Kishimoto I. Ghrelin as a treatment for cardiovascular diseases. Hypertension. 2014;64(3):450–4.

    Article  CAS  PubMed  Google Scholar 

  42. Soeki T, Kishimoto I, Schwenke DO, Tokudome T, Horio T, Yoshida M, et al. Ghrelin suppresses cardiac sympathetic activity and prevents early left ventricular remodeling in rats with myocardial infarction. Am J Physiol Heart Circ Physiol. 2008;294(1):H426–32.

    Article  CAS  PubMed  Google Scholar 

  43. Mao Y, Tokudome T, Otani K, Kishimoto I, Nakanishi M, Hosoda H, et al. Ghrelin prevents incidence of malignant arrhythmia after acute myocardial infarction through vagal afferent nerves. Endocrinology. 2012;153(7):3426–34.

    Article  CAS  PubMed  Google Scholar 

  44. Yasuda T, Masaki T, Kakuma T, Yoshimatsu H. Centrally administered ghrelin suppresses sympathetic nerve activity in brown adipose tissue of rats. Neurosci Lett. 2003;349(2):75–8.

    Article  CAS  PubMed  Google Scholar 

  45. Mano-Otagiri A, Ohata H, Iwasaki-Sekino A, Nemoto T, Shibasaki T. Ghrelin suppresses noradrenaline release in the brown adipose tissue of rats. J Endocrinol. 2009;201(3):341–9.

    Article  CAS  PubMed  Google Scholar 

  46. Prior LJ, Davern PJ, Burke SL, Lim K, Armitage JA, Head GA. Exposure to a high-fat diet during development alters leptin and ghrelin sensitivity and elevates renal sympathetic nerve activity and arterial pressure in rabbits. Hypertension. 2014;63(2):338–45. Proposed that ghrelin acutely reduced mean arterial pressure by central reducing sympathetic nerve activity to the heart or to nonrenal vasculature.

    Article  CAS  PubMed  Google Scholar 

  47. Sato T, Nakashima Y, Nakamura Y, Ida T, Kojima M. Continuous antagonism of the ghrelin receptor results in early induction of salt-sensitive hypertension. J Mol Neurosci. 2011;43(2):193–9. Demonstrated that continuous antagonism of the ghrelin receptor results in hypertension and increases in sympathetic nervous activity.

    Article  CAS  PubMed  Google Scholar 

  48. Tan DY, Meng S, Manning Jr RD. Role of neuronal nitric oxide synthase in Dahl salt-sensitive hypertension. Hypertension. 1999;33(1Pt2):456–61.

    Article  CAS  PubMed  Google Scholar 

  49. Mao Y, Tokudome T, Kishimoto I, Otani K, Nishimura H, Yamaguchi O, et al. Endogenous ghrelin attenuates pressure overload-induced cardiac hypertrophy via a cholinergic anti-inflammatory pathway. Hypertension. 2015;65(6):1238–44. Demonstrated that the modulation of parasympathetic nervous activity by ghrelin plays a role in the pressure overload-induced cardiac hypertrophy.

    Article  CAS  PubMed  Google Scholar 

  50. Callaghan B, Kosari S, Pustovit RV, Sartor DM, Ferens D, Ban K, et al. Hypotensive effects of ghrelin receptor agonists mediated through a novel receptor. Br J Pharmacol. 2014;171(5):1275–86.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  51. Broad J, Callaghan B, Sanger GJ, Brock JA, Furness JB. Analysis of the ghrelin receptor-independent vascular actions of ulimorelin. Eur J Pharmacol. 2015;752:34–9.

    Article  CAS  PubMed  Google Scholar 

  52. Xu X, Ding F, Pang J, Gao X, Xu RK, Hao W, et al. Chronic administration of hexarelin attenuates cardiac fibrosis in the spontaneously hypertensive rat. Am J Physiol Heart Circ Physiol. 2012;303(6):H703–11.

    Article  CAS  PubMed  Google Scholar 

  53. Mao Y, Tokudome T, Kishimoto I. The cardiovascular action of hexarelin. J Geriatr Cardiol. 2014;11(3):253–8.

    PubMed Central  CAS  PubMed  Google Scholar 

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Correspondence to Ichiro Kishimoto.

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Mao, Y., Tokudome, T. & Kishimoto, I. Ghrelin and Blood Pressure Regulation. Curr Hypertens Rep 18, 15 (2016). https://doi.org/10.1007/s11906-015-0622-5

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