Treatment of cachexia with ghrelin in patients with COPD
Treatment of cachexia with ghrelin in patients with COPD
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DOI：
10.1378/chest.128.3.1187
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发表时间：
2005-09-01
期刊：
影响因子：
9.6
通讯作者：
Kangawa, K
中科院分区：
文献类型：
--
作者：
Nagaya, N;Itoh, T;Kangawa, K
研究目的：Ghrelin是一种新的生长激素释放肽，通过GH不依赖的机制诱导正能量、平衡、降低脂肪利用和刺激摄食。我们调查了Ghrelin是否能改善慢性阻塞性肺疾病患者的恶病质和功能。7例慢性阻塞性肺疾病恶病质患者静脉注射人Ghrelin(2 mg/kg，2次/d)，疗程3周。观察Ghrelin治疗前后的摄食量、身体组成、肌肉力量、运动量、肺功能和交感神经活动。结果：单次Ghrelin治疗后，血清GH显著增加(21倍)。用Ghrelin治疗3周后，平均体重(+/-SEM)显著增加(49.3+/-3.6至50.3+/-3.8公斤；p<；0.05)。在Ghrelin治疗期间，食物摄入量显著增加。Ghrelin增加了瘦身、体重以及外周和呼吸肌的力量。Ghrelin显著增加Karnofsky、运动状态评分和6min步行距离(370+/-30至432+/-35m；p<；0.05)，但对肺功能无明显影响。Ghrelin可减弱过度的交感神经活动，表现为血浆去甲肾上腺素水平显著降低(889+/-123至597+/-116pg/mL；p<；0.05)。结论：这些初步结果表明，反复应用Ghrelin可改善COPD恶病质患者的身体、成分、肌肉损耗、功能能力和交感增强。
Study objectives: Ghrelin is a novel growth hormone (GH)-releasing peptide that also induces a positive energy, balance by, decreasing fat utility, and stimulating feeding through GH-independent mechanisms. We investigated whether ghrelin improves cachexia and functional capacity in patients with COPD.Methods: This is an open-label pilot study. Human ghrelin (2 mu g/kg bid) was IV administered to seven cachectic patients with COPD for 3 weeks. Food intake, body, composition, muscle strength, exercise capacity, pulmonary function, and sympathetic nerve activity, were examined before and after ghrelin therapy.Results: A single administration of ghrelin markedly, increased serum GH (21-fold). Three-week treatment with ghrelin resulted in a significant increase in mean (+/- SEM) body weight (49.3 +/- 3.6 to 50.3 +/- 3.8 kg; p < 0.05). Food intake was significantly, increased during ghrelin therapy. Ghrelin increased lean body, mass and peripheral and respiratory muscle strength. Ghrelin significantly, increased Karnofsky, performance status score and the distance walked in 6 min (370 +/- 30 to 432 +/- 35 m; p < 0.05), although it did not significantly alter pulmonary function. Ghrelin attenuated the exaggerated sympathetic nerve activity,, as indicated by a marked decrease in plasma norepinephrine level (889 +/- 123 to 597 +/- 116 pg/mL; p < 0.05).Conclusions: These preliminary results suggest that repeated administration of ghrelin improves body, composition, muscle wasting, functional capacity, and sympathetic augmentation in cachectic patients with COPD.