Clinical application of ghrelin for chronic respiratory failure
Clinical application of ghrelin for chronic respiratory failure
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DOI：
10.1507/endocrj.64.s1
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发表时间：
2017-01-01
影响因子：
2
通讯作者：
Nakazato, Masamitsu
中科院分区：
文献类型：
--
作者：
Matsumoto, Nobuhiro;Tsubouchi, Hironobu;Nakazato, Masamitsu
慢性呼吸衰竭通常由慢性阻塞性肺疾病、慢性下呼吸道感染或间质性肺炎引起，随着疾病进展，经常导致恶病质。患有慢性呼吸衰竭伴恶病质的患者表现出增加的发病率。虽然恶病质状态是一个重要的临床问题，但恶病质没有有效的治疗方法。Ghrelin具有多种作用，包括增加食物摄入、减弱交感神经活动、抑制炎症、增加心输出量和控制脂肪利用。Ghrelin的这些作用是治疗严重消耗性慢性呼吸道疾病的理想靶点。在一些临床研究中，包括一项小型随机对照试验，对患有慢性呼吸衰竭的恶病质患者给予ghrelin可改善运动耐量、呼吸困难和食欲。这些研究中的患者增加了肌肉质量和体重。在另一项关于慢性下呼吸道感染伴恶病质的研究中，ghrelin通过减少气道中中性粒细胞的积聚来抑制气道炎症，从而改善氧合和运动耐量。虽然需要进一步的临床研究来阐明其有效性，但ghrelin有望成为慢性呼吸衰竭恶病质患者的新疗法。
Chronic respiratory failure, which is often caused by chronic obstructive pulmonary disease, chronic lower respiratory tract infection, or interstitial pneumonia, often leads to cachexia with disease progression. Patients who have chronic respiratory failure with cachexia exhibit increased morbidity. Although cachectic status is an important clinical problem, there are no effective therapies for cachexia. Ghrelin has various effects, including increasing food intake, attenuating sympathetic nerve activity, inhibiting inflammation, increasing cardiac output, and controlling fat utilization. These effects of ghrelin are ideal targets for the treatment of severely wasting chronic respiratory disease. In a few clinical studies, including a small randomized controlled trial, ghrelin administration to cachectic patients with chronic respiratory failure improved exercise tolerance, dyspnea, and appetite. The patients in these studies gained muscle mass and weight. In another study of chronic lower respiratory tract infection with cachexia, ghrelin suppressed airway inflammation by decreasing neutrophil accumulation in the airway, resulting in improvements in oxygenation and exercise tolerance. Although further clinical investigations are needed to clarify its usefulness, ghrelin is expected to become a novel therapy for cachectic patients with chronic respiratory failure.