Abstract
                ABSTRACT   Background: Ghrelin is the endogenous ligand of the growth hormone (GH) secretagogue receptor and is the first hormone linking  gastrointestinal-pituitary axis. Actions of ghrelin on GH secretion provide a strong force for envisioning that one of the major role of  ghrelin could be the regulation of secretion of GH.   Aims & Objective: To explore the intriguing dimensions on the possible physiological role of the Ghrelin /GHRP system.  Materials and Methods: The search was performed in electronic databases (Medline, Embase, Cochrane, Google scholar) and by hand  searching by 2 reviewers. Clinical trials (Randomised and non-randomised trials), review articles, systematic reviews, conference  proceedings and meta-analysis were included in the study.   Results: Ghrelin stimulates strong increase in circulating GH levels both in vitro and in vivo in a dose-dependent manner. Human or  animal ghrelin was found to be significantly more potent than a synthetic GHS, hexarelin. The regulation of GH by Ghrelin is influenced by  various other factors like autonomic nervous system, GHRH, IGF-1, anterior pituitary hormones, obesity, etc.  Conclusion: Ghrelin is a specific endogenous ligand for the GHS receptor and suggests the existence of a GHS–GHS receptor signaling  system in the regulation of GH secretion. Stomach-ghrelin - pituitary-GH axis links nutritional intake to regulation of GH secretion.  However, the mechanism underlying the feedback actions of GH on the regulation of ghrelin remains unanswered.  Under physiological  conditions, ghrelin administered either centrally or peripherally, exerts a potent, time-dependent stimulation of pulsatile secretion of GH  by ghrelin-pituitary-GH axis.