Role of ghrelin and leptin in the regulation of carbohydrate metabolism. Part I. Ghrelin.

Ghrelin is a polypeptide that is excreted by the secretory cells of the gastric and intestinal mucosa, the arcuate nucleus of the hypothalamus as well as by the epsilon cells (ε) located in the pancreatic islets. It plays an important role in maintaining the energy balance of the organism and influences the endocrine function of the pancreas and glucose metabolism. It takes part in the regulation of glucose homeostasis through the modulation of insulin secretion and insulin sensitivity. Due to the broad spectrum of ghrelin's biological effects, ways to modify them are presently being investigated. Much attention is focused on the enzyme called ghrelin O-acyl transferase (GOAT), which mediates the physiological functions of ghrelin. Acyl-ghrelin and des-acyl-ghrelin appear to have opposite glucoregulatory effects. The regulation of acylation by GOAT seems therefore to play a role in mediating glucose metabolism. The modulation of GOAT or ghrelin signaling may be a clinically relevant strategy to treat obesity and metabolic diseases such as type 2 diabetes.