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Ipamorelin Peptide | Ultimate Guide In 2023

Ipamorelin is a synthetic peptide belonging to the growth hormone secretagogue (GHS) class of peptides.

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Ipamorelin Peptide
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Ipamorelin, a synthetic peptide based on the ghrelin hormone, has gained significant attention in recent years for its potential applications in various fields, including anti-aging research, muscle regeneration, bone strength, and pain mitigation. Here is a look at what ipamorelin is, the properties of ipamorelin, what ipamorelin costs, and where the future of ipamorelin research is headed. You can learn more about Ipamorelin by visiting Peptide Sciences .

What is Ipamorelin?

Ipamorelin is a synthetic peptide belonging to the growth hormone secretagogue (GHS) class of peptides. It consists of five amino acids and is a derivative of ghrelin. Developed in the 1990s, ipamorelin has been primarily studied for its ability to stimulate the release of growth hormone (GH) from the pituitary gland and for its impact on intestinal motility[1], [2]. It is considered one of the most specific growth hormone secretagogues, having almost no negative hormonal effects outside of naturally increasing growth hormone levels and no substantial off-target effects. Research shows that ipamorelin has no impact on ACTH, prolactin, FSH, LH, thyroid hormone, or cortisol levels[3].

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Ipamorelin Structure

Peptide Sequence: Aib-His-D-2Nal-D-Phe-Lys

Molecular Formula: C38H49N9O5

Molecular Weight: 711.868 g/mol

PubChem CID: 9831659

CAS Number: 170851-70-4

Synonyms: Y9M3S784Z6, CHEMBL58547

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Source: PubChem

Data deposited in or computed by PubChem

Ipamorelin Mechanism of Action

Ipamorelin exerts its effects by binding to the ghrelin receptor, also known as the growth hormone secretagogue receptor (GHSR). This binding triggers a cascade of events that leads to the release of growth hormone. Ipamorelin most specifically targets the GHSR-1A subtype, which is predominantly expressed in the pituitary gland, but is also found on the vagus nerve and throughout the gastrointestinal tract.

Upon binding to the GHSR-1A, ipamorelin activates the G-protein-coupled receptor (GPCR) pathway. This activation results in the stimulation of intracellular signaling molecules, including cyclic adenosine monophosphate (cAMP) and protein kinase A (PKA). The cAMP/PKA pathway ultimately leads to the release of growth hormone from somatotroph cells in the pituitary gland.

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The Growth Hormone Secretagogue Receptor

People are often confused by the ability of ipamorelin and other GHSR agonists to have effects outside of the growth hormone axis. These effects are often independent of the effects of these peptides on GH levels and can vary from one peptide to another. As it turns out, GHSR is widely expressed in various tissues, including the hypothalamus, pituitary gland, gastrointestinal tract, and peripheral organs. In the hypothalamus, it regulates the release of growth hormone (GH) from the pituitary gland. In peripheral tissues, it is involved in diverse physiological processes such as energy homeostasis, appetite regulation, cardiovascular function, pain perception, and immune responses. How a specific peptide interacts with GHSRs outside of the GH system will determine the peptide’s secondary effects. Modulating GHSR activity outside of the central nervous system can have implications for conditions related to growth hormone deficiency, obesity, metabolic disorders, cardiovascular health, and gastrointestinal motility, among others. The selective activation or inhibition of the GHSR holds promise for the development of targeted therapies for several conditions including diabetes and several visceral pain syndromes.

What Does Ipamorelin Do?

Ipamorelin is a growth hormone secretagogue, so its primary effect is to naturally increase levels of growth hormone. This, of course, is not the peptide’s only effect. Research shows that ipamorelin has several properties that make it of interest to researchers. Among those properties, the ability of ipamorelin to increase bone density and thwart the effects of bone loss has been of primary interest. Here is a look at the myriad effects associated with ipamorelin.

Increased Growth Hormone Secretion

One of the primary benefits of ipamorelin is its ability to stimulate the release of growth hormone. As a ghrelin mimetic, ipamorelin increases growth hormone levels by binding to the growth hormone secretagogue receptor. This leads to a large, relatively narrow (in terms of time) spike in growth hormone. In general, the GHSR agonists cause larger growth hormone increases than the growth hormone releasing hormone analogues. Increased growth hormone levels can have various positive effects on the body, including enhanced muscle growth, improved recovery, increased fat metabolism, and improved bone density.

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Growth hormone is well-known for its anabolic properties, promoting the growth and development of muscle tissue. By stimulating growth hormone release, ipamorelin can contribute to increased protein synthesis, leading to greater muscle hypertrophy. This is particularly true following intense exercise, which can result in muscle damage and fatigue. Growth hormone plays a vital role in the recovery process by stimulating tissue repair and reducing inflammation.

Growth hormone also promotes the breakdown of stored fat (lipolysis) and inhibits fat accumulation. Ipamorelin's ability to boost growth hormone secretion can lead to increased fat metabolism, leading to a leaner physique. Research in mice shows that ipamorelin increases lean body mass and reduces fat mass, resulting in a learner overall physique. This happens even though the peptide increases energy intake and promotes eating behavior.

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Enhanced Bone Density

Growth hormone also plays a role in maintaining the health and integrity of connective tissues, such as tendons and ligaments. By stimulating natural growth hormone release, ipamorelin may help improve the strength and resilience of these tissues, reducing the risk of injuries and supporting overall joint health. Growth hormone is especially important for maintaining healthy bone density and bone mineralization. It stimulates the production of osteoblasts, the cells responsible for bone formation. By increasing growth hormone levels, ipamorelin contributes to improved bone density, reducing the risk of osteoporosis and fractures, especially in individuals at risk for bone loss due to aging or certain medical conditions

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The benefits of ipamorelin on bone health appear to be more robust than those of other growth hormone secretagogues. Research in mouse models shows that ipamorelin may be more effective in promoting bone health than current therapies such as bisphosphonates and monoclonal antibodies. Additionally, ipamorelin cost is lower than that of most existing therapies, a fact that has made it particularly attractive to researchers looking to drive down the cost of treating bone disease. Ipamorelin costs about $100 for 5 mg, making it the most affordable of the growth hormone secretagogues and substantially less expensive than many other bone loss treatments. When the other properties of ipamorelin are factored in, such as its ability to boost muscle mass and decrease fat mass, ipamorelin cost becomes even more attractive.

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Research in rat models shows that ipamorelin is particularly effective in counteracting the effects of steroids used to treat inflammatory conditions. In fact, these rat models show that ipamorelin completely stops bone loss associated with long-term corticosteroid use and can even increase bone formation in these settings by as much as 400%[4]–[6]. This shows that ipamorelin can promote robust bone growth and foster the development of new bone tissue. Further studies indicate that ipamorelin also increases bone mineral density systemically, thereby increasing the strength of both existing bone and newly formed bone [3]. Additionally, ipamorelin helps to offset some of the other side effects of corticosteroid use, such as muscle wasting and increased visceral fat deposition. This means that the ipamorelin peptide addresses all the major drawbacks of corticosteroid use and is thus of interest as a way to mitigate side effects and maybe even allow for more intensive treatment. If ipamorelin makes it possible to increase corticosteroid use without increasing side effects, it could make it easier to treat refractory inflammatory conditions and bring relief to millions.

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Potential Cognitive Benefits

Growth hormone has been implicated in various cognitive functions, including memory, learning, and attention. Some studies suggest that naturally increased growth hormone levels may have positive effects on cognitive performance, particularly memory retention and concentration. However, it is important to note that the relationship between growth hormone and cognitive function is complex and not fully understood. Further research is necessary to explore the specific mechanisms and extent of cognitive benefits associated with ipamorelin-induced growth hormone secretion.

Anti-Aging Effects

Aging is associated with a decline in growth hormone levels, which can contribute to several age-related changes in the body. Somatopause refers to the natural decline in growth hormone (GH) production that occurs with age. It is often considered a component of the overall aging process and is associated with various physiological changes.

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It is important to note that while somatopause is a natural part of the aging process, the decline in growth hormone levels can vary among individuals. Not everyone will experience the same extent of decline or exhibit the same symptoms associated with somatopause. Additionally, other factors, such as lifestyle, overall health, and genetic predisposition, can influence the effects of somatopause.

Peptide therapies like ipamorelin have been investigated for their potential to increase growth hormone secretion and potentially mitigate some of the effects of somatopause. These therapies aim to restore growth hormone levels to a more youthful range, potentially improving body composition, bone health, metabolism, and cognitive function.

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It is important to note that the anti-aging effects associated with ipamorelin, and growth hormone in general, are not limited to physical features like body composition and bone strength. There is good evidence to support the role of natural growth hormone in cognitive function, memory, and mood. Some studies have indicated that increased growth hormone can improve cognitive performance by increasing memory retention and the ability to concentrate. In addition, as is discussed below, ipamorelin has been linked to improved heart health in some animal models as well. Thus, the anti-aging effects associated with ipamorelin are not merely cosmetic, but rather appear to be an actual slowing of the aging process.

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Improved Sleep Quality

Growth hormone is involved in the regulation of sleep patterns, and its secretion follows a pulsatile pattern, with most of the secretion occurring during deep sleep stages. This relationship between growth hormone and sleep has led to the exploration of ipamorelin's potential impact on sleep quality[7], [8].

Growth hormone is intricately involved in regulating the sleep-wake cycle. During deep sleep stages, particularly during slow-wave sleep (SWS), the majority of growth hormone secretion occurs. SWS is characterized by slow brain waves, relaxed muscles, and restorative/healing processes. Growth hormone contributes to the restorative functions of sleep, including tissue repair, muscle growth, and overall recovery. Sleep is when most mammals do most of their growth, whether that be the height and weight changes associated with childhood and puberty or the muscle changes associated with resistance training. Ipamorelin stimulates the release of growth hormone, leading to increased levels of this hormone in the body. By naturally elevating growth hormone levels, ipamorelin may contribute to improved sleep quality, particularly by enhancing the amount and quality of deep sleep stages.

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Ipamorelin and Energy Homeostasis

Ghrelin is associated not just with increases in growth hormone secretion, but with increases in energy intake as well. Often referred to as the hunger hormone, ghrelin is known to stimulate appetite and increase feeding behavior in humans as well as in animal models. Research shows that ipamorelin has a similar impact on energy homeostasis.

When ipamorelin binds to the growth hormone secretagogue receptor (GHS-R) in the hypothalamus, it triggers the release of neuropeptide Y, which plays a role in regulating appetite and feeding behavior. Neuropeptide Y is a neurotransmitter that is widely distributed in the central nervous system, including the hypothalamus. It is involved in various physiological processes, including the regulation of appetite, energy homeostasis, and stress response. The release of neuropeptide Y in response to ipamorelin not only increases food intake but also influences food preference. NPY has been shown to enhance the preference for calorie-dense foods, leading to an increased storage of energy as fat[9]. This effect may contribute to the observed increase in body weight associated with ipamorelin use.

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What Is Ipamorelin’s Role in Controlling Blood Sugar?

Research indicates that ipamorelin can stimulate the secretion of insulin from the pancreas in both normal and diabetic rats. increased insulin secretion triggered by ipamorelin suggests its potential in improving glucose metabolism and regulating blood glucose levels. It appears to trigger this release through direct interaction with calcium channels in the pancreas as well as via the adrenergic receptor[10]. This means that ipamorelin might offer a means of insulin control for people whose pancreas produces enough insulin but has become somewhat desensitized to the signals telling it to release insulin. This could make ipamorelin useful in a subset of type 2 diabetes, but also makes the peptide a useful means of exploring the pathophysiology that leads to diabetes in the first place.

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Ipamorelin and Heart Health

The relationship between ghrelin and heart health is complex and thus is given its own section for discussion. There is ongoing research with several ghrelin mimetics, including ipamorelin, to better understand potential therapeutic applications. Research conducted in cell culture and animal models suggests that ghrelin may have cardioprotective effects following heart attack and cardiac damage. Research in animal models indicates that ghrelin administration decreases the risk of a fatal cardiac arrhythmia following a heart attack. It is also observed that ghrelin, which is produced in small quantities in the vascular system, may help reduce scar formation and hypertrophy of the heart. These effects have the potential to prevent heart failure and mitigate long-term consequences of heart damage[11], [12].

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The precise mechanisms by which ghrelin exerts its cardioprotective effects are not fully understood. There are different hypotheses regarding the underlying processes. Some researchers speculate that ghrelin modulates the crosstalk between the autonomic nervous system and cardiac cells, potentially influencing signaling pathways involved in heart function. Others suggest that the effects may be mediated through direct stimulation of specific receptors, leading to reduced apoptosis (cell death) and inflammation in the heart tissue[13]–[15].

Ipamorelin, as a selective ghrelin receptor agonist, offers a valuable tool for researchers studying the effects of ghrelin on heart health. Its use in research can help explore the potential therapeutic applications of ghrelin and elucidate the underlying mechanisms involved. Ipamorelin's ease of administration, specificity, and relatively favorable side effect profile make it an attractive option for investigating the role of ghrelin in cardiac protection.

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What Is Ipamorelin’s Effect on Stress and Pain?

Interestingly, ipamorelin has also been linked to improvements in pain and anxiety. Neuropeptide Y is known to have anxiolytic (anti-anxiety) and stress-reducing effects. Its release can help alleviate anxiety and reduce stress levels, potentially contributing to the overall well-being of individuals receiving ipamorelin treatment. Neuropeptide Y has also been shown to modulate pain perception. It can reduce the sensation of pain, providing analgesic effects. This property of neuropeptide Y may be relevant in the context of postoperative ileus, where ipamorelin's ability to stimulate appetite and reduce pain perception could help facilitate early re-feeding following abdominal surgery. Research in rats suggests that ipamorelin may reduce pain perception by as much as 200%[16], [17].

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It appears that ipamorelin specifically reduces visceral pain and may therefore be valuable in treating conditions like inflammatory bowel disease and irritable bowel syndrome as well. Research in rats indicates that ghrelin receptors in the GI system can attenuate colonic hypersensitivity and pain perception. This is an important finding because the treatment of visceral pain is complicated and many current options, like opioids, present serious drawbacks such as dependence and addiction. The ability to control visceral pain without opioids would make the treatment of several GI conditions safer and more effective.

Ipamorelin Cost Effectiveness

The affordability and favorable side effect profile of ipamorelin make it an attractive option for future research trials and development as a therapeutic. The lower ipamorelin cost compared to other bone loss preventatives may make it more accessible and feasible for wider use in clinical settings and the peptide has already undergone phase 1 clinical trials that could thus make it easier for researchers to take it to clinical trials for a different indication than postoperative ileus.

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The affordability factor may contribute to the potential to use ipamorelin as a cost-effective alternative for preventing bone loss. This is important because 50% of the population will experience mild to moderate bone loss by age 50 while the severe bone loss of osteoporosis will affect as many as 40% of women over the age of 50[18]. Preventing fractures, particularly those related to osteoporosis, is crucial for mitigating the socioeconomic impact in an aging population. Strategies include promoting bone health through adequate nutrition, exercise, fall prevention measures, and appropriate medical interventions, such as the use of bone-strengthening medications when necessary. The socioeconomic impacts of fractures in the elderly include the following.

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Reduced Life Expectancy

Fractures in the elderly population, especially hip fractures, are associated with increased mortality rates. The complications and immobility resulting from fractures can lead to a decline in overall health and a higher risk of complications such as infections, blood clots, and pneumonia. This, in turn, can contribute to a reduced life expectancy for individuals who experience fractures.

Prolonged Medical Care

Fractures often require extensive medical care and rehabilitation, particularly in older adults. The management of fractures may involve hospitalization, surgical interventions, postoperative care, physical therapy, and ongoing medical monitoring. This prolonged medical care can place a significant burden on healthcare systems, increase healthcare costs, and impact the availability of resources for other medical needs.

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Loss of Independence and Functional Decline

Fractures, especially hip fractures, can result in a loss of independence and a decline in functional abilities. Older adults who experience fractures may require assistance with activities of daily living, such as dressing, bathing, and mobility. This loss of independence can have a significant impact on their quality of life and may necessitate long-term care services or modifications to living arrangements.

Increased Healthcare Costs

The economic burden associated with fractures in the elderly is substantial. The costs include direct medical expenses related to hospitalization, surgeries, rehabilitation, medications, and follow-up care. Additionally, indirect costs can arise from lost productivity due to disability, caregiver burden, and the need for long-term care services. These increased healthcare costs can strain healthcare systems and have broader economic implications.

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Impact on Caregivers and Society

Fractures can also have a significant impact on caregivers, who often assume the responsibility of providing care and support to older adults recovering from fractures. This can lead to caregiver burden, increased healthcare expenditures, and potential impact on the caregiver's ability to work or pursue other activities. The socioeconomic impact extends to society, as the costs associated with fractures affect healthcare systems, insurance providers, and the allocation of resources for medical care and support services.

Gender Differences in Ipamorelin Costs and Benefits

Gender differences in the benefits of ipamorelin and its potential applications in specific conditions, such as pregnancy-related complications, are areas of ongoing research. While the existing studies in animals suggest that ipamorelin may have larger benefits in females compared to males, it is important to note that further research is needed to fully understand the underlying mechanisms and establish the clinical implications.

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Research in rats indicates that ipamorelin may be more effective in females compared to males, possibly due to their relatively lower testosterone levels. Lower testosterone levels are associated with lower bone mineral density and decreased muscle anabolism, making individuals with lower testosterone levels more susceptible to bone and muscle loss. Ipamorelin may provide benefits in such individuals by stimulating growth hormone release and counteracting these effects.

Researchers are investigating whether testosterone levels alone are responsible for the observed differences in response to ipamorelin or if there are additional underlying factors contributing to the gender disparity. Understanding the biochemistry and molecular mechanisms involved in the anabolic processes affected by ipamorelin could provide valuable insights into the complex interactions between hormones, growth factors, and tissue responses. For instance, some research suggests that ipamorelin may have benefits for pregnant women by promoting blood vessel growth. Preeclampsia, a condition characterized by high blood pressure during pregnancy, can increase the risk of complications and preterm delivery. Studies have shown that patients with early-onset preeclampsia have alterations in ghrelin levels, and administration of ipamorelin can potentially address this issue by promoting blood vessel growth[19], [20]. However, further research is needed to establish the safety and effectiveness of ipamorelin in the treatment of preeclampsia.

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Ipamorelin Cost: A Note on Administration

Ipamorelin research is typically conducted via Sub-Q or IV administration. Research, however, shows that ipamorelin can be effectively introduced via inhalation. This route of administration alters the peptide’s concentration as the bioavailability is just 20% via nasal inhalation[21]. That said, in the future slight alterations of ipamorelin might be made to increase nasal absorption. This would drive down ipamorelin cost in the long run by eliminating the need for syringes, hypodermic needles, and appropriate means of disposal. Thus, even though ipamorelin cost is among the lowest of all peptides, it could be made even lower in the future if alternative mechanisms of administration are developed.

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Ipamorelin Summary

Ipamorelin is a synthetic peptide and a member of the growth hormone secretagogue (GHS) class. It stimulates the natural release of growth hormone (GH) from the pituitary gland and has been primarily studied for its effects on GH regulation and intestinal motility. Ipamorelin is a short peptide consisting of five amino acids and is derived from ghrelin, a hormone involved in appetite regulation and GH release. Ipamorelin's ability to stimulate GH release and its minimal impact on other hormonal pathways make it an attractive candidate for future research and potential therapeutic applications. It has shown promise in various areas, including the prevention of bone loss, improving muscle growth and recovery, and mitigating the effects of corticosteroid treatment. Ongoing research aims to further understand the potential benefits, optimal dosing, safety, and long-term effects of ipamorelin in various conditions. It continues to be an area of interest for researchers exploring its potential applications.

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Resources

[1] D. E. Beck, W. B. Sweeney, M. D. McCarter, and Ipamorelin 201 Study Group, “Prospective, randomized, controlled, proof-of-concept study of the Ghrelin mimetic ipamorelin for the management of postoperative ileus in bowel resection patients,” Int. J. Colorectal Dis., vol. 29, no. 12, Art. no. 12, Dec. 2014, doi: 10.1007/s00384-014-2030-8.

[2] B. Greenwood-Van Meerveld, K. Tyler, E. Mohammadi, and C. Pietra, “Efficacy of ipamorelin, a ghrelin mimetic, on gastric dysmotility in a rodent model of postoperative ileus,” J. Exp. Pharmacol., vol. 4, pp. 149–155, 2012, doi: 10.2147/JEP.S35396.

[3] K. Raun et al., “Ipamorelin, the first selective growth hormone secretagogue,” Eur. J. Endocrinol., vol. 139, no. 5, Art. no. 5, Nov. 1998, doi: 10.1530/eje.0.1390552.

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[5] H. Oxlund, G. Ortoft, J. S. Thomsen, C. C. Danielsen, C. Ejersted, and T. T. Andreassen, “The anabolic effect of PTH on bone is attenuated by simultaneous glucocorticoid treatment,” Bone, vol. 39, no. 2, Art. no. 2, Aug. 2006, doi: 10.1016/j.bone.2006.01.142.

[6] J. Svensson et al., “The GH secretagogues ipamorelin and GH-releasing peptide-6 increase bone mineral content in adult female rats,” J. Endocrinol., vol. 165, pp. 569–77, Jul. 2000.

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[7] M. Kluge et al., “Ghrelin increases slow wave sleep and stage 2 sleep and decreases stage 1 sleep and REM sleep in elderly men but does not affect sleep in elderly women,” Psychoneuroendocrinology, vol. 35, no. 2, pp. 297–304, Feb. 2010, doi: 10.1016/j.psyneuen.2009.07.007.

[8] J. C. Weikel et al., “Ghrelin promotes slow-wave sleep in humans,” Am. J. Physiol. Endocrinol. Metab., vol. 284, no. 2, pp. E407-415, Feb. 2003, doi: 10.1152/ajpendo.00184.2002.

[9] M. Alfalah, Neuropeptide Y and Related Peptides. Springer Science & Business Media, 2004.

[10] E. Adeghate and A. S. Ponery, “Mechanism of ipamorelin-evoked insulin release from the pancreas of normal and diabetic rats,” Neuro Endocrinol. Lett., vol. 25, no. 6, pp. 403–406, Dec. 2004.

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[11] T. Tokudome, K. Otani, M. Miyazato, and K. Kangawa, “Ghrelin and the heart,” Peptides, vol. 111, pp. 42–46, Jan. 2019, doi: 10.1016/j.peptides.2018.05.006.

[12] S. Gupta and A. Mitra, “Heal the heart through gut (hormone) ghrelin: a potential player to combat heart failure,” Heart Fail. Rev., Oct. 2020, doi: 10.1007/s10741-020-10032-2.

[13] T. Tokudome and K. Kangawa, “Physiological significance of ghrelin in the cardiovascular system,” Proc. Jpn. Acad. Ser. B Phys. Biol. Sci., vol. 95, no. 8, pp. 459–467, 2019, doi: 10.2183/pjab.95.032.

[14] I. Kishimoto, T. Tokudome, H. Hosoda, M. Miyazato, and K. Kangawa, “Ghrelin and cardiovascular diseases,” J. Cardiol., vol. 59, no. 1, pp. 8–13, Jan. 2012, doi: 10.1016/j.jjcc.2011.11.002.

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[15] N. Sun et al., “Ghrelin attenuates depressive-like behavior, heart failure, and neuroinflammation in postmyocardial infarction rat model,” Eur. J. Pharmacol., vol. 901, p. 174096, Jun. 2021, doi: 10.1016/j.ejphar.2021.174096.

[16] E. N Mohammadi, T. Louwies, C. Pietra, S. R. Northrup, and B. Greenwood-Van Meerveld, “Attenuation of Visceral and Somatic Nociception by Ghrelin Mimetics,” J. Exp. Pharmacol., vol. 12, pp. 267–274, 2020, doi: 10.2147/JEP.S249747.

[17] H.-J. Huang et al., “Ghrelin alleviates anxiety- and depression-like behaviors induced by chronic unpredictable mild stress in rodents,” Behav. Brain Res., vol. 326, pp. 33–43, May 2017, doi: 10.1016/j.bbr.2017.02.040.

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[19] O. Erol et al., “Increased serum ghrelin in preeclampsia: is ghrelin a friend or a foe?,” Ginekol. Pol., vol. 87, no. 4, pp. 277–282, 2016, doi: 10.17772/gp/57852.

[20] W. Wu, X. Fan, Y. Yu, and Y. Wang, “Maternal serum ratio of ghrelin to obestatin decreased in preeclampsia,” Pregnancy Hypertens., vol. 5, no. 4, pp. 263–266, Oct. 2015, doi: 10.1016/j.preghy.2015.09.002.

[21] J. V. Gobburu, H. Agersø, W. J. Jusko, and L. Ynddal, “Pharmacokinetic-pharmacodynamic modeling of ipamorelin, a growth hormone releasing peptide, in human volunteers,” Pharm. Res., vol. 16, no. 9, Art. no. 9, Sep. 1999, doi: 10.1023/a:1018955126402.

Disclaimer: The above is a sponsored post, the views expressed are those of the sponsor/author and do not represent the stand and views of Outlook Editorial.

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