Table 1.

Physiology and biochemistry of ghrelin: (8–10).

Gene	Chromosome 3 (3q26.2)
Synthesis	Stomach ghrelin cells
Precursor	Preproghrelin, 117 amino acid peptides→ post-translational cleavage→ Proghrelin
Hormone	Ghrelin, 28 amino acid peptides
Receptor	GHSR (Growth hormone secretagogue receptor), G-protein coupled receptor
Main physiological role	Growth hormone release; Starvation, same as in calorie restriction in sepsis, causes to synthesize octonylated peptide ghrelin from proghrelin by Ghrelin O- acyltransferase (GOAT) which stimulates Growth hormone from pituitary cells to normalize blood glucose levels (10). Sepsis and prolonged illness can cause hyperglycemia. Given the impact of Ghrelin in controlling glucose homeostasis, the beneficial outcomes of Ghrelin treatment in sepsis could be mediated through maintaining normoglycemia in septic patients. Appetite stimulation; Anti-inflammation