Ghrelin downstream signaling pathways in VMH and ARC. By activating intracellular downstream signaling molecules and promoting neurotransmitter transmission, ghrelin eventually promotes appetite. VMH, ventromedial nucleus of the hypothalamus; ARC, arcuate nucleus; PLC, phospholipase C; IP3, inositol triphosphate; PKC, protein kinase C; CaMKK2, calcium-dependent protein kinase kinase 2; MAPK, mitogen-activated protein kinase; CREB, cAMP-response element binding protein; FOXO1, Forkhead Box O1; BSX, brain-specific homeobox transcription factor; Npy, Neuropeptide Y; AgRP, agouti-related protein; GABA, γ-aminobutyric acid; POMC, pro-opiomelanocortin. Created with BioRender.com.