Ghrelin and reproduction: ghrelin as novel regulator of the gonadotropic axis.

Identification of ghrelin in late 1999, as the endogenous ligand of the growth hormone secretagogue receptor (GHSR), opened up a new era in our understanding of the regulatory mechanisms of several neuroendocrine systems, including growth and energy homeostasis. Based on similarities with other endocrine integrators and its proposed role as signal for energy insufficiency, it appeared tempting to hypothesize that ghrelin might also operate as regulator of reproductive function. Yet, contrary to other of its biological actions the reproductive "dimension" of ghrelin has remained largely unexplored. Nonetheless, experimental evidence, coming mostly from animal studies, have been gathered during the last years suggesting that ghrelin may actually function as a metabolic modulator of the gonadotropic axis, with predominant inhibitory effects in line with its role as signal of energy deficit. These effects likely include inhibition of luteinizing hormone (LH) secretion (which has been reported in different species and developmental stages), as well as partial suppression of normal puberty onset. In addition, expression and/or direct gonadal actions of ghrelin have been reported in the human, rat, and chicken. Altogether, those findings document a novel reproductive facet of ghrelin, which may cooperate with other neuroendocrine integrators, as leptin, in the joint control of energy balance and reproduction.