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Unacylated ghrelin (UAG), also known as des-acyl ghrelin or UnAG, is the predominant circulating form of the peptide hormone ghrelin. Unlike acylated (active) ghrelin—which stimulates appetite and growth hormone release via the growth hormone secretagogue receptor 1a (GHS-R1a)—unacylated ghrelin does not bind to GHS-R1a and was long considered inactive. However, recent research has shown that UAG exerts distinct biological effects independent of GHS-R1a signaling. These include improving insulin sensitivity and glucose metabolism; protecting against muscle atrophy; promoting muscle regeneration; exerting anti-inflammatory and antioxidant effects through pathways involving sirtuin 1 (SIRT1), superoxide dismutase 2 (SOD-2), p53 deacetylation, histone modification, and microRNA-126 regulation; and potentially enhancing skeletal muscle perfusion in peripheral artery disease. UAG is being investigated as a therapeutic agent for metabolic disorders such as Prader-Willi syndrome (PWS) and peripheral artery disease (PAD)[3][4][5][6].
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