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The stimulation of growth hormone secretion is a tightly regulated process involving the hypothalamic release of growth hormone-releasing hormone (GHRH), which acts on the Growth hormone-releasing hormone receptor (GHRHR) in the pituitary to induce GH release. A distinct synergistic pathway involves the peptide hormone ghrelin, which binds the Growth hormone secretagogue receptor (GHSR) to further stimulate growth hormone release. Both GHRHR and GHSR are G protein-coupled receptors located on the surface of pituitary somatotroph cells. The process is subject to complex feedback regulation by circulating levels of GH and IGF-1, as well as inhibitory input from somatostatin. Clinically, drugs and compounds targeting these receptors are used to diagnose and treat conditions of abnormal GH secretion, including growth hormone deficiency, acromegaly, and related metabolic syndromes. Excess GH stimulation poses risks including gigantism, acromegaly, diabetes, and cardiovascular complications, while deficiency impairs normal growth and metabolism.
Agonists at GHRHR increase pituitary GH secretion. Agonists at GHSR increase pituitary GH secretion via ghrelin signaling. Antagonists at GHRHR or GHSR decrease GH secretion.
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