Peptides like Examorelin do not share similar structure as ghrelin but may also activate the GHSR1a, which may mediate hunger hormone signal regulation and, perhaps most notably, hGH stimulating actions. Specifically, Examorelin is derived from another GHS which is called Growth hormone-releasing peptide-6 (GHRP-6). Below, we break down the mechanisms and the potential research implications related to Examorlein’s activity on these pituitary receptors.
Research
Examorelin and GHSR1a Activation
A series of potential structural rearrangements within the receptor mediate the potential activation of GHSR1a by peptides like Examorelin. Research by Yin et al. suggests that GHSR1a is a G protein-coupled receptor containing seven transmembrane domains, forming a deep cavity where the peptide may bind.(2) It is posited that examorelin interacts with this binding pocket—particularly involving the third, sixth, and seventh transmembrane segments—and that specific amino acid residues, such as Glu124, possibly help establish the electrostatic interactions needed to stabilize the receptor’s active form.
The receptor’s overall structure also seems to rely on elements like a disulfide bond between critical extracellular cysteine residues, which appears to be essential for maintaining the proper conformation during activation. This receptor is thought to undergo a reciprocal rearrangement of its transmembrane α-helices upon peptide binding. This “seesaw” movement—where the sixth and seventh transmembrane domains shift relative to the third—potentially exposes intracellular regions that are capable of interacting with heterotrimeric G proteins.
Such an interaction may then trigger downstream signaling pathways, such as the phospholipase C (PLC)/inositol trisphosphate (IP3) cascade, which is associated with the mobilization of intracellular calcium. This increase in calcium levels is a common second messenger response in many cellular processes. The rise in calcium concentration may then regulate the release of hGH from the cells bearing GHSR1a, such as anterior pituitary cells.
Examorelin and hGH Synthesis
Research by Imbimbo et al. posits that Examorelin may contribute to a potential, concentration‐dependent increase in growth hormone synthesis by pituitary cells.(3) Compared to the baseline level of approximately 3.9 ng/mL observed with placebo, Examorelin experimentation concentration-dependently was suggested to elevate the response to nearly 55.0 ng/mL, where it plateaued.
The stimulatory effect reaches its maximum within 30 to 40 minutes after initiating the growth cycle, and then declines to baseline levels within roughly 240 minutes, with an estimated half-life of around 50 to 58 minutes. These findings suggest that while the Examorelin-induced response is robust, it is also transient, and its overall duration is limited to a few hours. The researchers also commented, “Plasma glucose, luteinising hormone, follicle-stimulating hormone, thyroid-stimulating hormone and insulin-like growth factor I were unaffected by hexarelin”.
Examorelin and Other Pituitary Hormones
Researchers such as Frieboes et al. have also highlighted the possibility that Examorelin may impact the secretion of ACTH and cortisol in pituitary cells through a couple of interrelated mechanisms.(4) Examorelin appears to stimulate growth hormone release in a way that might lead to feedback inhibition of endogenous growth hormone‐releasing hormone. This potential feedback might then shift the balance toward a relative increase in central corticotropin‐releasing hormone, thereby resulting in an early elevation of ACTH and cortisol.
In addition, this study implies that the early rise in ACTH and cortisol might be modulated by other factors such as arginine vasopressin. However, this possibility remains unclear. These findings, observed in murine models, suggest a complex interaction where the initial stimulation of the hypothalamic–pituitary–adrenocortical axis is followed by a phase of negative feedback, which may account for the subsequent blunting of cortisol levels later in the course of experimentation with the peptide.
Examorelin’s Neuroprotective Potential
Research by Brywe et al. suggests that Examorelin may reduce nerve cell damage in models of hypoxia, particularly in regions such as the cerebral cortex, hippocampus, and thalamus.(5) This protective potential is possibly associated with a decrease in caspase-3-like activity, which may imply a reduction in caspase-dependent cell death. Moreover, Examorelin seems to increase the phosphorylation of Akt and glycogen synthase kinase-3β, suggesting that the activation of the PI3K/Akt pathway might be involved in mediating its neuroprotective actions. Interestingly, despite no detectable change in ERK phosphorylation, tn support in IGF-I receptor phosphorylation was observed by researchers.
This raises the possibility that Examorelin might transactivate the IGF-I receptor or modulate its signaling, thereby contributing to cellular survival pathways. Overall, the findings indicate that Examorelin’s neuroprotective potential might be, at least partly, mediated by a combination of Akt activation, GSK3β inhibition, and modulation of IGF-I receptor signaling, although further studies are needed to fully elucidate these mechanisms.
Examorelin’s Synergistic Potential
Apart from GHSR1a, pituitary cells also appear to have GHRH receptors, which are thought to be the main receptors responsible for stimulating the cells into producing hGH. The main agonist for these receptors is considered the endogenous hormone called GHRH and research by Arvat et al. suggests that when the cells are exposed simultaneously to Examorelin and GHRH, activating both types of receptors may exert synergistic actions.(6)
These two peptides (Examorelin and GHRH) may act via complementary mechanisms at the pituitary level. The scientists commented that when the pituitary cells were exposed to each of the peptides individually, Examorelin induced a hGH response with an area under the curve (AUC) of approximately 2,200.8 ± 256.9 µg/L/h, which was substantially higher than the AUC of 792.2 ± 117.6 µg/L/h elicited by GHRH exposure.
Perhaps most notably, when Examorelin and GHRH were combined, the hGH release by the pituitary cells increased to 4,259.2 ± 308.0 µg/L/h. Thus, the researchers concluded that “the two substances induced a true synergistic effect, with GH release after HEX plus GHRH (…) being higher (…) than the arithmetic sum of the GH increases induced by each compound separately.” It is also posited that Examorelin might directly stimulate somatotroph cells—possibly by depolarizing the cell membrane and increasing intracellular Ca²⁺. This is believed to counteract the inhibitory impact of somatostatin. In contrast, GHRH’s impacts seem to be more susceptible to negative feedback, likely through a somatostatin-mediated pathway.
Examorelin and Hunger Hormone Signal Regulation
Examorelin may impact hunger hormone signaling by broadly stimulating ghrelin receptors in other nerve cells beyond the pituitary somatotroph cells. This potential receptor activation in specific central nervous system regions might promote cellular activities that lead to an increased release of hunger hormone signal-promoting neuropeptides, such as Neuropeptide Y and Agouti-related peptide, which are posited to play a critical role in energy balance regulation.
Examorelin is believed to possibly contribute to the reduction of the production of hunger hormone signal-suppressing factors like melanocyte-stimulating hormone (α-MSH). The peptide may, in this way, play a role in shifting the physiological balance toward better-supported hunger hormone signals and potentially increased caloric intake. In addition, there is a possibility that Examorelin might interact with the mesolimbic reward system—integral to the regulation of drives that research models feel torward palatable sustenance—via activation of the GHSR-1a receptor. This interaction may initiate cAMP signaling pathways, potentially heightening the motivation to consume calories and otherwise alter reward-based behaviors around caloric intake and hunger hormone signals.
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References:
- Khatib N, Gaidhane S, Gaidhane AM, Khatib M, Simkhada P, Gode D, Zahiruddin QS. Ghrelin: ghrelin as a regulatory Peptide in growth hormone secretion. J Clin Diagn Res. 2014 Aug;8(8):MC13-7. doi: 10.7860/JCDR/2014/9863.4767. Epub 2014 Aug 20. PMID: 25302229; PMCID: PMC4190751.
- Yin Y, Li Y, Zhang W. The growth hormone secretagogue receptor: its intracellular signaling and regulation. Int J Mol Sci. 2014 Mar 19;15(3):4837-55. doi: 10.3390/ijms15034837. PMID: 24651458; PMCID: PMC3975427.
- Imbimbo BP, Mant T, Edwards M, Amin D, Dalton N, Boutignon F, Lenaerts V, Wüthrich P, Deghenghi R. Growth hormone-releasing activity of hexarelin in humans. A dose-response study. Eur J Clin Pharmacol. 1994;46(5):421-5. doi: 10.1007/BF00191904. PMID: 7957536.
- Frieboes RM, Antonijevic IA, Held K, Murck H, Pollmächer T, Uhr M, Steiger A. Hexarelin decreases slow-wave sleep and stimulates the secretion of GH, ACTH, cortisol and prolactin during sleep in healthy volunteers. Psychoneuroendocrinology. 2004 Aug;29(7):851-60. doi: 10.1016/S0306-4530(03)00152-5. PMID: 15177700.
- Brywe KG, Leverin AL, Gustavsson M, Mallard C, Granata R, Destefanis S, Volante M, Hagberg H, Ghigo E, Isgaard J. Growth hormone-releasing peptide hexarelin reduces neonatal brain injury and alters Akt/glycogen synthase kinase-3beta phosphorylation. Endocrinology. 2005 Nov;146(11):4665-72. doi: 10.1210/en.2005-0389. Epub 2005 Aug 4. PMID: 16081643.
- Arvat E, Di Vito L, Gianotti L, Ramunni J, Boghen MF, Deghenghi R, Camanni F, Ghigo E. Mechanisms underlying the negative growth hormone (GH) autofeedback on the GH-releasing effect of hexarelin in man. Metabolism. 1997 Jan;46(1):83-8. doi: 10.1016/s0026-0495(97)90173-6. PMID: 9005975.
- Bresciani, E., Pitsikas, N., Tamiazzo, L., Luoni, M., Bulgarelli, I., Cocchi, D., Locatelli, V., & Torsello, A. (2008). Feeding behavior during long-term hexarelin administration in young and old rats. Journal of endocrinological investigation, 31(7), 647–652. https://doi.org/10.1007/BF03345618