Research Overview
A small molecule, not a peptide
MK-677 came out of Merck's programme to convert the peptidic growth hormone-releasing peptides into orally available drug-like molecules. The resulting spiropiperidine scaffold retains agonist activity at GHS-R1a but has none of the amide backbone that makes peptides substrates for gastric and intestinal proteases. It is therefore absorbed intact, which is why it is the only orally administered secretagogue in common research use.
Sustained versus pulsatile signalling
What published work has examined
- Sleep architecture, where reported effects on slow-wave and REM sleep are consistent with ghrelin-receptor involvement in sleep regulation.
- Body composition, with reported increases in fat-free mass in older adult study populations.
- Bone turnover markers and bone mineral density endpoints in trials of extended duration.
- Appetite and food intake, an expected consequence of ghrelin-receptor agonism.
- Effects on fasting glucose and insulin sensitivity, which have been reported and are a recognised consideration in this class.