Fig. 11

Possible mechanisms of Ghrelin therapy in mitigating ileum injury. RI and CI increase miR-34a and miR-696, as well as NF-κB. Increases in NF-κB expression trigger cytokines and chemokines in ileum. Increases in IL-1β/18, IL-6, and TNF-α stimulate Myd88, which reduces AKT activation and elevates MAPK activation, thereby increasing apoptosis. On the other hand, increases in NF-κB transcribe iNOS that triggers caspase-3 activation, also resulting in apoptosis. Ghrelin therapy inhibits NF-κB, reinforces RI/CI-induced increases in G-CSF, MIP-2 and KC and promotes tissue repair. This therapy also increases AKT activation which promotes cell survival