Growth hormone–releasing hormone (GHRH), also known as somatocrinin or by several other names in its endogenous forms and as somatorelin (INN) in its pharmaceutical form, is a releasing hormone of growth hormone (GH). It is a 44-amino acid peptide hormone produced in the arcuate nucleus of the hypothalamus. GHRH first appears in the human hypothalamus between 18 and 29 weeks of gestation, which corresponds to the start of production of growth hormone and other somatotropes in fetuses. Nomenclature Endogenous: somatocrinin somatoliberin growth hormone–releasing hormone (GHRH or GH-RH; HGNC symbol is GHRH) growth hormone–releasing factor (GHRF or GRF) somatotropin-releasing hormone (SRH) somatotropin-releasing factor (SRF) Pharmaceutical: somatorelin (INN) Origin GHRH is released from neurosecretory nerve terminals of these arcuate neurons, and is carried by the hypothalamo-hypophyseal portal system to the anterior pituitary gland, where it stimulates growth hormone (GH) secretion by stimulating the growth hormone-releasing hormone receptor. GHRH is released in a pulsatile manner, stimulating similar pulsatile release of GH. In addition, GHRH also promotes slow-wave sleep directly. Growth hormone is required for normal postnatal growth, bone growth, regulatory effects on protein, carbohydrate, and lipid metabolism. Effect GHRH stimulates GH production and release by binding to the GHRH receptor (GHRHR) on cells in the anterior pituitary. Receptor The GHRHR is a member of the secretin family of G protein-coupled receptors, and is located on chromosome 7 in humans. This protein is transmembranous with seven folds, and its molecular weight is approximately 44 kD. Signal transduction GHRH binding to GHRHR results in increased GH production mainly by the cAMP-dependent pathway, but also by the phospholipase C pathway (IP3/DAG pathway), and other minor pathways. The cAMP-dependent pathway is initiated by the binding of GHRH to its receptor, causing receptor conformation that activates Gs alpha subunit of the closely associated G-Protein complex on the intracellular side. This results in stimulation of membrane-bound adenylyl cyclase and increased intracellular cyclic adenosine monophosphate (cAMP). cAMP binds to and activates the regulatory subunits of protein kinase A (PKA), allowing the free catalytic subunits to translocate to the nucleus and phosphorylate the transcription factor cAMP response element-binding protein (CREB). Phosphorylated CREB, together with its coactivators, p300 and CREB-binding protein (CBP) enhances the transcription of GH by binding to CREs cAMP-response elements in the promoter region of the GH gene. It also increases transcription of the GHRHR gene, providing positive feedback. In the phospholipase C pathway, GHRH stimulates phospholipase C (PLC)