Sermorelin
A synthetic GHRH analogue consisting of the first 29 amino acids of native GHRH and the first GHRH peptide to receive FDA approval (as Geref, for pediatric GH deficiency). Considered one of the safest and best-studied GH-stimulating peptides, with one of the longest clinical track records. Preserves natural pulsatile GH release by working within the body's existing hypothalamic-pituitary feedback loop.
Typical Dosage
Standard: 200-300 mcg subcutaneous once daily before bed. Often cycled 5 days on, 2 days off. Treatment courses of 3-6 months. Can be combined with Ipamorelin for enhanced GH release.
Administration
Subcutaneous injection (typically before bedtime)
Mechanism of Action
Sermorelin is a synthetic peptide consisting of the first 29 amino acids of endogenous growth hormone-releasing hormone (GHRH 1-44). These 29 residues contain the full biological activity domain required for GHRH receptor activation — the remaining 15 amino acids of native GHRH are not necessary for receptor binding or signal transduction.
Sermorelin binds to the GHRH receptor on anterior pituitary somatotrophs, activating the Gs/adenylyl cyclase pathway to increase intracellular cAMP. This triggers PKA-mediated phosphorylation of CREB and stimulates both GH gene transcription and the release of pre-formed GH vesicles. Because sermorelin works through the body's own regulatory system, GH release occurs in a physiological pulsatile pattern governed by the interplay between GHRH stimulation and somatostatin inhibition — the hypothalamic-pituitary feedback loop remains intact.
This preservation of feedback regulation is sermorelin's primary safety advantage over exogenous GH administration. The pituitary gland can only release as much GH as it has synthesized, providing a natural ceiling effect that prevents supraphysiological GH levels. Somatostatin feedback still functions normally, ensuring appropriate pulse spacing. Additionally, because the pituitary itself is being stimulated rather than bypassed, sermorelin may help maintain or even restore pituitary somatotroph function over time. It was the first GHRH analogue to receive FDA approval (as Geref), specifically for evaluating pituitary GH reserve and treating pediatric GH deficiency, giving it one of the longest clinical track records among GH-stimulating peptides.
Regulatory Status
Previously FDA approved (Geref) for pediatric GH deficiency. Withdrawn 2008 for commercial reasons. Available through compounding pharmacies.
Risks & Safety
Common: injection site reactions (redness, swelling), headache, facial flushing, transient dizziness. Serious: theoretical risk of promoting existing tumors via GH/IGF-1 axis (class effect). Rare: allergic reactions, local urticaria. One of the best-tolerated GH peptides. Previously FDA approved (discontinued 2008 for commercial reasons, not safety concerns). Not currently FDA approved.
Research Papers
4Published: December 31, 2025
Abstract
Therapeutic peptides are emerging as promising adjuncts in the management of orthopaedic injuries, grounded in their ability to modulate molecular signaling networks central to cellular medicine. By acting on key pathways such as PI3K/Akt, mTOR, MAPK, TGF-β, and AMPK, peptides exert influence over tissue regeneration, inflammation resolution, and neuromuscular recovery. Wound-healing peptides such as BPC-157, TB-500, and GHK-Cu promote angiogenesis, integrin-mediated extracellular matrix remodeling, and fibroblast activation, whereas growth hormone secretagogues like ipamorelin, CJC-1295, tesamorelin, sermorelin, and AOD-9604 activate IGF-1 signaling and satellite cell repair. Recovery-enhancing agents such as epithalon, delta sleep-inducing peptide, and pinealon target circadian and mitochondrial regulators, and neuroactive peptides like selank, semax, and dihexa enhance brain-derived neurotrophic factor and HGF/c-Met pathways critical to neuroplasticity. Although preclinical studies are promising, there is a current lack of clinical trials. This review integrates current mechanistic insights with orthopaedic relevance, emphasizing safety, efficacy, and future directions for responsible integration into musculoskeletal care.
Published: January 14, 2026
Abstract
Growth hormone-releasing hormone (GHRH) and its synthetic analogs are considered performance-enhancing substances and are therefore prohibited by the World Anti-Doping Agency (WADA). The analysis of GHRH and its analogs in urine presents significant analytical challenges due to their inherent in vivo instability, rapid renal clearance, and low urinary concentrations. The present study aimed to develop a robust nano-LC quadrupole/orbitrap mass spectrometry (nano-LC-Q/Orbitrap MS) method for both screening and confirmation analyses of GHRH and its synthetic analogs (sermorelin/CJC-1293, tesamorelin, and CJC-1295) and the primary metabolite of sermorelin in urine, in accordance with WADA requirements. The sample preparation workflow was systematically investigated. Existing solid-phase extraction (SPE) protocols were compared, and two additional commercially available SPE cartridges were evaluated. Within the SPE step, the influence of various washing and elution solvent strengths on peptide recovery was also systematically examined. The effectiveness of different cleanup solvents during the ultrafiltration step was further assessed. Based on these evaluations, a refined approach was developed, incorporating an initial ultrafiltration step followed by SPE. The proposed method was fully validated according to WADA guidelines, assessing key parameters such as selectivity, reliability, limits of detection (LOD), carryover, limits of identification (LOI), robustness, autosampler stability, and matrix effects. The validation results confirmed the method's suitability and robustness for anti-doping testing. Achieved LODs (≤ 0.5 ng/mL) and LOIs (0.5-0.75 ng/mL) demonstrated sufficient sensitivity for effective detection and confirmation analysis of the target peptides in urine.
Published: October 8, 2025
Abstract
GHRH antagonists (GHRHAnt) were developed to suppress cancers and have been associated with robust anti-inflammatory and anti-oxidative activities. The mechanisms involved in those effects are not completely understood. MDA-MB-468 and A549 cancer cells, which express GHRH receptors, were treated with GHRHAnt JV-1-36, to evaluate the effects of that compound in autophagy. JV-1-36 induces autophagy in MDA-MB-468 and A549 cells since exposure to the aforementioned peptide elevated the expression levels of the autophagy-related protein (ATG) - 5, ATG - 3, ATG - 7, and ATG-16L1. In contrast, MCF-7 cells - which do not express GHRH receptors - did not respond to GHRHAnt. Our findings suggest that the beneficial effects of GHRHAnt in cancers may involve autophagy. Further studies will attempt to delineate the underlying mechanisms.
Published: March 31, 2025
Abstract
Growth hormone-releasing hormone (GHRH) antagonists exert antitumor functions in different experimental cancers. However, their role in combination with radiotherapy in non-small cell lung cancer (NSCLC) remains unknown. Therefore, we investigated the radiosensitizing effect of GHRH antagonists in NSCLC. A549 and H522 NSCLC cell lines were exposed to ionizing radiation (IR) and GHRH antagonists MIA-602 and MIA-690, either individually or in combination. Cell viability and proliferation were evaluated by MTT, BrdU, flow cytofluorimetry, and clonogenic assays; gene and protein expression, signaling pathways, and apoptosis were analyzed by real-time PCR, Western blot, annexin staining, and caspase-3 assay. GHRH antagonists showed antitumor effects alone and potentiated IR-induced inhibition of cell viability and proliferation. The combination of MIA-690 and IR decreased the expression of GHRH receptor, its oncogenic splice variant 1, and IGF1 mRNA levels. Additionally, cell cycle inhibitors and proapoptotic markers were upregulated, whereas cyclins, oncogenic MYC, and the antiapoptotic protein Bcl-2 were downregulated. Radioresistance was prevented by MIA-690, which also blunted epithelial-mesenchymal transition by enhancing E-cadherin and reducing mesenchymal, oxidative, and proangiogenic effectors. Finally, both MIA-602 and MIA-690 enhanced radiosensitivity in primary human NSCLC cells. These findings highlight the potential of GHRH antagonists as radiosensitizers in NSCLC treatment.
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