糖尿病肺病已知是糖尿病并发症之一，但对其治疗策略的报告很少。本研究旨在为糖尿病肺病增加新的治疗策略，揭示ghrelin对糖尿病肺病生物内外具有保护作用，并探讨其可能的分子机制。我们的研究对象为糖尿病小鼠和16HBE细胞。我们通过H＆E染色，调查ghrelin对链脲佐菌素诱导的肺部组织形态学改变的影响。此外，通过酶联免疫吸附实验检测前炎症因子（白介素-1β（IL-1β）和肿瘤坏死因子-α（TNF-α））的变化。为了阐明分子机制，我们检测了TLR4通路的关键蛋白质，并通过免疫组化（IHC）、实时PCR和Western blot分析在体内和体外观察其变化。H＆E染色的结果显示，ghrelin可以减轻高血糖引起的肺部病理变化。酶联免疫吸附实验的结果表明，在ghrelin治疗后，高血糖引起的IL-1β和TNF-α升高的水平在肺部变为降低。在IHC、实时PCR和Western blot分析的结果中，我们发现高血糖或高葡萄糖使TLR4通路升高，并且ghrelin的治疗在体内和体外都显着抑制了它。 Ghrelin通过调节TLR4通路抑制糖尿病肺病的炎症反应。本研究可能会影响对糖尿病肺病的研究，ghrelin用于糖尿病肺病的治疗潜力值得考虑。©作者（或其雇主）2023年。在CC BY-NC许可下允许重复使用。不得进行商业再利用。由BMJ发布。

Diabetic lung disease is already known as one of the diabetes complications, but report on its therapeutic strategy is rare. The present study aimed to add novel therapeutic strategy for diabetic lung disease, to reveal the protective effect of ghrelin on diabetic lung disease both in vivo and in vitro, and to discuss its probable molecular mechanism.Diabetic mice and 16HBE cells were our research objects. We surveyed the effect of ghrelin on streptozotocin-induced lung tissue morphology changes by H&E staining. Furthermore, the changes of proinflammatory cytokines (interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α)) were detected by ELISA. To expound the molecular mechanism, we detected critical proteins of TLR4 pathway and observed their changes by immunohistochemistry (IHC), real-time PCR and western blot analysis in vivo and in vitro, respectively.The results of H&E staining showed that pathological alterations of the lung induced by hyperglycemia were ameliorated by ghrelin. The results of ELISA demonstrated that the elevated levels of IL-1β and TNF-α induced by hyperglycemia turned to decrease in the lung after ghrelin treatment. In the results of IHC, real-time PCR and western blot analysis, we found that the TLR4 pathway was elevated by hyperglycemia or high glucose and is remarkably inhibited by the treatment of ghrelin both in vivo and in vitro.Ghrelin could inhibit inflammation of diabetic lung disease by regulating the TLR4 pathway. This study might affect research on diabetic lung disease, and the therapeutic potential of ghrelin for diabetic lung disease is worth considering.© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.