Expression of ghrelin in fundus is increased after gastric banding in morbidly obese patients
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Background: Ghrelin, a 28 amino-acid acylated orexigenic peptide secreted by the stomach, acts on the hypothalamic arcuate nucleus which stimulates feeding behavior. Serum ghrelin level increases during fasting and decreases after a meal. Serum ghrelin is low in obese patients. Whether ghrelin is implicated in weight loss in obese patients after laparoscopic adjustable gastric banding (LAGB) is still debated. In this study, we assessed serum ghrelin level and gastric fundus expression before and 1 year after LAGB.
Methods: Gastric fundus expression of ghrelin was assessed by immunohistochemistry using a rabbit anti-human ghrelin antibody simultaneously with serum total ghrelin levels (RIA) in 13 obese patients (2 men and 11 women) after an overnight fast, before LAGB and 1 year after. Immunostaining was “blindly” analyzed by a single pathologist, measuring the density of stained fundic cells near muscularis mucosa.
Results: Mean age of the 13 patients was 41 years, and mean baseline BMI was 46 kg/m2. Pre- and post-LAGB gastric expression of ghrelin was analyzable in 11 patients. It was always identified, mostly with moderate or intense staining. Mean density of stained cells significantly increased 1 year after LAGB: 31/mm2 (21–38) before vs 38/mm2 (27–57) after surgery (P<0.01). This increase did not correlate with changes in BMI, nor did pre- or postoperative gastric expression of ghrelin correlate with the corresponding serum values.
Conclusion: We showed for the first time that ghrelin expression assessed by immunohistochemistry was present in the fundus of all 11 obese patients and that it was significantly increased 1 year after LAGB, which would exclude a pathogenetic role of ghrelin in weight loss after LAGB.
- Ghigo E, Broglio F, Arvat E et al. Ghrelin: more than a natural GH secretagogue and/or an orexigenic factor. Clin Endocrinol 2005; 62: 1–17. CrossRef
- Tanaka-Shintani M, Watanabe M. Distribution of ghrelin-immunoreactive cells in human gastric mucosa: comparison with that of parietal cells. J Gastroenterol 2005; 40: 345–9. CrossRef
- Dornonville De La Cour C, Lindqvist A, Egecioglu E et al. Ghrelin treatment reverses the reduction in weight gain and body fat in gastrectomised mice. Gut 2005; 54: 907–13. CrossRef
- Torbergsen K, Wiksen H, Johansen K et al. Immunoreactivity of gastric ECL and A-like cells in fasted and fed rats and mice. Biotech Histochem 2005; 80: 21–30. CrossRef
- Cummings DE, Purnell JQ, Frayo RS et al. A preprandial rise in plasma ghrelin levels suggests a role in meal initiation in humans. Diabetes 2001; 50: 1714–9. CrossRef
- Tschop M, Weyer C, Tataranni PA et al. Circulating ghrelin levels are decreased in human obesity. Diabetes 2001; 50: 707–9. CrossRef
- Hansen TK, Dall R, Hosoda H et al. Weight loss increases circulating levels of ghrelin in human obesity. Clin Endocrinol (Oxf) 2002; 56: 203–6. CrossRef
- Buchwald H, Avidor Y, Braunwald E et al. Bariatric surgery. A systematic review and meta-analysis. JAMA 2004; 292: 1724–37. CrossRef
- O’Brien PE, Dixon JB, Laurie C et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program. A randomised trial. Ann Intern Med 2006; 144: 625–33.
- Nijhuis J, Van Dielen FMH, Buurman WA et al. Ghrelin, leptin and insulin levels after restrictive surgery: a 2-year follow-up study. Obes Surg 2004; 14: 783–7. CrossRef
- Kotidis EV, Koliakos GG, Baltzopoulos VG et al. Serum ghrelin, leptin and adiponectin levels before and after weight loss: comparison of three methods of treatment — A prospective study. Obes Surg 2006; 16: 1425–32. CrossRef
- Foschi D, Corsi F, Rizzi A et al. Vertical banded gastroplasty modifies plasma ghrelin secretion in obese patients. Obes Surg 2005; 15: 1129–32. CrossRef
- Cummings DE, Weigle DS, Frayo RS et al. Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med 2002; 346: 1623–30. CrossRef
- Fruhbeck G, Rotellar F, Hernandez-Lizoain JL et al. Fasting plasma ghrelin concentrations 6 months after gastric bypass are not determined by weight loss or changes in insulinemia. Obes Surg 2004; 14: 1208–15. CrossRef
- Geloneze B, Tambascia MA, Pilla VF et al. Ghrelin: a gut-brain hormone: effect of gastric bypass surgery. Obes Surg 2003; 13: 17–22. CrossRef
- Cohen R, Uzzan B, Bihan H et al. Ghrelin levels and sleeve gastrectomy in super-super-obesity. Obes Surg 2005; 15: 1501–2. CrossRef
- Langer FB, Reza Hoda MA, Bohdjalian A et al. Sleeve gastrectomy and gastric banding: Effects on plasma ghrelin. Obes Surg 2005; 15: 1024–9. CrossRef
- Adami GF, Cordera R, Marinari G et al. Plasma ghrelin concentration in the short-term following biliopancreatic diversion. Obes Surg 2003;13: 889–92. CrossRef
- Garcia-Unzueta MT, Fernandez-Santiago R, Dominguez-Diez A et al. Fasting plasma ghrelin levels increase after biliopancreatic diversion: one-year follow-up. Obes Surg 2005; 15: 187–90. CrossRef
- Ram E, Vishne T, Diker D et al. Impact of gastric banding on plasma ghrelin, growth hormone, cortisol, DHEA and DHEA-S levels. Obes Surg 2005; 15: 1118–23. CrossRef
- Busetto L, Segato G, De Luca M et al. High ghrelin concentration is not a predictor of less weight loss in morbidly obese women treated with laparoscopic adjustable gastric banding. Obes Surg 2006; 16: 1068–74. CrossRef
- Zinzindohoue F, Chevallier JM, Douard R et al. Laparoscopic gastric banding: A minimally invasive surgical treatment for morbid obesity. Prospective study of 500 consecutive patients. Ann Surg 2003; 237: 1–9. CrossRef
- Mottershead M, Karteris M, Barclay JY et al. Immunohistochemical and quantitative mRNA assessment of ghrelin expression in gastric and oesophageal adenocarcinoma. J Clin Pathol 2007; 60: 405–9. CrossRef
- Tatsuguchi A, Miyake K, Gudis K et al. Effect of Helicobacter pylori infection on ghrelin expression in human gastric mucosa. Am J Gastroenterol 2004; 99: 2121–7. CrossRef
- Stenstrom B, Zhao CM, Tommeras K et al. Is gastrin partially responsible for body weight reduction after gastric bypass? Eur Surg Res 2006; 38: 94–101.
- Couce ME, Cottam D, Esplen J et al. Is ghrelin the culprit for weight loss after gastric bypass surgery? A negative answer. Obes Surg 2006; 16: 870–8. CrossRef
- Fruhbeck G, Diez-Caballero A, Gil MJ et al. The decrease in plasma ghrelin concentrations following bariatric surgery depends on the functional integrity of the fundus. Obes Surg 2004; 14: 606–12. CrossRef
- Hanusch-Enserer U, Cauza E, Brabant G et al. Plasma ghrelin in obesity before and after weight loss after laparoscopical adjustable gastric banding. J Clin Endocrinol Metab 2004; 89: 3352–8. CrossRef
- Levin BE, Dunn-Meynell AA, Ricci MR et al. Abnormalities of leptin and ghrelin regulation in obese-prone juvenile rats. Am J Physiol Endocrinol Metab 2003; 285: E949-E957.
- Osawa H, Nakazato M, Date Y et al. Impaired production of gastric ghrelin in chronic gastritis associated with Helicobacter pylori. J Clin Endocrinol Metab 2005; 90: 10–6. CrossRef
- Osawa H, Kita H, Ohnishi H et al. Changes in plasma ghrelin levels, gastric ghrelin production, and body weight after Helicobacter pylori cure. J Gastroenterol 2006; 41: 954–61. CrossRef
- Expression of ghrelin in fundus is increased after gastric banding in morbidly obese patients
Volume 17, Issue 9 , pp 1159-1164
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- morbid obesity
- bariatric surgery
- gastric banding
- Industry Sectors
- Author Affiliations
- 1. Department of Pharmacology-Hormonology, Hôpital Avicenne, Assistance Publique — Hôpitaux de Paris, Bobigny, France
- 2. Bariatric Surgical College, Hôpital Avicenne, Assistance Publique — Hôpitaux de Paris, Bobigny, France
- 4. Department of Pathology, Hôpital Avicenne, Assistance Publique — Hôpitaux de Paris, Bobigny, France
- 5. Department of Gastroenterology, Hôpital Avicenne, Assistance Publique — Hôpitaux de Paris, Bobigny, France
- 6. Department of Gastroenterology, Hôpital Bichat, Assistance Publique — Hôpitaux de Paris, Paris, France