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Title: Ghrelin in gastric mucosal diseases conected with Helicobacter pylori infection

Abstract:

Ghrelin is a hormone produced by neuroendocrine cells of gastric mucosa. Its concentration varies in cases of Helicobacter pylori (Hp) infection of stomach. However this relation is not completely defined. Determination of changes in ghrelin plasma and gastric mucosa concentrations in cases of diseases of gastric mucosa related to Hp infection constituted the aim of the study. 78 patients in whom endoscopy of upper gastrointestinal tract was performed in 2nd Chair of General Surgery of Jagiellonian University Medical College from January 2006 to May 2008 constituted material of the study. Patients were divided into four main groups on the basis of initial diagnosis made at admission to the Department. Group 1 – patients suffering from gastric cancer with concomitant Hp infection (n=25); Group 2 – patients with inflammatory lesions of prepyloric region with Hp infection and concomitant duodenal peptic ulcer disease (n=18); Group 3 – patients with atrophic gastritis of fundus and body of the stomach without Hp infection found during endoscopy (n=10); Group 4 – patients without morphological and histological lesions of gastric mucosa and without Hp infection (n=25). Ghrelin plasma concentration was measured in fasting plus 60 and 90 minutes after meal. In the group 1 measurement was performed twice – before and after the surgical operation. Furthermore gastrin and leptin concentrations were assessed in particular groups in the same manner as abovementioned. Additionally endoscopic biopsies of gastric mucosa of fundus, body and prepyloric region were performed in every patient. In patients suffering from gastric cancer biopsies of tumor were also performed. Biopsy specimens were examined to assess ghrelin and gastrin mRNA expression in gastric mucosa. The study showed significant influence of Hp infection on ghrelin and gastrin plasma concentrations. The highest ghrelin concentrations were found in patients from the group 2 – i.e. patients with prepyloric gastritis with Hp infection and concomitant duodenal ulcer - 503 pg/ml; 95% CI: 285,1 – 886,2. Ghrelin concentrations were found to be the lowest in the group 3 - – 144 pg/ml; 95% CI: 93 – 222. In the group 1 – patients with gastric cancer and concomitant Hp infection – ghrelin concentrations before the surgical operation amounted 203 pg/ml; 95% CI: 161 – 257,4, while in the group 4 (control group) - 255 pg/ml; 95% CI: 160,5 – 406,3. In patients from the group 1 after total gastrectomy ghrelin concentrations proved to significantly decrease to the level of 135 pg/ml; 95% CI: 83 – 220, that was not found in patients after distal stomach resection – 220 pg/ml; 95% CI: 103-473,2. Higher ghrelin plasma concentrations were also found in patients with gastric cancer localized not in the fundus as compared to patients with cancer localized in the fundus of stomach, but those differences were not statistically significant. The highest basal (measured in fasting) gastrin plasma concentrations were found in the group 2 - 56,1 pM/l; 95% CI: 22-144 – and group 3 - 56,4 pM/l; 95% CI: 27,4-115,2. I the group 1 before the surgery mean gastrin concentration amounted 29,1 pM/l; 95% CI: 20- 43, decreased after total gastrectomy to the level of 16 pM/l; 95% CI: 11,5-21,3, while after distal stomach resection to the level of 17 pM/l; 95% CI: 11-28,1. The lowest gastrin concentrations were found in the control group (group 4) – 18,3 pM/l; 95% CI: 8,4-39,5. The highest basal (measured in fasting) leptin concentrations were found in the group 4 (control group), i.e. without Hp infection - – 6,6 ng/ml; 95%CI: 4,4-11, whereas the lowest concentrations were found in the group 1, i.e. patients with gastric cancer with concomitant Hp infection in whom amounted (before the surgery) - 2,1ng/ml; 95% CI: 1,3 – 3,3. After the surgery leptin concentrations did not change significantly regardless of the type of resection. ; The study proved that presence of Hp infection in stomach in patients with duodenal ulcer significantly increase ghrelin and gastrin plasma concentrations, while in patients with gastric cancer ghrelin concentration despite Hp infection remains low, probably because carcinomatous cells do not present ghrelin-production activity, that was confirmed on RT-PCR examination of biopsy specimens of the cancer. As contrasted to this fact, gastrin is produced by cancer tissue in abundance. Similarly in patients with atrophic gastritis without Hp infection ghrelin levels are low, while gastrin levels are markedly increases.

Level of degree:

2 - studia doktoranckie

Degree discipline:

choroby układu trawiennego

Degree grantor:

Wydział Lekarski

Promoter:

Kazimierz Rembiasz

Date issued:

2009

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Identifier:

oai:dl.cm-uj.krakow.pl:942

Call number:

ZB-110927

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tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

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Last modified:

Sep 17, 2019

In our library since:

Nov 21, 2012

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http://dl.cm-uj.krakow.pl:8080/publication/942

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ZB-110927 Sep 17, 2019
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