title: Catheter-directed gastric artery chemical embolization for modulation of systemic ghrelin levels in a porcine model: initial experience.
abstract: OBJECTIVE
  To prospectively test, in a porcine model, the hypothesis that use of catheter-directed gastric artery chemical embolization (GACE) can result in substantial suppression of systemic ghrelin levels.
  
  
  METHODS
  The institutional animal care and use committee approved this study. Adult healthy swine (40-45 kg, n=8) were tested. GACE was performed by infusing morrhuate sodium selectively into the left gastric artery. Six swine (animals A-F) underwent left GACE by using a dose-escalating regimen of morrhuate sodium, whereas two control swine underwent a sham procedure. Weight and fasting plasma ghrelin levels were compared in swine at baseline and at weeks 1-4. At week 4, stomachs were excised and analyzed. Analysis of the change in ghrelin values and weight was performed with both paired t test and unpaired Student t test.
  
  
  RESULTS
  In control swine (n=2), there was no significant difference in ghrelin values before (844.8 pg/mL +/- 40 [standard deviation]) and after (997 pg/mL +/- 93) the procedure (P=.5). Swine that received a low dose of morrhuate sodium (animals A-D) showed a significant increase in serum ghrelin values from 683.7 pg/mL +/- 241 to 1555.9 pg/mL +/- 312 (P=.002). At a higher dose, the mean baseline ghrelin values decreased from 466 pg/mL to 187 pg/mL +/- 162. Weight changes of +1.4% and +8.6% were seen in swine that underwent GACE and control swine, respectively. Histochemical staining showed preservation of overall tissue architecture and parietal cells.
  
  
  CONCLUSIONS
  Use of GACE can result in increased or suppressed ghrelin levels.
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Johns Hopkins Hospital, Blalock 545, 600 N Wolfe St, Baltimore, MD 21287, USA. aarepal@jhmi.edu
authors.forename: Aravind
authors.initials: A
authors.lastname: Arepally
authors.forename: Brad P
authors.initials: BP
authors.lastname: Barnett
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Montgomery
authors.forename: Tarak H
authors.initials: TH
authors.lastname: Patel
mesh_terms: D000818:Animals; D002404:Catheterization; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D005240:Feasibility Studies; D054439:Ghrelin; D007150:Immunohistochemistry; D036361:Peptide Hormones / Q000097:blood*; D010865:Pilot Projects; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000494:pharmacology; D012976:Sodium Morrhuate / Q000008:administration & dosage / Q000494:pharmacology; D013270:Stomach / Q000098:blood supply*; D013552:Swine
chemical_list: D054439:Ghrelin; D036361:Peptide Hormones; D012597:Sclerosing Solutions; D012976:Sodium Morrhuate