Catheter-directed gastric artery chemical embolization suppresses systemic ghrelin levels in porcine model.
OBJECTIVE
To prospectively test, in a porcine model, the hypothesis that catheter-directed gastric artery chemical embolization (GACE) can result in suppression of systemic ghrelin levels and affect weight gain.


METHODS
This study, which had Animal Care and Use Committee approval, was performed in healthy, growing swine (weight range, 40-45 kg; n = 10). GACE was performed in five swine with the infusion of sodium morrhuate (125 mug) selectively into the gastric arteries that supply the fundus. Five control animals underwent a sham procedure with 5 mL of saline. Weight and fasting plasma ghrelin levels were obtained in animals at baseline and in weeks 1-4. Statistical testing for substantial differences in ghrelin blood levels over time and between treated and untreated animals was performed by using a cross-sectional time-series linear model with feasibility generalized least squares.


RESULTS
The pattern of the change in ghrelin levels over time was significantly different between control and treated animals (P < .004). In treated animals, ghrelin levels were significantly reduced at week 1 (mean, 664.1 pg/mL +/- 103.1 [standard error of the mean], P < .02), week 2 (mean, 618.1 pg/mL +/- 180.4, P < .001), week 3 (mean, 578.4 pg/mL +/- 214.9, P < .001), and week 4 (mean, 876.6 pg/mL +/- 228.6, P < .03) relative to baseline (mean, 1006.3 pg/mL +/- 190.1). The percentage change in serum ghrelin values in swine treated with GACE decreased from baseline to -34%, -38.6%, -42.5%, and -12.9% during weeks 1-4, respectively. In control swine, percentage change in serum ghrelin was -1.7%, -9.7%, +2.6%, and +18.2% during weeks 1-4, respectively. At the end of 4 weeks, control swine continued to gain weight, with a 15.1% increase from their original weight, while the weight in swine treated with GACE plateaued at an increase of 7.8% from the original weight.


CONCLUSIONS
Catheter-directed GACE can suppress the appetite hormone ghrelin and affect weight gain.
Arepally
Aravind
A
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, 600 N Wolfe St, Blalock 544, Baltimore, MD 21287, USA. aarepal@jhmi.edu
Barnett
Brad P
BP
Patel
Tarak H
TH
Patel
Tarek T
TT
Howland
Valerie
V
Boston
Ray C
RC
Kraitchman
Dara L
DL
Malayeri
Ashkan A
AA
D000818:Animals; D002404:Catheterization; D004621:Embolization, Therapeutic; D054439:Ghrelin / Q000097:blood*; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use; D012976:Sodium Morrhuate / Q000627:therapeutic use; D013270:Stomach / Q000098:blood supply*; D013552:Swine; D015430:Weight Gain / Q000187:drug effects*
D054439:Ghrelin; D012597:Sclerosing Solutions; D012976:Sodium Morrhuate
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