The influence of the eradication of Helicobacter pylori on gastric ghrelin, appetite, and body mass index in patients with peptic ulcer disease.
OBJECTIVE
Helicobacter pylori (H. pylori) infection has been known to influence the gastric leptin and ghrelin secretion, for which the exact pathogenic role has not been documented yet. This study was designed to investigate the influence of H. pylori eradication on plasma or gastric levels of ghrelin, body mass index (BMI), and resultant levels of appetite in patients with peptic ulcer disease.


METHODS
Twenty-two patients with H. pylori-associated active duodenal or gastric ulcer were treated with 7 weeks of antisecretory medication followed with 7 days of eradication regimen. The plasma and tissue ghrelin levels, tumor necrosis factor-alpha (TNF-alpha) mRNA, BMI, and appetite scale were checked before and after treatment. An additional endoscopic examination was conducted in 10 patients taking both ulcer treatment and H. pylori eradication.


RESULTS
Gastric ghrelin mRNA expression was significantly increased after either ulcer healing or H. pylori eradication, whereas gastric TNF-alpha mRNA expression was decreased after ulcer treatment and H. pylori eradication. In parallel with these changes, the visual analog scales for hunger and prospective food consumption were significantly increased after ulcer healing and H. pylori eradication. An increase in BMI was not statistically related to ulcer healing and H. pylori eradication therapy. In the subgroup analysis of 10 patients performed with additional endoscopic examination, ulcer treatment was associated with increased plasma ghrelin level and tissue ghrelin expression irrelevant to H. pylori eradication.


CONCLUSIONS
Restored tissue levels of ghrelin and improved status of appetite was achieved with gastric ulcer healing and H. pylori eradication.
Jang
Eun Jeong
EJ
Digestive Disease Center, Daejin Medical Center Jesaeng Hospital at Bundang, Bundang-gu, Seongnam, Korea.
Park
Sang Woon
SW
Park
Ju Sang
JS
Park
Sang Jong
SJ
Hahm
Ki-Baik
KB
Paik
So Ya
SY
Sin
Mi Kyung
MK
Lee
Eon Sook
ES
Oh
Sang Woo
SW
Park
Cheol Young
CY
Baik
Hyun Wook
HW
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001066:Appetite / Q000187:drug effects*; D015992:Body Mass Index; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000097:blood / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D004435:Eating / Q000187:drug effects; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism; D054439:Ghrelin / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D016481:Helicobacter Infections / Q000097:blood / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012333:RNA, Messenger / Q000378:metabolism; D013270:Stomach / Q000187:drug effects*; D013276:Stomach Ulcer / Q000097:blood / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014945:Wound Healing / Q000187:drug effects
D000900:Anti-Bacterial Agents; C515349:GHRL protein, human; D054439:Ghrelin; D054328:Proton Pump Inhibitors; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha