Effects of ghrelin administration on the early postoperative inflammatory response after esophagectomy.
OBJECTIVE
Ghrelin is a unique gastric hormone, which has pleiotropic biological functions, including anti-inflammatory effects. The aim of this study was to investigate the effects of administering ghrelin on reducing postoperative systemic inflammation in patients undergoing esophagectomy.


METHODS
The safety and effectiveness of postoperative ghrelin administration were investigated among twenty esophageal cancer patients who underwent esophagectomy between May 2010 and August 2011. Two different regimens of ghrelin administration, twice daily rapid drip infusion (3 μg/kg, twice a day) or continuous infusion (0.5 μg/kg/h), were employed. The duration of the systemic inflammatory response syndrome (SIRS) and the hematological parameters were compared between groups.


RESULTS
Patients treated with ghrelin showed shorter SIRS durations than controls (1.6 ± 2.7 vs. 4.1 ± 3.7 days, respectively; p = 0.0065) and also showed lower C-reactive protein concentrations than controls (11.0 ± 4.6 mg/dL vs. 15.3 ± 7.3 mg/mL, respectively, on postoperative day 3, p = 0.030). Ghrelin administration was not associated with any adverse events. The incidence of operative morbidity was equivalent between groups. The two ghrelin administration regimens showed similar durations of systemic inflammatory response (rapid drip: 2.2 ± 3.3 vs. continuous: 1.1 ± 1.9 days, p = 0.17).


CONCLUSIONS
Postoperative ghrelin administration is safe and may suppress protracted postoperative inflammation in patients who undergo esophagectomies.
Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 E2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
Akihiro
A
Takata
Shuji
S
Takiguchi
Kohei
K
Murakami
Yasuhiro
Y
Miyazaki
Hiroshi
H
Miyata
Tsuyoshi
T
Takahashi
Yukinori
Y
Kurokawa
Makoto
M
Yamasaki
Kiyokazu
K
Nakajima
Masaki
M
Mori
Kenji
K
Kangawa
Yuichiro
Y
Doki
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents; D015415:Biomarkers / Q000097:blood; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D054439:Ghrelin / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D016896:Treatment Outcome; D055815:Young Adult
D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D054439:Ghrelin; D015850:Interleukin-6