title: Perturbation of acyl ghrelin profile after liver transplantation.
abstract: BACKGROUND
  A significant problem to be solved for patients after liver transplantation (LT) is malnutrition with anorexia in the early posttransplant period. We hypothesized that this problem was due to the change in ghrelin metabolism during LT. The aim of this study was to examine the balance of acyl ghrelin (AG) and desacyl ghrelin and the dependence of the regulation mechanism on hepatic-related enzymes in patients during LT.
  
  
  METHODS
  AG, desacyl ghrelin, and acyl/total ghrelin (A/T) concentrations in blood samples were measured in 15 patients with liver failure (LF), 15 patients after LT, and 10 controls. The correlations between the participants' ghrelin profiles and hepatic function-related data, including liver enzymes, were evaluated. In vitro assays using synthetic AG for assessment of deacylation activity in serum were performed.
  
  
  RESULTS
  AG and A/T ratio were significantly higher in the LF patients than the patients after LT and controls (AG: 25.9 ± 12.6 versus 16.4 ± 12.6 and 9.8 ± 7.6 fmol/mL, P < 0.05; A/T ratio: 17.4 ± 4.1 versus 12.2 ± 5.5 and 11.8% ± 5.9%, P < 0.05). The serum cholinesterase level was inversely correlated with AG and A/T ratio (P < 0.01). In vitro assays showed that deacylation activity was significantly lower in patients with LF than controls (10.5% versus 42.4%, 90 min; P < 0.01). Degradation of AG was partially suppressed by a cholinesterase inhibitor.
  
  
  CONCLUSIONS
  Deacylation activity was lower in LF patients, which could cause elevation of AG levels. Serum cholinesterase may be responsible for deacylation in humans.
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Murakami
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: stakiguchi@gesurg.med.osaka-u.ac.jp.
authors.forename: Shuji
authors.initials: S
authors.lastname: Takiguchi
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Kurokawa
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamasaki
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.affiliation: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
mesh_terms: D000215:Acylation; D000368:Aged; D016022:Case-Control Studies; D002802:Cholinesterases / Q000378:metabolism; D005260:Female; D054439:Ghrelin / Q000378:metabolism*; D006801:Humans; D017093:Liver Failure / Q000097:blood; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000209:etiology*; D008875:Middle Aged
chemical_list: D054439:Ghrelin; D002802:Cholinesterases
keywords: Acyl ghrelin; Deacylation; Liver failure; Liver transplantation