Abnormal ghrelin secretion contributes to gastrointestinal symptoms in multiple system atrophy patients

Abstract

Patients with multiple system atrophy (MSA) often have evidence of compromised gastrointestinal motility. Ghrelin is a gut hormone that influences gastrointestinal motility in humans. The aim of this study was to determine whether ghrelin secretion is affected in MSA patients, and to investigate the relation between ghrelin secretion and gastrointestinal symptoms. Plasma levels of active ghrelin and unacylated ghrelin were measured in patients with MSA (n = 30), other atypical parkinsonian disorders including progressive supranuclear palsy-Richardson syndrome and corticobasal syndrome (n = 24), and control subjects (n = 24) using enzyme-linked immunosorbent assays. Gastrointestinal symptoms were quantified in all subjects using a self-report questionnaire. The ratio of active ghrelin to total ghrelin in the plasma (active ghrelin ratio) was lower in patients with MSA (mean: 8.0 %) than in patients with other atypical parkinsonian disorders (mean: 13.7 %, P = 0.001) and control subjects (mean: 13.9 %, P = 0.001). The active ghrelin ratio was correlated with the severity of gastrointestinal symptoms in MSA (r = −0.5, P = 0.004). Our observations indicate that ghrelin secretion is affected in patients with MSA. The low active ghrelin ratio may contribute to gastrointestinal symptoms in MSA.

Role of ghrelin in small intestinal motility following pediatric intracerebral hemorrhage in mice

“…To date, multiple brain-gut peptides have been identified (38)(39)(40)(41)(42), including somatostatin, gastri), cholecystokinin, vasoactive intestinal peptide, motilin, substance P and ghrelin. Ghrelin is an endogenous ligand of the growth hormone secretagogue receptor, and has been shown to be important in several diseases (26)(27)(28)(29)(30). However, the dynamic changes in serum levels of ghrelin during the early stages of ICH, and its time-dependent correlation with SIM, have not been reported previously.…”

“…There has been increasing interest regarding its potent effects on gastric emptying and GI motility. A number of studies have shown that the peptide is vital in protecting against GI dysmotility in various diseases, including multiple system atrophy (26), systemic sclerosis (27), stress (28), shock (29), diabetes (30) and brain events (11)(12)(13)(14). However, the protective role and underlying mechanisms of ghrelin in ICH-induced small intestinal dysmotility remain to be elucidated, which has limited systemic treatment paradigms for pediatric ICH.…”