Gastrointestinal peptides in children before and after hematopoietic stem cell transplantation

Abstract

Background: Gastrointestinal tract function and it's integrity are controlled by a number of peptides whose secretion is influenced by severe inflammation. In stomach the main regulatory peptide is ghrelin. For upper small intestine cholecystokinin and lower small intestine glucagon-like peptide- 1 are secreted, while fibroblast growth factor-21 is secreted by several organs, including the liver, pancreas, and adipose tissue [12]. Hematopoietic stem cell transplantation causes serious mucosal damage, which can reflect on this peptides. Methods: The aim of the study was to determine fasting plasma concentrations of ghrelin, cholecystokinin, glucagon- like peptide-1, and fibroblast growth factor -21, and their gene expressions, before and 6 months after hematopoietic stem cell transplantation. 27 children were studied, c ontrol group included 26 healthy children. Results: Acute graft versus host disease was diagnosed in 11 patients (41%, n=27). Median pre-transplantation concentrations of gastrointestinal peptides , as well as their gene expressions, were significantly lower in studied group compared with the control group. Only median of fibroblast growth factor-21 concentration was near-significantly higher before stem cell transplantation than in the control group. The post–hematopoietic transplant results revealed significantly higher concentrations of the studied peptides (except fibroblast growth factor-21) and respective gene expressions as compare to pre transplant results . M edian glucagone like peptide-1 concentrations were significantly decreased in patients with features of acute graft versus host disease . Moreover, negative correlation between glucagone like peptide-1 concentrations and acute graft versus host disease severity was found. Conclusions: Increased concentrations and gene expressions of gastrointestinal tract regulation peptides can be caused by stimulation of regeneration in the severe injured organ . Measurement of these parameters may be a useful method of assessment of severity of gastrointestinal tract complications of hematopoietic stem cell transplantation.

Glucagon-Like Peptide-1 Is Associated With Systemic Inflammation in Pediatric Patients Treated With Hematopoietic Stem Cell Transplantation

“…In this study, GLP-1 levels in the patients, including pre-transplant levels, were generally higher than in healthy controls, suggesting that similar mechanisms may, to some extent, be activated already at the timepoint of referral in these often severely affected patients. Our findings, however, appear to be in contrast to a study by Skoczén et al, reporting decreased GLP-1 levels before conditioning in pediatric HSCT patients ( 48 ). The reason for this discrepancy is unclear and difficult to judge based on the limited number of participants in their study (27 patients; of those nine had a non-malignant diagnosis) and with an absence of observations in the early post-transplant period.…”