Quantitative immunohistochemical analysis of duodenal ghrelin cells after sleeve gastrectomy in Wistar rats

Abstract

PURPOSE: Sleeve gastrectomy (SG) removes substantial part of the gastric mucosa, which produces ghrelin. This reduction is expected to force other organs, such as the duodenum, to compensate by increasing the number of ghrelin-producing cells. The purpose of this study was to evaluate whether this response occurs. METHODS: Twelve adult male, Wistar rats underwent SG and were reoperated 30 or 60 days after the initial surgery. During the second surgery, a segment of the duodenum was resected to count ghrelin cells using immunohistochemistry. In six animals, SG was not performed, and the duodenal segment served as a control for ghrelin cell counts. The ghrelin cell index (GCI), which is the number of ghrelin cells divided by the number of villi in each segment, was measured and used in statistical analysis by one-way analysis of variance (ANOVA). RESULTS: There were increases in the absolute numbers of cells 30 and 60 days after SG, but statistical analysis by ANOVA showed no significant difference between the groups. CONCLUSION: A compensatory increase in the number of duodenal immunopositive ghrelin cells did not occur as a response to sleeve gastrectomy.

Does gastric resection volume influence sleeve gastrectomy results? a prospective study

“…These results may depend on a different hormonal response induced by resection. 29,30 In fact, in these cases, we observed a rapid control of glucose levels: at 6 months of follow up we observed similar results to those obtained at 12 postoperative months for resection inferior to 1800 mL. In our opinion, the rapid stabilization of glucose levels and blood pressure indicate a major hormonal depletion induced by a major gastric resection.…”

“…Some animal studies show an overexpression of ghrelin secreting duodenal cells several months after gastric resection, and a subsequent increase in hormonal blood levels. 30 Once confirmed in humans, these data could justify the different metabolic reaction in patients with an RGV>1800 mL. Further studies on hormonal signaling, especially ghrelin, are actually in progress in our Department to support this hypothesis.…”

Clinical application of ghrelin administration for gastric cancer patients undergoing gastrectomy

“…In the long term, postoperative plasma ghrelin levels sometimes approach preoperative levels in patients who have undergone distal gastrectomy. It has been reported that the number of ghrelin-producing cells does not increase after gastrectomy [39]. Persistent low body weight after gastrectomy might stimulate ghrelin secretion from individual ghrelin-producing cells in a negative feedback manner.…”

Alterations in Small Intestine and Liver Morphology, Immunolocalization of Leptin, Ghrelin and Nesfatin-1 as Well as Immunoexpression of Tight Junction Proteins in Intestinal Mucosa after Gastrectomy in Rat Model

“…Unfortunately, literature concerning the consequences of gastrectomy on the expression of the hormones assessed in the present study is very limited. Teive et al [78] observed no significant changes in the number of ghrelin-positive cells in the duodenum of rats after SG.…”