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Ghrelin as an acute-phase reactant during postoperative stress response.

P Maruna¹, R Gürlich, M Rosická

¹Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic. maruna@LF1.cuni.cz

Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme

|April 12, 2008

Summary

Postoperative ghrelin levels significantly increase after colon cancer surgery, acting as an acute-phase reactant. This elevation correlates with inflammatory cytokines, suggesting a role for inflammation in ghrelin

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Area of Science:

Endocrinology
Surgical Oncology
Immunology

Background:

Ghrelin, a growth hormone-releasing peptide, has an unclear role in inflammation and stress response.
Understanding perioperative ghrelin dynamics is crucial for surgical patient management.

Purpose of the Study:

To characterize perioperative circulating ghrelin levels in patients undergoing different surgical procedures.
To compare plasma ghrelin changes with cortisol, cytokines, and acute-phase proteins post-surgery.

Main Methods:

Prospective study involving 44 patients: 22 with colon cancer resection (Group 1) and 22 with cholecystectomy (Group 2).
Repeated measurement of plasma ghrelin, cortisol, TNF-alpha, IL-1beta, IL-6, IL-8, soluble IL-2 receptor, C-reactive protein, and alpha1-antitrypsin over 72 hours post-operation.

Main Results:

Plasma ghrelin significantly elevated 24 hours after colon cancer resection compared to preoperative levels and Group 2.
Ghrelin levels normalized 36-48 hours post-surgery, with a subsequent decline.
Strong correlations observed between ghrelin and TNF-alpha, and ghrelin and IL-6 24 hours post-surgery.

Conclusions:

Ghrelin functions as an acute-phase reactant following major abdominal surgery.
Inflammatory cytokines likely play a regulatory role in postoperative ghrelin elevation.
Inflammatory factors appear to be the primary drivers of ghrelin elevation after surgery.