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Ghrelin: new insight to mechanisms and treatment of postoperative gastric ileus.

Abstract
Postoperative gastric ileus develops after abdominal surgery and if prolonged leads to longer hospitalization times. Besides discomfort for the patient such as abdominal bloating and pain, this condition is associated with a great increase in healthcare costs. In order to develop new and effective treatment strategies to alleviate the ileus, a good understanding of the pathophysiogical underlying mechanisms is necessary. Postoperative gastric ileus consists of two phases, a first neural/humoral phase and a second inflammatory phase. The present review will focus on the role of the orexigenic and prokinetic hormone ghrelin in the development of postoperative ileus. Although ghrelin and ghrelin mimetics have been used during the recent years in pre-clinical and a first clinical trial to alleviate symptoms of postoperative ileus, the regulation of this hormone under conditions of abdominal surgery has just recently begun to be explored. Growing evidence indicates that postoperative restoration of ghrelin signaling leads to an orexigenic effect whereas the gastroprokinetic actions seem to require supraphysiological doses. Since the expression of ghrelin-O-acyltransferase (GOAT), the only ghrelin acylating enzyme, is reduced after abdominal surgery, the stimulation of GOAT signaling may also be a new promising approach to restore levels of acyl ghrelin under these conditions and a potential useful addition to ghrelin mimetics.
AuthorsAndreas Stengel, Yvette Taché
JournalCurrent pharmaceutical design (Curr Pharm Des) Vol. 17 Issue 16 Pg. 1587-93 ( 2011) ISSN: 1873-4286 [Electronic] United Arab Emirates
PMID21548864 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Review)
Chemical References
  • Ghrelin
Topics
  • Abdomen (surgery)
  • Animals
  • Energy Intake
  • Gastrointestinal Motility
  • Ghrelin (physiology)
  • Humans
  • Ileus (complications, physiopathology, therapy)
  • Postoperative Complications
  • Surgical Procedures, Operative (adverse effects)

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