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 pathophysiological 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.
Keywords: abdominal surgery, desacyl ghrelin, drug treatment, ghrelin-O-acyltransferase, GOAT, sympathectomy, non-cholinergic, hypothalamus, antagonists, Opioid, muscularis, histiocytes, macrophages, oligonucleotides, secretagogue, acylation, decarboxylase
Current Pharmaceutical Design
Title: Ghrelin: New Insight to Mechanisms and Treatment of Postoperative Gastric Ileus
Volume: 17 Issue: 16
Author(s): Andreas Stengel and Yvette Tache
Affiliation:
Keywords: abdominal surgery, desacyl ghrelin, drug treatment, ghrelin-O-acyltransferase, GOAT, sympathectomy, non-cholinergic, hypothalamus, antagonists, Opioid, muscularis, histiocytes, macrophages, oligonucleotides, secretagogue, acylation, decarboxylase
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 pathophysiological 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.
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Cite this article as:
Stengel Andreas and Tache Yvette, Ghrelin: New Insight to Mechanisms and Treatment of Postoperative Gastric Ileus, Current Pharmaceutical Design 2011; 17 (16) . https://dx.doi.org/10.2174/138161211796196990
DOI https://dx.doi.org/10.2174/138161211796196990 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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