Development of the selective ghrelin replacement therapy according to the ghrelin dependency in each patient

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K10457
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: General surgery
• Research Institution: Osaka University
• Principal Investigator: Miyazaki Yasuhiro 大阪大学, 医学系研究科, 助教 (00571390)
• Co-Investigator(Kenkyū-buntansha): 瀧口 修司 名古屋市立大学, 大学院医学研究科, 教授 (00301268) ; 黒川 幸典 大阪大学, 医学系研究科, 助教 (10470197) ; 山崎 誠 大阪大学, 医学系研究科, 准教授 (50444518) ; 高橋 剛 大阪大学, 医学系研究科, 助教 (50452389)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: グレリン / グレリン依存性 / 幽門側胃切除 / 胃全摘 / スリーブ状胃切除 / 外科代謝栄養学

Outline of Final Research Achievements

To validate the evidence of ghrelin dependency, we planned to examine the mRNA level of ghrelin at fornix gastric mucosa in patients before and 1 year after distal or sleeve gastrectomy. Our study revealed the re-enhanced ghrelin expression at the lesser curvature of remnant stomach for several cases who underwent sleeve gastrectomy. Such re-enhanced cases showed the lesser body weight reduction, who were thought to have higher ghrelin dependency rather than non-enhanced cases. In addition to these results, there were the wide variability of effect by ghrelin replacement therapy in our clinical trial.
Our conclusion and implication is that ghrelin dependency existed in human. Ghrelin dependency level may be useful as the predictor to estimate the effectiveness of the ghrelin activator drugs.

Free Research Field

胃外科学，外科代謝栄養学

Academic Significance and Societal Importance of the Research Achievements

胃癌に対する胃切除や化学療法（抗癌剤）は，胃が産生するグレリンホルモンの低下をきたすため多くの症状が出ますが，患者ごとにその症状が異なるのは，グレリンホルモンへの依存性による可能性が本研究で示唆されました．今後，この依存性が高い患者には，グレリンホルモン薬を投与するなどQOL改善に直結する治療開発につながる可能性があり，社会的意義が大きいと思われます．