Ghrelin plasma levels, gastric ghrelin cell density and bone mineral density in women with rheumatoid arthritis

Abstract

Generalized bone loss can be considered an extra-articular manifestation of rheumatoid arthritis (RA) that may lead to the occurrence of fractures, resulting in decreased quality of life and increased healthcare costs. The peptide ghrelin has demonstrated to positively affect osteoblasts in vitro and has anti-inflammatory actions, but the studies that correlate ghrelin plasma levels and RA have contradictory results. We aimed to evaluate the correlation between total ghrelin plasma levels, density of ghrelin-immunoreactive cells in the gastric mucosa, and bone mineral density (BMD) in twenty adult women with established RA with 6 months or more of symptoms (mean age of 52.70±11.40 years). Patients with RA presented higher ghrelin-immunoreactive cells density in gastric mucosa (P=0.008) compared with healthy females. There was a positive relationship between femoral neck BMD and gastric ghrelin cell density (P=0.007). However, these same patients presented a negative correlation between plasma ghrelin levels and total femoral BMD (P=0.03). The present results indicate that ghrelin may be involved in bone metabolism of patients with RA. However, the higher density of ghrelin-producing cells in the gastric mucosa of these patients does not seem to induce a corresponding elevation in the plasma levels of this peptide.

Role and molecular mechanism of ghrelin in degenerative musculoskeletal disorders

“…Promoting osteoblast proliferation and differentiation and inhibiting apoptosis [57], [58] GHSR/ERK and GHSR/PI3K/AKT Inhibiting apoptosis in MC3T3-E1 cells [59] GH-IGF-I axis Increasing BMD [60] OA JAK2/STAT3/IRF-1 Suppressing the expression of MMPs and ADAMTs and inhibiting degradation of human chondrocyte aggregates and Col II [61], [62] NF-κB Antagonizing exaggerated catabolism in degenerative chondrocytes [63] AKT Suppressing the disorganized anabolism [ an important role in promoting the proliferation and differentiation of osteoblasts.…”

“…OA occurs because of cartilage damage and degeneration caused by inflammatory factors. Recent studies have shown that ghrelin has cartilage‐protective and anti‐inflammatory effects, 63 suggesting that decreased ghrelin levels may be associated with OA development.…”