Ghrelin Suppression and Fat Loss after Left Gastric Artery Embolization in Canine Model

Bawudun, Dilmurat; Xing, Yan; Liu, Wenya; Huang, Yu-Jie; Ren, Wei; Ma, Mei; Xu, Xiping; Teng, Gao‐Jun

doi:10.1007/s00270-012-0362-8

Cited by 48 publications

(40 citation statements)

References 22 publications

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“…Arepally et al described the first gastric artery chemical embolization, showing reductions in ghrelin levels in an animal model and suggested the use of this less invasive technique to treat obesity [15]. In a study by Bawudun et al, after they performed left gastric artery embolization (LGAE) in a canine model, they found that plasma ghrelin values were significantly lower than at baseline and that significant weight loss also occurred [25]. Currently, there are many image-guided interventional studies regarding embolization of the left gastric artery and its effectiveness with respect to total weight loss and decreased ghrelin levels.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Weight Loss, Ghrelin, and Leptin Hormones After Ligation of Left Gastric Artery and Sleeve Gastrectomy in a Rat Model

et al. 2017

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BackgroundLigation of the left gastric artery (LLGA), which supplies the fundus of the stomach, may reduce the appetite hormone ghrelin, resulting in weight control. The aim of this study was to compare LLGA and sleeve gastrectomy (SG) in terms of postoperative outcomes in a rat model.Material/MethodsFifteen male Wistar albino rats, weighing >350 grams (range 350–525 grams), were enrolled in LLGA (N=5), SG (N=5), and control (N=5) groups. Blood samples were drawn preoperatively and also during the first and fourth week postoperatively to assay ghrelin and leptin hormone levels. Body weight was measured in each group.ResultsThe maximum reduction in ghrelin level (41.5%) was found in the LLGA group. Considerable% total weight loss (TWL) (mean 24.1%) was observed in the SG group, and slight%TWL was noted in the control and LLGA groups (means of 0.1% and 2.1%, respectively). There was no significant difference in mean percent weight change between the LLGA and the SG groups (p=0.08). Blood sample analysis revealed no statistically significant changes in ghrelin or leptin levels between the groups (p=0.9 and p=0.3, respectively).ConclusionsWe present evidence that LLGA causes the same reduction in ghrelin hormone levels as SG at 4 weeks after surgery in a rat model. However, LLGA did not cause the same%TWL as SG. The mechanism of weight loss in SG is most likely due to restriction and to the effects of the procedure, rather than due to neurohormonal changes.

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Section: Discussionmentioning

confidence: 99%

Comparison of Weight Loss, Ghrelin, and Leptin Hormones After Ligation of Left Gastric Artery and Sleeve Gastrectomy in a Rat Model

et al. 2017

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“…Although ghrelin-producing cells are present throughout the gastrointestinal tract, the highest density is in the gastric fundus, with 10–20 times more ghrelin per gram of tissue than the duodenum, the next richest source, with cell density decreasing caudally (5,6,19,20). Bariatric embolization of the fundus with particles has previously been shown to result in significant depression of serum ghrelin levels with a corresponding impact on weight in both porcine and canine models (15,16). Given the complexity of ghrelin regulation, the actual etiology for serum depression of ghrelin was previously unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Third, embolization of all arteries to the gastric fundus to stasis was performed to maximize ischemic insult to the gastric fundus, which may be responsible for the development of ulcers. In a different study, embolization solely of the left gastric artery was adequate to induce a depression in serum ghrelin levels but without producing ulcers (15). Although ghrelin is an important hormone that promotes hunger, numerous other hormones can affect hunger, and the impact of bariatric embolization on these hormones was not studied.…”

Section: Discussionmentioning

confidence: 99%

Histopathologic and Immunohistochemical Sequelae of Bariatric Embolization in a Porcine Model

Paxton

Alley

Crow

et al. 2014

Journal of Vascular and Interventional Radiology

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Purpose To evaluate the histopathologic sequelae of bariatric embolization on the gastric mucosa and to correlate with immunohistochemical evaluation of the gastric fundus, antrum, and duodenum. Materials and Methods This study was performed on 12 swine stomach and duodenum specimens after necropsy. Of the 12 swine, 6 had previously undergone bariatric embolization of the gastric fundus, and the 6 control swine had undergone a sham procedure with saline. Gross pathologic, histopathologic, and immunohistochemical examinations of the stomach and duodenum were performed. Specifically, mucosal integrity, fibrosis, ghrelin-expressing cells, and gastrin-expressing cells were assessed. Results Gross and histopathologic evaluation of treatment animals showed healing or healed mucosal ulcers in 50% of animals, with gastritis in 100% of treatment animals and in five of six control animals. The ghrelin-immunoreactive mean cell density was significantly lower in the gastric fundus in the treated animals compared with control animals (15.3 vs 22.0, P < .01) but similar in the gastric antrum (9.3 vs 14.3, P = .08) and duodenum (8.5 vs 8.6, P = .89). The gastrin-expressing cell density was significantly lower in the antrum of treated animals compared with control animals (82.2 vs 126.4, P = .03). A trend toward increased fibrosis was suggested in the gastric fundus of treated animals compared with controls (P = .07). Conclusions Bariatric embolization resulted in a significant reduction in ghrelin-expressing cells in the gastric fundus without evidence of upregulation of ghrelin-expressing cells in the duodenum. Healing ulcerations in half of treated animals underscores the need for additional refinement of this procedure.

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“…Multiple animal studies using distally penetrating embolic agents showed up to a 60% decrease in serum ghrelin levels, with decreased weight gain in growing swine compared with control groups [48–50]. Bawudun et al [51] also showed suppressed ghrelin and weight gain after gastric artery embolization in a canine model. Using a porcine model, Diana et al [52] showed significant ghrelin reduction in the pigs that underwent gastric artery embolization with 100–300-μm beads followed by coil embolization, compared with the group treated with 500–700-μm beads alone.…”

Section: Bariatric Embolizationmentioning

confidence: 99%

Current and cutting-edge interventions for the treatment of obese patients

Vairavamurthy

Cheskin

Kraitchman

et al. 2017

European Journal of Radiology

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The number of people classified as obese, defined by the World Health Organization as having a body mass index ≥30, has been rising since the 1980s. Obesity is associated with comorbidities such as hypertension, diabetes mellitus, and nonalcoholic fatty liver disease. The current treatment paradigm emphasizes lifestyle modifications, including diet and exercise; however this approach produces only modest weight loss for many patients. When lifestyle modifications fail, the current “gold standard” therapy for obesity is bariatric surgery, including Roux-en-Y gastric bypass, sleeve gastrectomy, duodenal switch, and placement of an adjustable gastric band. Though effective, bariatric surgery can have severe short- and long-term complications. To fill the major gap in invasiveness between lifestyle modification and surgery, researchers have been developing pharmacotherapies and minimally invasive endoscopic techniques to treat obesity. Recently, interventional radiologists developed a percutaneous transarterial catheter-directed therapy targeting the hormonal function of the stomach. This review describes the current standard obesity treatments (including diet, exercise, and surgery), as well as newer endoscopic bariatric procedures and pharmacotherapies to help patients lose weight. We present data from two ongoing human trials of a new interventional radiology procedure for weight loss, bariatric embolization.

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Ghrelin Suppression and Fat Loss after Left Gastric Artery Embolization in Canine Model

Abstract: LGAE could suppress the plasma concentration of ghrelin, which results in subcutaneous fat size reduction and weight loss. Compensatory ghrelin production might occur in the remnant gastric fundus after LGAE.

Cited by 48 publications

References 22 publications

Comparison of Weight Loss, Ghrelin, and Leptin Hormones After Ligation of Left Gastric Artery and Sleeve Gastrectomy in a Rat Model

Comparison of Weight Loss, Ghrelin, and Leptin Hormones After Ligation of Left Gastric Artery and Sleeve Gastrectomy in a Rat Model

Histopathologic and Immunohistochemical Sequelae of Bariatric Embolization in a Porcine Model

Current and cutting-edge interventions for the treatment of obese patients

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