Sung, E. Z. H., da Silva, N. F., Goodyear, S. J., McTernan, P. G. (Philip G.), Sanger, G. J. and Nwokolo, Chuka U.. (2009) Increased plasma ghrelin following infliximab in Crohn's disease. Alimentary Pharmacology and Therapeutic, Vol.29 (No.1). pp. 83-89. ISSN 0269-2813

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Abstract

Background Ghrelin, a potent orexigenic peptide produced by the stomach, may be affected by circulating inflammatory mediators. Aim To assess the effect of an anti-TNF alpha antibody on ghrelin in patients with Crohn's disease (CD). Methods Fifteen patients with Crohn's receiving infliximab were studied before and 1 week after infusion. Following an overnight fast, blood was sampled before a meal and then every 20 min for 2 h. Total ghrelin and CRP were measured using ELISA. Acylated ghrelin and TNF alpha, IFN gamma, IL-1 beta and IL-6 were measured with bioplex. Harvey Bradshaw Activity Index was assessed. Results Median (95% CI) 2-h integrated plasma total ghrelin increased from 162 (99-311) before infliximab to 200 (128-387) pg/mL h, (P = 0.02) after. Following infliximab, 20 min postmeal, median acylated ghrelin decreased from 50.3 (24-64) to 38.6 (26-82) pg/mL, (P = 0.04) thus reverting to a traditional meal related ghrelin curve. Median (range) disease activity decreased from 5 (2-28) before to 3 (0-22), (P = 0.0001) and Median (95% CI) TNFa decreased from 2.8 (1.89-4.48) to 1.31 (0.73-2.06) pg/mL (P = 0.002). Conclusions Infliximab increases circulating total ghrelin by 25% in CD and restores the postprandial response of acylated ghrelin to food intake. Acylated and de-sacyl ghrelin remain unchanged, suggesting that an alternate isoform could be affected by infliximab.

Item Type:	Journal Article
Subjects:	Q Science > QP Physiology R Medicine > RC Internal medicine R Medicine > RS Pharmacy and materia medica
Divisions:	Faculty of Medicine > Warwick Medical School > Metabolic and Vascular Health Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Crohn's disease -- Treatment -- Research, Ghrelin, Infliximab
Journal or Publication Title:	Alimentary Pharmacology and Therapeutic
Publisher:	Blackwell Publishing
ISSN:	0269-2813
Date:	1 January 2009
Volume:	Vol.29
Number:	No.1
Number of Pages:	7
Page Range:	pp. 83-89
Identification Number:	10.1111/j.1365-2036.2008.03850.x
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
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URI:	http://wrap.warwick.ac.uk/id/eprint/28860

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