Abnormal ghrelin secretion contributes to gastrointestinal symptoms in multiple system atrophy patients

• Published in: Journal of neurology Vol. 260; no. 8; pp. 2073 - 2077
• Main Authors: Ozawa, Tetsutaro, Tokunaga, Jun, Arakawa, Musashi, Ishikawa, Atsushi, Takeuchi, Ryoko, Mezaki, Naomi, Miura, Takeshi, Sakai, Naoko, Hokari, Mariko, Takeshima, Akari, Utsumi, Kota, Kondo, Takashi, Yokoseki, Akio, Nishizawa, Masatoyo
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2013; Springer Nature B.V
• Subjects: Aged; Antiparkinson Agents - therapeutic use; Atrophy; Autonomic Nervous System Diseases - etiology; Autonomic Nervous System Diseases - physiopathology; Dementia; Enzymes; Fecal incontinence; Female; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - etiology; Gastrointestinal Diseases - metabolism; Ghrelin - blood; Ghrelin - secretion; Growth hormones; Hormones - blood; Humans; Levodopa - therapeutic use; Male; Medicine; Medicine & Public Health; Motility; Multiple System Atrophy - complications; Multiple System Atrophy - metabolism; Multiple System Atrophy - physiopathology; Nervous system; Neurology; Neuroradiology; Neurosciences; Original Communication; Plasma; Japan; Multiple system atrophy; Gastrointestinal symptom; Autonomic dysfunction; Progressive supranuclear palsy; Ghrelin; Corticobasal syndrome
• ISSN: 0340-5354; 1432-1459; 1432-1459
• DOI: 10.1007/s00415-013-6944-9

Patients with multiple system atrophy (MSA) often have evidence of compromised gastrointestinal motility. Ghrelin is a gut hormone that influences gastrointestinal motility in humans. The aim of this study was to determine whether ghrelin secretion is affected in MSA patients, and to investigate the relation between ghrelin secretion and gastrointestinal symptoms. Plasma levels of active ghrelin and unacylated ghrelin were measured in patients with MSA ( n  = 30), other atypical parkinsonian disorders including progressive supranuclear palsy-Richardson syndrome and corticobasal syndrome ( n  = 24), and control subjects ( n  = 24) using enzyme-linked immunosorbent assays. Gastrointestinal symptoms were quantified in all subjects using a self-report questionnaire. The ratio of active ghrelin to total ghrelin in the plasma (active ghrelin ratio) was lower in patients with MSA (mean: 8.0 %) than in patients with other atypical parkinsonian disorders (mean: 13.7 %, P  = 0.001) and control subjects (mean: 13.9 %, P  = 0.001). The active ghrelin ratio was correlated with the severity of gastrointestinal symptoms in MSA ( r  = −0.5, P  = 0.004). Our observations indicate that ghrelin secretion is affected in patients with MSA. The low active ghrelin ratio may contribute to gastrointestinal symptoms in MSA.