Gastric ghrelin is reduced in children with Helicobacter pylori gastritis compared to children without Helicobacter pylori.

OBJECTIVE

Ghrelin is an orexigenic hormone that regulates growth hormone release, appetite, energy balance, and fat utilization. We aimed to evaluate the number of ghrelin-positive cells in the gastric fundus among children referred for upper gastrointestinal endoscopy (UGE) with various indications.

METHODS

Retrospective study of pediatric patients referred for UGE during 2015-2017. The number of ghrelin-positive cells in the gastric fundus was calculated using immunohistochemical staining with a specific antighrelin antibody) and compared between patients with and without Helicobacter pylori (H. pylori)-induced gastritis.

RESULTS

A total of 53 children (H. pylori gastritis [n = 18] and without H. pylori gastritis (celiac disease [CeD] (n = 15), faltering growth [n = 6], and controls [n = 14])) were included. The mean number per mm2 of gastric ghrelin-positive cells was lower for the H. pylori gastritis group (49.8 ± 29.7), than for non-H. pylori group (CeD [91.2 ± 26.2], faltering growth [83 ± 43.0], and control [91.9 ± 40.2]), p = 0.001. Severe acute gastric antral inflammation (grade 2-3 in the Sydney system) presented in 7 (39%) of the H. pylori gastritis group and 1 (2.9%) in non-H. pylori group, p = 0.001. Severe chronic gastric antral inflammation (grade 2-3 in the Sydney system) presented in 7 (39%) of the H. pylori gastritis group compared to 3 (8.6%) in non-H. pylori group, p = 0.02. A negative correlation was observed between ghrelin-positive cell count and acute antral inflammation severity (r = -0.4, p = 0.004).

CONCLUSIONS

Among pediatric patients with H. pylori gastritis, compared to patients without H. pylori, the mean number of ghrelin-stained positive cells in the gastric fundus was lower, and higher proportions had more severe acute and chronic inflammations.