Ghrelin, which is a novel growth hormone releasing peptide produced mainly in the gastric fundus, increases appetite and influences energy homeostasis. It has been estabilised that Helicobacter pylori (H. pylori) infection decreases gastric ghrelin production. A Japanese study reported that H. pylori eradication increases gastric ghrelin expression. The aim of this study was to investigate the effect of H. pylori eradication on gastric ghrelin level and the subsequent influence on appetite and weight in patients with peptic ulcer. Twenty two patients with H. pylori-positive peptic ulcer (gastric/duodenal ulcer=13/9) were enrolled in this study. Following H. pylori eradication using 1 week-triple therapy, all of them received 7 weeks-proton pump inhibitor for ulcer treatment. Follow-up endoscopy and ¹³C-urea breath test were performed to evaluate the healing of the ulcer and H. pylori eradication, respectively. Before and 7 weeks after eradication, biopsy specimens were obtained from the antrum and the fundus for immunohistochemical analysis of gastric ghrelin expression using anti-ghrelin antibody. Gastric ghrelin levels were quantitatively determined by the number of ghrelin-positive determined at the same time. H. pylori infection was eradicated in 15 of 22 patients. On follow-up endoscopy, the ulcers in all patients were completely cured. The ghrelin-positive cell number and VAS score for hunger were significantly increased in patients with successful H. pylori eradication, compared to patients with failure of H. pylori eradication. BMI was significantly increased in all patients, irrespective of H. pylori eradication. In patients with peptic ulcer, successful eradication of H. pylori results in the significant increase in gastric ghrelin concentration and the subsequent increase of appetite and BMI. However, healing of peptic ulcer may increase BMI irrespective of successful H. pylori eradication and change of gastric ghrelin level. (Cancer Prev Res 10, 29-33, 2005)

Keywords: Helicobacter pylori, Ghrelin, Appetite, Peptic ulcer