Korean J Gastroenterol.  2009 Feb;53(2):84-89.

Influence of Long-term Gastric Acid Suppression Therapy on the Expression of Serum Gastrin, Chromogranin A, and Ghrelin

• Kim BW
• Lee BI
• Kim HK
• Cho YS
• Chae HS
• Lee HK
• Kim HJ
• Han SW

Abstract

BACKGROUND/AIMS: Long-term use of proton pump inhibitor (PPI) induces hypergastrinemia, which results from the suppression of gastric acid secretion. Hypergastrinemia causes enterochromaffin-like (ECL) cell hyperplasia, which is a predisposing factor of carcinoid tumor of stomach. The aim of this study was to identify the effect of long-term gastric acid suppression on the gastric peptides levels, such as gastrin, chromogranin A, or ghrelin.
METHODS
Control group included patients who had no medication over six months. Both H2RA (H2 receptor antagonist) and PPI groups had medication at least for six months. Fasting blood was taken from each patient to assay serum gastrin, chromogranin A, and ghrelin by RIA and ELISA techniques.
RESULTS
The patients with the above reference range of serum gastrin and chromogranin A were more commonly found in PPI group compared to control and H2RA group. However, serum ghrelin level was within the reference range in all the patients regardless of groups. There was no difference in the ratio of serum gastrin/chromogranin A among three groups. Both average serum levels of gastrin and chromogranin A were significantly elevated in PPI group compared to control and H2RA group. There was a significant correlation between the level of serum gastrin and chromogranin A.
CONCLUSIONS
Long-term administration of H2RA does not affect the serum gastrin and chromogranin A level. However, long-term administration of PPI increases serum gastrin and chromogranin A. Ghrelin may influence gastric acid secretion in other pathway than ECL cell-mediated pathway such as gastrin or chromogranin A.

Keyword

Proton pump inhibitor; Gastrin; Chromogranin A; Ghrelin

MeSH Terms

Adult
Aged
Anti-Ulcer Agents/*therapeutic use
Chromogranin A/*blood
Female
Gastrins/*blood
Ghrelin/*blood
Histamine H2 Antagonists/*therapeutic use
Humans
Male
Middle Aged
Proton Pump Inhibitors/*therapeutic use
Time Factors