Abstract
Gastrointestinal tract function and it's integrity are controlled by a number of peptides whose secretion is influenced by severe inflammation. In stomach the main regulatory peptide is ghrelin. For upper small intestine cholecystokinin and glucagon-like peptide- 1 are secreted, while fibroblast growth factor-21 is secreted by several organs, including the liver, pancreas, and adipose tissue [12]. Hematopoietic stem cell transplantation causes serious mucosal damage, which can reflect on this peptides. The aim of the study was to determine fasting plasma concentrations of ghrelin, cholecystokinin, glucagone- like peptide-1, and fibroblast growth factor -21, and their gene expressions, before and 6 months after hematopoietic stem cell transplantation. 27 children were studied. C ontrol group included 26 healthy children. Acute graft versus host disease was diagnosed in 11 patients (41%, n=27). Median pre-transplantation concentrations of ghrelin, cholecystokinin , and glucagone like peptide-1, as well as their gene expressions, were significantly lower compared with the control group. In contrast, median fibroblast growth factor-21 concentrations were near-significantly higher before stem cell transplantation than in the control group. A comparison of pre- and post-transplantation groups revealed significantly higher concentrations of the studied peptides (except fibroblast growth factor-21) and respective gene expressions in the post–hematopoietic transplant group. M edian glucagone like peptide-1 concentrations were significantly decreased in patients with features of acute graft versus host disease. Moreover, negative correlation between glucagone like peptide-1 concentrations and acute graft versus host disease severity was found. Increased concentrations and gene expressions of gastrointestinal tract regulation peptides can be caused by stimulation of regeneration in the severe injured organ. Measurement of these parameters may be a useful method of assessment of severity of gastrointestinal tract complications of hematopoietic stem cell transplantation.