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.