Novel Approaches for Treating Obesity

Scientists have been looking for non-invaisve ways to combat obesity by studying the hormone ghrelin that controls appetite - the signal that tells us we are hungry and should eat.

In one study investigators at John Hopkins found a way to shut down the blood supply to the fundus, the area of the stomach that produces the ghrelin hormone, by chemically blocking the main artery.

Researchers at Johns Hopkins University took 10 healthy, growing pigs - which are anatomically similar to humans - and divided them into two groups. Guided by X-ray technology, they threaded a catheter through a blood vessel in each pig's groin until it reached the gastric artery.

At this point, in one group, they injected saline solution. In the other, they injected sodium morrhuate, a chemical that creates an arterial blockage. The pigs' blood ghrelin levels were monitored for one month thereafter. In the control group, ghrelin remained the same, while in the sodium morrhuate group, the hormone dropped by up to 60 percent.

In the latter group, appetite also was inhibited, and the pigs' weight plateaued.  According to the researchers this procedure produced an effect similar to bariatric surgery by suppressing ghrelin levels and subsequently lowering appetite.

Another study explored the development of a vaccine against ghrelin hormone. Reporting on the research at The Endocrine Society's 93rd Annual Meeting in Boston, Mariana Monteiro, MD, PhD, an associate professor at the University of Porto in Portugal said that an anti-ghrelin vaccine may become an alternate treatment for obesity, to be used in combination with diet and exercise.

Monteiro's group developed a therapeutic vaccine using a noninfectious virus carrying ghrelin. The vaccicne was injected into mice to stimulate an immune response and subsequent development of antibodies against ghrelin, The hope was that the antibodies in turn would suppress the ghrelin hormone and thus appetite. The researchers vaccinated normal-weight mice and mice with diet-induced obesity and compared them with control mice that received only saline injections.

Mice vaccinated with the live vaccine developed increasing amounts of specific anti-ghrelin antibodies, increased their energy expenditure and decreased their food intake. Within 24 hours after the first vaccination injection, obese mice ate 82 percent of the amount that control mice ate. After three injections with the vaccine, the subject mice ate only 50% of the control group. During the course of the study, researchers found no toxic effects as a result of the vaccine.

Bariatric surgery, in which part of the stomach or small intestine is removed, reconstructed or bypassed, can effectively suppress appetite and lead to major weight loss, but it's risky and can have serious complications.

Today obesity is approaching epidemic proportions throughout America but throughout the world. Finding  minimally invasive and inexpensive alternatives would make an enormous difference in choices and outcomes for obese people.


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