{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:57:32Z","timestamp":1777643852018,"version":"3.51.4"},"reference-count":103,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2016,12,26]],"date-time":"2016-12-26T00:00:00Z","timestamp":1482710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Ghrelin, discovered in 1999, is a 28-amino-acid hormone, best recognized as a stimulator of growth hormone secretion, but with pleiotropic functions in the area of energy homeostasis, such as appetite stimulation and energy expenditure regulation. As the intrinsic ligand of the growth hormone secretagogue receptor (GHS-R), ghrelin appears to have a broad array of effects, but its primary role is still an area of debate. Produced mainly from oxyntic glands in the stomach, but with a multitude of extra-metabolic roles, ghrelin is implicated in complex neurobiological processes. Comprehensive studies within the areas of obesity and metabolic surgery have clarified the mechanism of these operations. As a stimulator of growth hormone (GH), and an apparent inducer of positive energy balance, other areas of interest include its impact on carcinogenesis and tumour proliferation and its role in the cancer cachexia syndrome. This has led several authors to study the hormone in the cancer setting. Ghrelin levels are acutely reduced following an oesophagectomy, a primary treatment modality for oesophageal cancer. We sought to investigate the nature of this postoperative ghrelin suppression, and its neurobiological implications.<\/jats:p>","DOI":"10.3390\/ijms18010035","type":"journal-article","created":{"date-parts":[[2016,12,28]],"date-time":"2016-12-28T11:22:14Z","timestamp":1482924134000},"page":"35","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Neurobiological Impact of Ghrelin Suppression after Oesophagectomy"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7028-9351","authenticated-orcid":false,"given":"Conor","family":"Murphy","sequence":"first","affiliation":[{"name":"Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin 4, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carel","family":"Le Roux","sequence":"additional","affiliation":[{"name":"Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin 4, Ireland"},{"name":"Gastrosurgical Laboratory, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2016,12,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1038\/45230","article-title":"Ghrelin is a growth-hormone-releasing acylated peptide from stomach","volume":"402","author":"Kojima","year":"1999","journal-title":"Nature"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2607","DOI":"10.1210\/en.2003-1596","article-title":"Orexigenic action of peripheral ghrelin is mediated by neuropeptide Y and agouti-related protein","volume":"145","author":"Chen","year":"2004","journal-title":"Endocrinology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1530\/EJE-10-0099","article-title":"GOAT: The master switch for the ghrelin system?","volume":"163","author":"Romero","year":"2010","journal-title":"Eur. J. Endocrinol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1038\/35038090","article-title":"Ghrelin induces adiposity in rodents","volume":"407","author":"Tschop","year":"2000","journal-title":"Nature"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1038\/35051587","article-title":"A role for ghrelin in the central regulation of feeding","volume":"409","author":"Nakazato","year":"2001","journal-title":"Nature"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1016\/S0896-6273(03)00063-1","article-title":"The distribution and mechanism of action of ghrelin in the CNS demonstrates a novel hypothalamic circuit regulating energy homeostasis","volume":"37","author":"Cowley","year":"2003","journal-title":"Neuron"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1053\/gast.2002.35954","article-title":"The role of the gastric afferent vagal nerve in ghrelin-induced feeding and growth hormone secretion in rats","volume":"123","author":"Date","year":"2002","journal-title":"Gastroenterology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.cmet.2006.09.004","article-title":"Peripheral ghrelin transmits orexigenic signals through the noradrenergic pathway from the hindbrain to the hypothalamus","volume":"4","author":"Date","year":"2006","journal-title":"Cell Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.brainres.2010.03.059","article-title":"Ascending projections from the caudal visceral nucleus of the solitary tract to brain regions involved in food intake and energy expenditure","volume":"1350","author":"Rinaman","year":"2010","journal-title":"Brain Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1159\/000054491","article-title":"Co-localization of growth hormone secretagogue receptor and NPY mRNA in the arcuate nucleus of the rat","volume":"70","author":"Willesen","year":"1999","journal-title":"Neuroendocrinology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1210\/endo.138.2.4907","article-title":"Induction of c-fos messenger ribonucleic acid in neuropeptide Y and growth hormone (GH)-releasing factor neurons in the rat arcuate nucleus following systemic injection of the GH secretagogue, GH-releasing peptide-6","volume":"138","author":"Dickson","year":"1997","journal-title":"Endocrinology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.bbr.2011.08.037","article-title":"Ghrelin is an orexigenic peptide and elicits anxiety-like behaviors following administration into discrete regions of the hypothalamus","volume":"226","author":"Currie","year":"2012","journal-title":"Behav. Brain Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1016\/S0196-9781(03)00159-1","article-title":"Hypothalamic paraventricular injections of ghrelin: Effect on feeding and c-Fos immunoreactivity","volume":"24","author":"Olszewski","year":"2003","journal-title":"Peptides"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1038\/ijo.2013.131","article-title":"GHS-R1a signaling in the DMH and VMH contributes to food anticipatory activity","volume":"38","author":"Merkestein","year":"2014","journal-title":"Int. J. Obes."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1210\/er.2002-0029","article-title":"Biological, physiological, pathophysiological, and pharmacological aspects of ghrelin","volume":"25","author":"Heiman","year":"2004","journal-title":"Endocr. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"R701","DOI":"10.1152\/ajpregu.00496.2013","article-title":"Remembering to eat: Hippocampal regulation of meal onset","volume":"306","author":"Parent","year":"2014","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.coph.2007.10.008","article-title":"A potential role for the hippocampus in energy intake and body weight regulation","volume":"7","author":"Davidson","year":"2007","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3644","DOI":"10.1002\/cne.23627","article-title":"Neuroanatomical characterization of a growth hormone secretagogue receptor-green fluorescent protein reporter mouse","volume":"522","author":"Mani","year":"2014","journal-title":"J. Comp. Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/j.biopsych.2012.07.002","article-title":"Ghrelin signaling in the ventral hippocampus stimulates learned and motivational aspects of feeding via PI3K-Akt signaling","volume":"73","author":"Kanoski","year":"2013","journal-title":"Biol. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e11190","DOI":"10.7554\/eLife.11190","article-title":"Hippocampus ghrelin signaling mediates appetite through lateral hypothalamic orexin pathways","volume":"4","author":"Hsu","year":"2015","journal-title":"eLife"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0304-3940(03)00789-4","article-title":"Centrally administered ghrelin suppresses sympathetic nerve activity in brown adipose tissue of rats","volume":"349","author":"Yasuda","year":"2003","journal-title":"Neurosci. Lett."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.regpep.2005.04.004","article-title":"Ghrelin regulates adiposity in white adipose tissue and UCP1 mRNA expression in brown adipose tissue in mice","volume":"130","author":"Tsubone","year":"2005","journal-title":"Regul. Pept."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.regpep.2009.11.010","article-title":"Genetic suppression of ghrelin receptors activates brown adipocyte function and decreases fat storage in rats","volume":"160","author":"Nemoto","year":"2010","journal-title":"Regul. Pept."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1677\/JOE-08-0374","article-title":"Ghrelin suppresses noradrenaline release in the brown adipose tissue of rats","volume":"201","author":"Ohata","year":"2009","journal-title":"J. Endocrinol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1111\/j.1474-9726.2011.00740.x","article-title":"Ablation of ghrelin receptor reduces adiposity and improves insulin sensitivity during aging by regulating fat metabolism in white and brown adipose tissues","volume":"10","author":"Lin","year":"2011","journal-title":"Aging Cell"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1091\/mbc.e06-05-0402","article-title":"Ghrelin and des-acyl ghrelin promote differentiation and fusion of C2C12 skeletal muscle cells","volume":"18","author":"Filigheddu","year":"2007","journal-title":"Mol. Biol. Cell"},{"key":"ref_27","first-page":"611","article-title":"Acylated and unacylated ghrelin impair skeletal muscle atrophy in mice","volume":"123","author":"Porporato","year":"2013","journal-title":"J. Clin. Investig."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1053\/gast.2001.22158","article-title":"Ghrelin is an appetite-stimulatory signal from stomach with structural resemblance to motilin","volume":"120","author":"Asakawa","year":"2001","journal-title":"Gastroenterology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1006\/bbrc.2000.3568","article-title":"Ghrelin stimulates gastric acid secretion and motility in rats","volume":"276","author":"Masuda","year":"2000","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"4953","DOI":"10.2174\/1381612811319270018","article-title":"A review of the cardiovascular and anti-atherogenic effects of ghrelin","volume":"19","author":"Rizzo","year":"2013","journal-title":"Curr. Pharm. Des."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3674","DOI":"10.1161\/01.CIR.0000149746.62908.BB","article-title":"Effects of ghrelin administration on left ventricular function, exercise capacity, and muscle wasting in patients with chronic heart failure","volume":"110","author":"Nagaya","year":"2004","journal-title":"Circulation"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1161\/hc3601.095575","article-title":"Chronic administration of ghrelin improves left ventricular dysfunction and attenuates development of cardiac cachexia in rats with heart failure","volume":"104","author":"Nagaya","year":"2001","journal-title":"Circulation"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1097\/00005344-200206000-00001","article-title":"Vasodilatory effect of ghrelin, an endogenous peptide from the stomach","volume":"39","author":"Okumura","year":"2002","journal-title":"J. Cardiovasc. Pharmacol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1530\/EJE-12-0456","article-title":"Mechanisms in endocrinology: Ghrelin: The differences between acyl-and des-acyl ghrelin","volume":"167","author":"Delhanty","year":"2012","journal-title":"Eur. J. Endocrinol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1136\/gut.2004.038737","article-title":"Stomach regulates energy balance via acylated ghrelin and desacyl ghrelin","volume":"54","author":"Asakawa","year":"2005","journal-title":"Gut"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.physbeh.2006.05.022","article-title":"Ghrelin and the short- and long-term regulation of appetite and body weight","volume":"89","author":"Cummings","year":"2006","journal-title":"Physiol. Behav."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"E297","DOI":"10.1152\/ajpendo.00582.2003","article-title":"Plasma ghrelin levels and hunger scores in humans initiating meals voluntarily without time- and food-related cues","volume":"287","author":"Cummings","year":"2004","journal-title":"AJP Endocrinol. Metab."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.2337\/diabetes.50.8.1714","article-title":"A preprandial rise in plasma ghrelin levels suggests a role in meal initiation in humans","volume":"50","author":"Cummings","year":"2001","journal-title":"Diabetes"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1152\/physrev.00012.2004","article-title":"Ghrelin: Structure and function","volume":"85","author":"Kojima","year":"2005","journal-title":"Physiol. Rev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"G699","DOI":"10.1152\/ajpgi.00448.2007","article-title":"Possible entrainment of ghrelin to habitual meal patterns in humans","volume":"294","author":"Frecka","year":"2008","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.neuroscience.2009.08.009","article-title":"Reduced anticipatory locomotor responses to scheduled meals in ghrelin receptor deficient mice","volume":"164","author":"Blum","year":"2009","journal-title":"Neuroscience"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"RC19","DOI":"10.1007\/BF03351037","article-title":"Post-prandial decrease of circulating human ghrelin levels","volume":"24","author":"Wawarta","year":"2001","journal-title":"J. Endocrinol. Investig."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/S0169-328X(97)00071-5","article-title":"Distribution of mRNA encoding the growth hormone secretagogue receptor in brain and peripheral tissues","volume":"48","author":"Guan","year":"1997","journal-title":"Mol. Brain Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1055\/s-0029-1233462","article-title":"Expression of ghrelin and its receptor in human tissues","volume":"41","author":"Ueberberg","year":"2009","journal-title":"Horm. Metab. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.regpep.2006.02.005","article-title":"Ghrelin-containing neuron in cerebral cortex and hypothalamus linked with the DVC of brainstem in rat","volume":"134","author":"Hou","year":"2006","journal-title":"Regul. Pept."},{"key":"ref_46","first-page":"881","article-title":"The Expression of the growth hormone secretagogue receptor ligand ghrelin in normal and abnormal human pituitary and other neuroendocrine tumors 1","volume":"86","author":"Korbonits","year":"2001","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1385\/ENDO:14:1:101","article-title":"Presence of ghrelin in normal and adenomatous human pituitary","volume":"14","author":"Korbonits","year":"2001","journal-title":"Endocrine"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1002\/cne.20823","article-title":"Expression of ghrelin receptor mRNA in the rat and the mouse brain","volume":"494","author":"Zigman","year":"2006","journal-title":"J. Comp. Neurol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1038\/nn1656","article-title":"Ghrelin controls hippocampal spine synapse density and memory performance","volume":"9","author":"Diano","year":"2006","journal-title":"Nat. Neurosci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1038\/npp.2011.70","article-title":"Hippocampal leptin signaling reduces food intake and modulates food-related memory processing","volume":"36","author":"Kanoski","year":"2011","journal-title":"Neuropsychopharmacology"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2010\/460549","article-title":"Ghrelin\u2019s roles in stress, mood, and anxiety regulation","volume":"2010","author":"Chuang","year":"2010","journal-title":"Int. J. Pept."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.biopsych.2014.10.021","article-title":"Ghrelin\u2019s role in the hypothalamic-pituitary-adrenal axis stress response: Implications for mood disorders","volume":"78","author":"Spencer","year":"2014","journal-title":"Biol. Psychiatry"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1038\/nn.2139","article-title":"The orexigenic hormone ghrelin defends against depressive symptoms of chronic stress","volume":"11","author":"Lutter","year":"2008","journal-title":"Nat. Neurosci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1016\/j.clinbiochem.2009.02.020","article-title":"Ghrelin, paraoxonase and arylesterase levels in depressive patients before and after citalopram treatment","volume":"42","author":"Barim","year":"2009","journal-title":"Clin. Biochem."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.neulet.2007.08.018","article-title":"The effects of electroconvulsive therapy on ghrelin, leptin and cholesterol levels in patients with mood disorders","volume":"426","author":"Kurt","year":"2007","journal-title":"Neurosci. Lett."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2725","DOI":"10.1007\/s00213-014-3640-0","article-title":"The role of ghrelin in addiction: A review","volume":"231","author":"Panagopoulos","year":"2014","journal-title":"Psychopharmacology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1210\/endo.143.4.8712","article-title":"Ultradian rhythmicity of ghrelin secretion in relation with gh, feeding behavior, and sleep-wake patterns in rats","volume":"143","author":"Tolle","year":"2002","journal-title":"Endocrinology"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"E407","DOI":"10.1152\/ajpendo.00184.2002","article-title":"Ghrelin promotes slow-wave sleep in humans","volume":"284","author":"Weikel","year":"2003","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.brainres.2006.02.072","article-title":"Ghrelin-induced sleep responses in ad libitum fed and food-restricted rats","volume":"1088","author":"Szentirmai","year":"2006","journal-title":"Brain Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.biopsych.2012.03.010","article-title":"Ghrelin regulates the hypothalamic-pituitary-adrenal axis and restricts anxiety after acute stress","volume":"72","author":"Spencer","year":"2012","journal-title":"Biol. Psychiatry"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2684","DOI":"10.1172\/JCI57660","article-title":"Ghrelin mediates stress-induced food-reward behavior in mice","volume":"121","author":"Chuang","year":"2011","journal-title":"J. Clin. Investig."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1038\/sj.ijo.0803001","article-title":"Ghrelin increases food intake in obese as well as lean subjects","volume":"29","author":"Druce","year":"2005","journal-title":"Int. J. Obes."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/j.1369-1600.2006.00002.x","article-title":"Ghrelin stimulates locomotor activity and accumbal dopamine-overflow via central cholinergic systems in mice: Implications for its involvement in brain reward","volume":"11","author":"Jerlhag","year":"2006","journal-title":"Addict. Biol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/j.1369-1600.2006.00041.x","article-title":"Ghrelin administration into tegmental areas stimulates locomotor activity and increases extracellular concentration of dopamine in the nucleus accumbens","volume":"12","author":"Jerlhag","year":"2007","journal-title":"Addict. Biol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1111\/j.1369-1600.2010.00294.x","article-title":"Role of ghrelin in food reward: Impact of ghrelin on sucrose self-administration and mesolimbic dopamine and acetylcholine receptor gene expression","volume":"17","author":"Skibicka","year":"2012","journal-title":"Addict. Biol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"R259","DOI":"10.1152\/ajpregu.00488.2011","article-title":"Ghrelin increases the motivation to eat, but does not alter food palatability","volume":"303","author":"Overduin","year":"2012","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"5841","DOI":"10.1523\/JNEUROSCI.5680-10.2011","article-title":"Ghrelin enhances olfactory sensitivity and exploratory sniffing in rodents and humans","volume":"31","author":"Tong","year":"2011","journal-title":"J. Neurosci."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.cmet.2008.03.007","article-title":"Ghrelin modulates brain activity in areas that control appetitive behavior","volume":"7","author":"Malik","year":"2008","journal-title":"Cell Metab."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.neuroscience.2011.02.016","article-title":"Ghrelin directly targets the ventral tegmental area to increase food motivation","volume":"180","author":"Skibicka","year":"2011","journal-title":"Neuroscience"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"24","DOI":"10.4103\/1319-3767.45050","article-title":"Functional outcome of gastrointestinal tract and quality of life after esophageal reconstruction of esophagus cancer","volume":"15","author":"Aghajanzadeh","year":"2009","journal-title":"Saudi J. Gastroenterol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1001\/jama.2014.732","article-title":"Prevalence of childhood and adult obesity in the United States, 2011\u20132012","volume":"311","author":"Ogden","year":"2014","journal-title":"JAMA"},{"key":"ref_72","unstructured":"American Cancer Society (2014). Cancer Facts and Figures, American Cancer Society."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.canep.2011.03.001","article-title":"Obesity, metabolic syndrome and esophageal adenocarcinoma: Epidemiology, etiology and new targets","volume":"35","author":"Ryan","year":"2011","journal-title":"Cancer Epidemiol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1056\/NEJMra035010","article-title":"Esophageal cancer","volume":"349","author":"Enzinger","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"2074","DOI":"10.1056\/NEJMoa1112088","article-title":"Preoperative Chemoradiotherapy for Esophageal or Junctional Cancer","volume":"366","author":"Hulshof","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1097\/01.sla.0000254367.15810.38","article-title":"Long-term outcomes following neoadjuvant chemoradiotherapy for esophageal cancer","volume":"245","author":"Reynolds","year":"2007","journal-title":"Ann. Surg."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1016\/S1470-2045(15)00040-6","article-title":"Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): Long-term results of a randomised controlled trial","volume":"16","author":"Shapiro","year":"2015","journal-title":"Lancet Oncol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1002\/bjs.6723","article-title":"Long-term weight change after oesophageal cancer surgery","volume":"96","author":"Martin","year":"2009","journal-title":"Br. J. Surg."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.jss.2011.09.016","article-title":"Ghrelin level and body weight loss after esophagectomy for esophageal cancer","volume":"176","author":"Miyazaki","year":"2012","journal-title":"J. Surg. Res."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.surg.2005.11.015","article-title":"Ghrelin reduction after esophageal substitution and its correlation to postoperative body weight loss in esophageal cancer patients","volume":"139","author":"Doki","year":"2006","journal-title":"Surgery"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1177\/0148607110381403","article-title":"Changes in gastrointestinal hormones and leptin after Roux-en-Y gastric bypass surgery","volume":"35","author":"Beckman","year":"2011","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1056\/NEJMoa012908","article-title":"Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery","volume":"346","author":"Cummings","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1038\/oby.2009.473","article-title":"Superior appetite hormone profile after equivalent weight loss by gastric bypass compared to gastric banding","volume":"18","author":"Bose","year":"2010","journal-title":"Obesity"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.molmet.2014.07.009","article-title":"Altered ghrelin secretion in mice in response to diet-induced obesity and Roux-en-Y gastric bypass","volume":"3","author":"Uchida","year":"2014","journal-title":"Mol. Metab."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"3177","DOI":"10.1210\/jc.2002-021734","article-title":"Ghrelin and adipose tissue regulatory peptides: Effect of gastric bypass surgery in obese humans","volume":"88","author":"Holdstock","year":"2003","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"50.e5","DOI":"10.1053\/j.gastro.2012.09.009","article-title":"The effects of vertical sleeve gastrectomy in rodents are ghrelin independent","volume":"144","author":"Chambers","year":"2013","journal-title":"Gastroenterology"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.regpep.2006.07.009","article-title":"Glucagon-like peptide 2 inhibits ghrelin secretion in humans","volume":"137","author":"Banasch","year":"2006","journal-title":"Regul. Pept."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.regpep.2007.03.002","article-title":"Glucagon-like peptide 1 (GLP-1) suppresses ghrelin levels in humans via increased insulin secretion","volume":"143","author":"Hagemann","year":"2007","journal-title":"Regul. Pept."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Elliott, J.A., Docherty, N.G., Eckhardt, H.G., Doyle, S.L., Guinan, E.M., Ravi, N., Reynolds, J.V., and le Roux, C.W. (2016). Weight loss, satiety, and the postprandial gut hormone response after esophagectomy: A prospective study. Ann. Surg.","DOI":"10.1097\/SLA.0000000000001918"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"3997","DOI":"10.1210\/jcem.87.8.8879","article-title":"Insulin regulates plasma ghrelin concentration","volume":"87","author":"Saad","year":"2002","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"2425","DOI":"10.3748\/wjg.14.2425","article-title":"Role of the duodenum in regulation of plasma ghrelin levels and body mass index after subtotal gastrectomy","volume":"14","author":"Wang","year":"2008","journal-title":"World J. Gastroenterol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.cmet.2015.07.009","article-title":"Roux-en-Y gastric bypass and vertical banded gastroplasty induce long-term changes on the human gut microbiome contributing to fat mass regulation","volume":"22","author":"Tremaroli","year":"2015","journal-title":"Cell Metab."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1210\/me.2014-1108","article-title":"Minireview: Gut microbiota: The neglected endocrine organ","volume":"28","author":"Clarke","year":"2014","journal-title":"Mol. Endocrinol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1016\/j.athoracsur.2010.11.072","article-title":"Postoperative weight loss does not resolve after esophagectomy despite normal serum ghrelin levels","volume":"91","author":"Koizumi","year":"2011","journal-title":"Ann. Thorac. Surg."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.surg.2009.11.026","article-title":"Randomized phase II study of clinical effects of ghrelin after esophagectomy with gastric tube reconstruction","volume":"148","author":"Yamamoto","year":"2010","journal-title":"Surgery"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1016\/j.jada.2007.07.017","article-title":"Weight-loss outcomes: A systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up","volume":"107","author":"Franz","year":"2007","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"2179","DOI":"10.1016\/j.biocel.2013.07.016","article-title":"Control of food intake and muscle wasting in cachexia","volume":"45","author":"Amitani","year":"2013","journal-title":"Int. J. Biochem. Cell Biol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2011\/601434","article-title":"Cancer cachexia: Mechanisms and clinical implications","volume":"2011","author":"Donohoe","year":"2011","journal-title":"Gastroenterol. Res. Pract."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1002\/jcsm.12059","article-title":"Pathophysiology of anorexia in the cancer cachexia syndrome","volume":"6","author":"Ezeoke","year":"2015","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"2920","DOI":"10.1210\/jc.2004-1788","article-title":"Active ghrelin levels and active to total ghrelin ratio in cancer-induced cachexia","volume":"90","author":"Garcia","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"3004","DOI":"10.1210\/en.2007-0016","article-title":"Ghrelin treatment causes increased food intake and retention of lean body mass in a rat model of cancer cachexia","volume":"148","author":"DeBoer","year":"2007","journal-title":"Endocrinology"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/S1470-2045(14)71154-4","article-title":"Anamorelin for patients with cancer cachexia: An integrated analysis of two phase 2, randomised, placebo-controlled, double-blind trials","volume":"16","author":"Garcia","year":"2015","journal-title":"Lancet Oncol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1378\/chest.128.3.1187","article-title":"Treatment of cachexia with ghrelin in patients with COPD","volume":"128","author":"Nagaya","year":"2005","journal-title":"Chest"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/18\/1\/35\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:29:20Z","timestamp":1760210960000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/18\/1\/35"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,12,26]]},"references-count":103,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,1]]}},"alternative-id":["ijms18010035"],"URL":"https:\/\/doi.org\/10.3390\/ijms18010035","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,12,26]]}}}