Gastric/intestinal electrical stimulation modulates appetite regulatory peptide hormones in the stomach and duodenum in rats

Background: Gastric/intestinal electrical stimulation (GIES) has been used to suppress appetite in the treatment of obesity with promising results. However, the mechanisms by which GIES benefits obese patients are not completely understood. This study investigated the acute effects of GIES on gastric and intestinal tissue levels of peptide hormones related to satiety and appetite in rats. Methods: 32 rats were divided into 4 groups: 1) sham stimulation, 2) gastric electrical stimulation (GES) with pulse trains, 3) GES with long pulse, and 4) duodenal electrical stimulation (DES) with pulse trains. After 2 hours of GIES, the rats were sacrificed immediately, and gastric fundus, duodenum and distal colon were harvested and extracted. Hormone levels of ghrelin, obestatin, cholecystokinin-8 (CCK-8) and peptide YY (PYY) were measured by radioimmunoassay (RIA). Results: 1) The mean gastric fundus ghrelin level was 1789.04 ± 362.81 pg/mg in the sham stimulation and significantly decreased with GES of pulse trains (597.85 ± 195.33 pg/mg, P = 0.012), GES of long pulse (754.6 ± 282.6 pg/mg, P = 0.039) and DES (731.69 ± 110.84pg/mg, P = 0.037). 2) The mean duodenal CCK-8 concentration was 413.27 ± 42.14 pg/mg in the sham stimulation and significantly increased by DES (762.6 ± 98.75 pg/mg, P = 0.013) but not in others. 3) Neither gastric obestatin nor distal colonic PYY was altered by any of GES or DES. Conclusions: GIES significantly impacts appetiterelated peptide hormones in gastric and duodenal tissues. Acute GIES-induced manipulation of gut peptide hormones related to appetite and satiety is a nonpharmacologic, well-tolerated clinical procedure that could substantially contribute to the successful treatment and long-term management of obesity.