Sleeve gastrectomy reveals gastrin dependent plasticity of the stomach

Sleeve gastrectomy(SG) is a surgical weight-loss procedure where most of the stomach is removed. The procedure prompts hormonal changes that assist with weight loss. Even though the surgery is within the stomach, the effects of the surgery on the stomach itself haven’t been studied thoroughly.

Gastrin is a gastric hormone that affects the secretion of hydrochloric acid from the stomach, the proliferation of intestinal-mucosa and gastric motility.
Our hypothesis is based on a mathematical model that suggests; following SG most of the body of the stomach is removed, removing with it most of the acid producing cells. This causes high pH levels in the stomach. As a result, a rise in gastrin levels is expected which would lead to changes in the proliferation of the mucosa, to adapt to the changes following the surgery.

As predicted, we found higher Gastrin levels after SG in patients after surgery. We also found a significant increase in mucosal length and changes within the enteroendocrine cell population and showed that these changes are Gastrin dependent using Gastrin-KO-mice.
We also found an increase in gut motility following surgery which is also affected by Gastrin levels.

Using the Gastrin-KO-mice we also saw that Gastrin wasn’t necessary for the metabolic changes and weight loss after SG.

To summarize, we found that SG leads to Gastrin-dependent structural and functional changes within the stomach which allow an increase in acid secretion. we are investigating the importance of these changes to the stomach and the systemic metabolism of the body.