The aim of this study was to examine the role of ghrelin, obestatin and glutamate and their receptors in the pathogenesis of children functional constipation.
Children aged 4-17 were the subject of the study: 121 children with constipation (55 boys and 66 girls), 36 patients at the same age (26 boys and 10 girls) were the controls. Expression of ghrelin, obestatin and glutamate receptors on gastric and colon specimens taken by endoscopy were assessed. The concentration of above agents was estimated in serum by ELISA test.
The lower median serum concentrations of ghrelin, in the constipated children than in controls were confirmed (1.9ng/ml vs. 2.6ng/ml, p < 0.05). The expression of metabotropic receptor for glutamate (mGlu7) RNA was higher in stomach (32.49 vs. 31.47, p < 0.05), and was lower in rectum in constipated patients compared to the control group (31.76 vs. 32.62, p < 0.05). Negative correlation between concentration of ghrelin in serum and colonic transient time (p = 0.01, rho = -0.23) was shown in study group.Higher median expression of obestatin receptor GPR39 in rectal mucosae was found in constipated group than in the controls (29.9 vs. 26.9, p < 0.05).
Ghrelin, and receptors for ghrelin, obestatin and glutamate in gastrointestinal mucosa play a role in the pathogenesis of functional constipation in children.

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