Tina was not tiny anymore. She noted that in the last 2 years that her weight had taken off and she had to purchase larger clothes. It was depressing. The more that she thought about it the more she wanted to eat to make herself feel better. She went to her doctor’s office and saw the nurse practitioner who said she had some abnormal blood tests. The last set of tests, called blood chemistries, had many asterisks on them. She said that her liver was inflamed and she noted that they were creeping up over the last couple of years. The previous primary care provider had let them go since they were only slightly elevated. She recommended that she avoid all acetaminophen and alcohol and to go see a liver doctor to discuss it. She visited and found that her liver was enlarged and also that there might be some scarring in the liver. Now she was scared. More blood tests and another visit with the liver nurse practitioner and she was told that there might be a new treatment but for now it was exercise and a low fat diet. The new treatment was Ghrelin.
GHRELIN is a hormone. It is a growth factor that helps prevent scar formation in the liver and even elsewhere in the body. Apparently, it is not well studied yet, but it can actually prevent cirrhosis from developing. One of the major problems with a liver that is inflamed is that it forms scars that causes all sorts of problems. The scarring causes bleeding in the intestinal tract that is often fatal. It also causes fluid to build up in the abdomen that is horribly uncomfortable. At this point, the scarring, which is caused by fibrosis is irreversible. Researchers are desperately trying to keep the scars from forming in the liver. When Ghrelin is given to rats prior to being poisoned with carbon tetrachloride (which causes horrible liver damage in hours) the Ghrelin rats survive with little scarring. People that have cirrhosis or scarring already have low Ghrelin levels. This hormone is unusual in that it is actually a type of growth hormone. If it can be given to people with chronic inflammation in their liver then they can avoid some of the cirrhosis that will occur with that irritation. This may actually prolong their lives!
Ghrelin is still not available to patients yet but will be soon. It is expected that it may be tried first with people that have severe hepatitis from a very bad virus, a medication, or from an injury. If it can prevent the scarring, the liver may have more of a chance to recover without a disabling scar.
Tina was placed on a low fat diet and was enrolled in an easy exercise program by her nurse practitioner. She started to lose a few pounds and was looking for ways to accelerate her weight loss. With her liver enzymes being up she took on the task with a new attitude and was much happier. She couldn’t wait until her chemistries were to be repeated in a few months time.