Impaired meal stimulated glucagon-like peptide 2 response in ileal resected short bowel patients with intestinal failure.
BACKGROUND
Glucagon-like peptide 2 (GLP-2) is a growth factor for the intestinal epithelium in rodents and may affect intestinal transit.


OBJECTIVE
To study the GLP-2 response to nutrient ingestion in seven short bowel patients with intestinal failure and seven controls.


METHODS
The patients and controls were admitted twice for two test meals after a night of fasting. Meal A was liquid (300 ml, 1.88 MJ); meal B was a regular breakfast (755 g, 3.92 MJ). Plasma samples were collected for 180 minutes; GLP-2 immunoreactivity was measured with an NH(2) terminal specific radioimmunoassay.


RESULTS
Both meals elicited significant increases in plasma GLP-2 in controls. The magnitude and duration of the responses were dependent on the meal size: the maximum median (25-75%) increases after meal A and B were 24 (3-28) and 48 (33-56) pmol/l. Plasma GLP-2 returned to basal concentrations 180 minutes after meal A, but remained at 50% of peak values after meal B. In the patients neither meal significantly changed the GLP-2 concentration; the maximum median elevation after meal B was 5 (2-8) pmol/l. There were significant differences between patients and controls with respect to the GLP-2 responses to meals A and B.


CONCLUSIONS
Identification of GLP-2 as a tissue specific intestinal growth factor and demonstration of an impaired meal stimulated GLP-2 response in short bowel patients raises the possibility that GLP-2 administration may constitute a new therapeutic strategy, enhancing jejunal adaptation in ileum resected short bowel patients with intestinal failure.
Jeppesen
P B
PB
Department of Medicine, Section of Gastroenterology, Rigshospitalet, Copenhagen, Denmark.
Hartmann
B
B
Hansen
B S
BS
Thulesen
J
J
Holst
J J
JJ
Mortensen
P B
PB
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005215:Fasting / Q000097:blood; D005260:Female; D005502:Food; D005768:Gastrointestinal Hormones / Q000097:blood*; D053767:Glucagon-Like Peptide 2; D004763:Glucagon-Like Peptides; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000097:blood*; D012778:Short Bowel Syndrome / Q000097:blood*
D005768:Gastrointestinal Hormones; D053767:Glucagon-Like Peptide 2; D010455:Peptides; D004763:Glucagon-Like Peptides