Plasma concentrations of glucagon-like peptide-2 in adult patients with treated and untreated coeliac disease.
BACKGROUND
Coeliac disease is a common chronic inflammatory enteropathy characterized by villous atrophy and crypt hyperplasia in the small intestine. The mechanism of the intestinal damage in coeliac disease remains unclear. Glucagon-like peptide (GLP)-2 is an enterotrophic peptide that causes crypt hyperplasia and intestinal cell proliferation. We postulate that GLP-2 may be involved in the mucosal changes found in coeliac disease.


OBJECTIVE
To study plasma concentrations of GLP-2 in untreated patients with coeliac disease and determine the response to a gluten-free diet (GFD).


METHODS
A 440 kcal gluten-free test meal was given to seven controls and 12 coeliac patients at three time intervals: (1) before commencing a GFD; (2) 3 months after a GFD; and (3) 9 months after a GFD. Serial blood sampling was performed over a 2-h period. Each sample was analysed using radioimmunoassay for GLP-2, GLP-1, N-terminal glucagon (N-glucagon) and C-terminal glucagon (C-glucagon).


RESULTS
Untreated coeliac patients had significantly higher basal and peak GLP-2 and N-glucagon plasma concentrations compared with controls. After 3 months on a GFD, there was a significant decrease in basal GLP-2 plasma concentrations. There was no significant difference between GLP-1 or C-glucagon in untreated coeliac patients compared with controls.


CONCLUSIONS
This is the first reported study of GLP-2 in coeliac disease. After a GFD there is recovery of the intestine and a reduction in the GLP-2 trophic response. Our findings support the theory that GLP-2 may be part of the mucosal healing and maintenance mechanisms in coeliac disease.
Caddy
Grant R
GR
Regional Regulatory Peptide Laboratory, Royal Hospitals Trust, Belfast, Northern Ireland, UK. gcaddy@doctors.org.uk
Ardill
Joy E S
JE
Fillmore
Davina
D
Caldwell
Carolyn M
CM
McKibben
Bronac M
BM
Gardiner
Keith R
KR
Watson
Peter R G
PR
D000328:Adult; D002446:Celiac Disease / Q000097:blood* / Q000178:diet therapy; D005260:Female; D005500:Follow-Up Studies; D005934:Glucagon / Q000097:blood; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D053767:Glucagon-Like Peptide 2; D004763:Glucagon-Like Peptides / Q000097:blood*; D005983:Glutens / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011863:Radioimmunoassay; D016896:Treatment Outcome
D053767:Glucagon-Like Peptide 2; D004763:Glucagon-Like Peptides; D005983:Glutens; D052216:Glucagon-Like Peptide 1; D005934:Glucagon