title: Glucagon-like peptide-1 and its receptor agonist exendin-4 modulate cholangiocyte adaptive response to cholestasis.
abstract: OBJECTIVE
  Cholangiopathies are characterized by progressive dysregulation of the balance between proliferation and death of cholangiocytes. In the course of cholestasis, cholangiocytes undergo a neuroendocrine transdifferentiation and their biology is regulated by neuroendocrine hormones. Glucagon-like peptide-1 (GLP-1), secreted by neuroendocrine cells, sustains beta-cell survival in experimental diabetes and induces the neuroendocrine transdifferentiation of pancreatic ductal cells. GLP-1 receptor (GLP-1R) selective agonist exendin-4 is used in humans as a novel therapeutic tool for diabetes. The aim of this study was to define if GLP-1 modulates cholangiocyte biologic response to cholestasis.
  
  
  METHODS
  Expression of GLP-1R in cholangiocytes was determined. Effects on cholangiocyte proliferation of the in vitro and in vivo exposure to GLP-1 or exendin-4, together with the intracellular signals, were then studied. Synthesis of GLP-1 by cholangiocytes and the effects of GLP-1R blockage on their growth were also determined.
  
  
  RESULTS
  Cholangiocytes express the GLP-1 receptor, which is up-regulated in the course of cholestasis. GLP-1 and exendin-4 increase cholangiocyte growth both in vitro and in vivo. The GLP-1R signal is mediated by the phosphatidyl-inositol-3-kinase, cAMP/Protein Kinase A, and Ca(2+)-CamKIIalpha but not by the ERK1/2 and PKCalpha pathways. Proliferating cholangiocytes synthesize GLP-1: neutralization of its action by GLP-1R antagonist blunts cholangiocyte response to cholestasis.
  
  
  CONCLUSIONS
  GLP-1 is required for the cholangiocyte adaptive response to cholestasis. Cholangiocytes are susceptible to the activation of GLP-1R and respond with increased proliferation and functional activity. Exendin-4 availability for employment in humans and these data may open novel perspectives for the medical treatment of cholangiopathies.
authors.affiliation: Department of Gastroenterology, Università Politecnica delle Marche, Ancona, Italy. m.marzioni@univpm.it <m.marzioni@univpm.it>
authors.forename: Marco
authors.initials: M
authors.lastname: Marzioni
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Alpini
authors.forename: Stefania
authors.initials: S
authors.lastname: Saccomanno
authors.forename: Cinzia
authors.initials: C
authors.lastname: Candelaresi
authors.forename: Juliet
authors.initials: J
authors.lastname: Venter
authors.forename: Chiara
authors.initials: C
authors.lastname: Rychlicki
authors.forename: Giammarco
authors.initials: G
authors.lastname: Fava
authors.forename: Heather
authors.initials: H
authors.lastname: Francis
authors.forename: Luciano
authors.initials: L
authors.lastname: Trozzi
authors.forename: Shannon
authors.initials: S
authors.lastname: Glaser
authors.forename: Antonio
authors.initials: A
authors.lastname: Benedetti
mesh_terms: D000222:Adaptation, Physiological / Q000187:drug effects / Q000502:physiology; D000818:Animals; D001652:Bile Ducts / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D002455:Cell Division / Q000187:drug effects / Q000502:physiology; D001651:Cholestasis, Extrahepatic / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology*; D000077270:Exenatide; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism*; D000067757:Glucagon-Like Peptide-1 Receptor; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D008297:Male; D010455:Peptides / Q000494:pharmacology*; D051381:Rats; D011916:Rats, Inbred F344; D018027:Receptors, Glucagon / Q000819:agonists / Q000378:metabolism*; D015398:Signal Transduction / Q000187:drug effects / Q000502:physiology; D015854:Up-Regulation / Q000187:drug effects / Q000502:physiology; D014688:Venoms / Q000494:pharmacology*
chemical_list: C000593833:GLP1R protein, human; C000593835:Glp1r protein, rat; D000067757:Glucagon-Like Peptide-1 Receptor; D007004:Hypoglycemic Agents; D010455:Peptides; D018027:Receptors, Glucagon; D014688:Venoms; D052216:Glucagon-Like Peptide 1; D000077270:Exenatide