title: Role of glucagon-like peptide-2 deficiency in neonatal short-bowel syndrome using neonatal piglets.
abstract: BACKGROUND
  Short-bowel syndrome (SBS) is the most common cause of neonatal intestinal failure. Recovery requires intestinal adaptation, dependent on enteral nutrition (EN) and growth factors such as glucagon-like peptide-2 (GLP-2), which is secreted from L cells in the ileum. Neonatal SBS often results in loss of ileum; therefore, we hypothesized that without ileum, endogenous GLP-2 production would be inadequate to promote adaptation. We compared endogenous GLP-2 production and adaptation in neonatal animals with SBS, with and without ileum.
  
  
  METHODS
  Neonatal piglets (4-6 d) were randomized to 75% mid-intestinal resection, 75% distal-intestinal resection, or sham control without resection. Postoperatively, all piglets commenced parenteral nutrition (PN), tapering as EN was increased to maintain specific growth.
  
  
  RESULTS
  The resected SBS piglets developed intestinal failure, requiring a longer duration of PN support and experiencing fat malabsorption. The piglets without ileum were not able to wean from PN during the study and did not show adaptation, specifically growth in intestinal length or crypt hyperplasia on histology of the jejunum. Adaptation was observed in the resected SBS piglets with ileum, and these piglets also had an increased plasma GLP-2 level that was not observed in piglets without ileum.
  
  
  CONCLUSIONS
  SBS piglets with ileum undergo adaptation associated with increased endogenous GLP-2 production. SBS piglets without ileum undergo limited adaptation and severe intestinal failure, requiring prolonged PN support. This appears to be related to a deficiency in endogenous GLP-2 production.
authors.affiliation: Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Hua
authors.forename: Justine M
authors.initials: JM
authors.lastname: Turner
authors.forename: David L
authors.initials: DL
authors.lastname: Sigalet
authors.forename: Pamela R
authors.initials: PR
authors.lastname: Wizzard
authors.forename: Patrick N
authors.initials: PN
authors.lastname: Nation
authors.forename: Diana R
authors.initials: DR
authors.lastname: Mager
authors.forename: Ron O
authors.initials: RO
authors.lastname: Ball
authors.forename: Paul B
authors.initials: PB
authors.lastname: Pencharz
authors.forename: Paul W
authors.initials: PW
authors.lastname: Wales
mesh_terms: D000222:Adaptation, Physiological; D000818:Animals; D000831:Animals, Newborn; D004041:Dietary Fats / Q000378:metabolism; D053767:Glucagon-Like Peptide 2 / Q000097:blood* / Q000378:metabolism; D007082:Ileum / Q000378:metabolism; D012778:Short Bowel Syndrome / Q000097:blood* / Q000503:physiopathology; D013552:Swine
chemical_list: D004041:Dietary Fats; D053767:Glucagon-Like Peptide 2