title: Glucagon-like peptide-2 induces rapid digestive adaptation following intestinal resection in preterm neonates.
abstract: Short bowel syndrome (SBS) is a frequent complication after intestinal resection in infants suffering from intestinal disease. We tested whether treatment with the intestinotrophic hormone glucagon-like peptide-2 (GLP-2) increases intestinal volume and function in the period immediately following intestinal resection in preterm pigs. Preterm pigs were fed enterally for 48 h before undergoing resection of 50% of the small intestine and establishment of a jejunostomy. Following resection, pigs were maintained on total parenteral nutrition (TPN) without (SBS, n = 8) or with GLP-2 treatment (3.5 μg/kg body wt per h, SBS+GLP-2, n = 7) and compared with a group of unresected preterm pigs (control, n = 5). After 5 days of TPN, all piglets were fed enterally for 24 h, and a nutrient balance study was performed. Intestinal resection was associated with markedly reduced endogenous GLP-2 levels. GLP-2 increased the relative absorption of wet weight (46 vs. 22%), energy (79 vs. 64%), and all macronutrients (all parameters P < 0.05). These findings were supported by a 200% increase in sucrase and maltase activities, a 50% increase in small intestinal epithelial volume (P < 0.05), as well as increased DNA and protein contents and increased total protein synthesis rate in SBS+GLP-2 vs. SBS pigs (+100%, P < 0.05). Following intestinal resection in preterm pigs, GLP-2 induced structural and functional adaptation, resulting in a higher relative absorption of fluid and macronutrients. GLP-2 treatment may be a promising therapy to enhance intestinal adaptation and improve digestive function in preterm infants with jejunostomy following intestinal resection.
authors.affiliation: Dept. of Human Nutrition, Faculty of Life Sciences, Univ. of Copenhagen, 30 Rolighedsvej, DK-1870 Frederiksberg C, Denmark. psa@life.ku.dk.
authors.forename: Andreas
authors.initials: A
authors.lastname: Vegge
authors.forename: Thomas
authors.initials: T
authors.lastname: Thymann
authors.forename: Pernille
authors.initials: P
authors.lastname: Lund
authors.forename: Barbara
authors.initials: B
authors.lastname: Stoll
authors.forename: Stine B
authors.initials: SB
authors.lastname: Bering
authors.forename: Bolette
authors.initials: B
authors.lastname: Hartmann
authors.forename: Jacob
authors.initials: J
authors.lastname: Jelsing
authors.forename: Niels
authors.initials: N
authors.lastname: Qvist
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Burrin
authors.forename: Palle B
authors.initials: PB
authors.lastname: Jeppesen
authors.forename: Jens J
authors.initials: JJ
authors.lastname: Holst
authors.forename: Per T
authors.initials: PT
authors.lastname: Sangild
mesh_terms: D000222:Adaptation, Physiological; D000824:Animal Nutritional Physiological Phenomena; D000818:Animals; D000831:Animals, Newborn; D049109:Cell Proliferation / Q000187:drug effects; D004261:DNA Replication / Q000187:drug effects; D004195:Disease Models, Animal; D004750:Enteral Nutrition; D005865:Gestational Age; D053767:Glucagon-Like Peptide 2 / Q000097:blood / Q000494:pharmacology*; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects; D007421:Intestine, Small / Q000187:drug effects* / Q000254:growth & development / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D007582:Jejunostomy; D009752:Nutritional Status; D010289:Parenteral Nutrition, Total; D047928:Premature Birth; D014176:Protein Biosynthesis / Q000187:drug effects; D011994:Recombinant Proteins / Q000494:pharmacology; D012778:Short Bowel Syndrome / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D013393:Sucrase / Q000378:metabolism; D013552:Swine; D013997:Time Factors; D015430:Weight Gain / Q000187:drug effects; D000520:alpha-Glucosidases / Q000378:metabolism
chemical_list: D053767:Glucagon-Like Peptide 2; D011994:Recombinant Proteins; D000520:alpha-Glucosidases; D013393:Sucrase
keywords: glucagon-like peptide-2; intestine; neonatal short bowel syndrome; premature