title: Exogenous glucagon-like peptide-2 improves outcomes of intestinal adaptation in a distal-intestinal resection neonatal piglet model of short bowel syndrome.
abstract: BACKGROUND
  Endogenous glucagon-like peptide-2 (GLP-2) levels and intestinal adaptation are reduced in distal-intestinal resection animal models of short bowel syndrome (SBS) that lack remnant ileum. We hypothesized that exogenous GLP-2 would improve intestinal adaptation in a distal-intestinal resection neonatal piglet model of SBS.
  
  
  METHODS
  In all, 35 piglets were randomized to 2 treatment and 3 surgical groups: control (sham), 75% mid-intestinal resection (JI), and 75% distal-intestinal resection (JC). Parenteral nutrition (PN) commenced on day 1 and was weaned as enteral nutrition (EN) advanced. IV GLP-2 (11 nmol/kg/d) or saline was initiated on day 2. Piglets were maintained for 14 d. Clinical, functional, morphological, and histological outcomes were obtained.
  
  
  RESULTS
  JC-GLP-2 piglets had fewer days on PN (10.0 ± 0.6 vs. 13.8 ± 0.2), more days on EN (4.0 ± 0.6 vs. 0.2 ± 0.2), a higher percentage of EN at termination (92 ± 5 vs. 52 ± 10%), fewer days of diarrhea (8.0 ± 0.7 vs. 12.3 ± 0.4), increased intestinal length (19 ± 4 vs. -5 ± 3%), and deeper jejunal crypts (248 ± 21 vs. 172 ± 12 μm), compared with saline piglets.
  
  
  CONCLUSIONS
  GLP-2 therapy improves clinical, morphological, and histological outcomes of intestinal adaptation in a distal-intestinal resection model of SBS. Since this anatomical subtype represents the majority of clinical cases of neonatal SBS, these results support a potential role for GLP-2 therapy in pediatric SBS.
authors.affiliation: Department of General Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Megha
authors.initials: M
authors.lastname: Suri
authors.affiliation: Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Justine M
authors.initials: JM
authors.lastname: Turner
authors.affiliation: Department of General Surgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: David L
authors.initials: DL
authors.lastname: Sigalet
authors.affiliation: Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Pamela R
authors.initials: PR
authors.lastname: Wizzard
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Patrick N
authors.initials: PN
authors.lastname: Nation
authors.affiliation: Department of Agricultural Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Ron O
authors.initials: RO
authors.lastname: Ball
authors.affiliation: 1] Research Institute, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada [2] Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada [3] Department of Nutritional Sciences, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Pencharz
authors.affiliation: 1] Department of Physiology, University of Toronto, Toronto, Ontario, Canada [2] Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Brubaker
authors.affiliation: 1] Department of General Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada [2] Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada [3] Research Institute, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Wales
mesh_terms: D000222:Adaptation, Physiological; D000818:Animals; D000831:Animals, Newborn; D004195:Disease Models, Animal; D053767:Glucagon-Like Peptide 2 / Q000235:genetics / Q000627:therapeutic use*; D007421:Intestine, Small / Q000503:physiopathology*; D012333:RNA, Messenger / Q000235:genetics; D012778:Short Bowel Syndrome / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D013552:Swine
chemical_list: D053767:Glucagon-Like Peptide 2; D012333:RNA, Messenger