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.

CONCLUSION:

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: Megha Suri, Justine M Turner, David L Sigalet, Pamela R Wizzard, Patrick N Nation, Ron O Ball, Paul B Pencharz, Patricia L Brubaker, Paul W Wales
• Journal: Pediatric research (Pediatr Res) Vol. 76 Issue 4 Pg. 370-7 (Oct 2014) ISSN: 1530-0447 [Electronic] United States
• PMID: 24995913 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Glucagon-Like Peptide 2
• RNA, Messenger

Topics

• Adaptation, Physiological
• Animals
• Animals, Newborn
• Disease Models, Animal
• Glucagon-Like Peptide 2 (genetics, therapeutic use)
• Intestine, Small (physiopathology)
• RNA, Messenger (genetics)
• Short Bowel Syndrome (drug therapy, physiopathology, surgery)
• Swine