Glucagon-like peptide-2 induces rapid digestive adaptation following intestinal resection in preterm neonates

• Published in: American journal of physiology: Gastrointestinal and liver physiology Vol. 305; no. 4; pp. G277 - G285
• Main Authors: Vegge, Andreas, Thymann, Thomas, Lund, Pernille, Stoll, Barbara, Bering, Stine B, Hartmann, Bolette, Jelsing, Jacob, Qvist, Niels, Burrin, Douglas G, Jeppesen, Palle B, Holst, Jens J, Sangild, Per T
• Format: Journal Article
• Language: English
• Published: United States American Physiological Society 15.08.2013
• Subjects: Adaptation, Physiological; alpha-Glucosidases - metabolism; Animal Nutritional Physiological Phenomena; Animals; Animals, Newborn; Babies; Cell Proliferation - drug effects; Disease Models, Animal; DNA Replication - drug effects; Enteral Nutrition; Gastrointestinal diseases; Gestational Age; Glucagon-Like Peptide 2 - blood; Glucagon-Like Peptide 2 - pharmacology; Hogs; Hormones and Signaling; Humans; Intestinal Absorption - drug effects; Intestine, Small - drug effects; Intestine, Small - growth & development; Intestine, Small - metabolism; Intestine, Small - pathology; Intestine, Small - surgery; Jejunostomy; Medical treatment; Nutritional Status; Parenteral nutrition; Parenteral Nutrition, Total; Peptides; Premature Birth; Protein Biosynthesis - drug effects; Recombinant Proteins - pharmacology; Short Bowel Syndrome - blood; Short Bowel Syndrome - drug therapy; Short Bowel Syndrome - etiology; Short Bowel Syndrome - pathology; Short Bowel Syndrome - physiopathology; Small intestine; Sucrase - metabolism; Swine; Time Factors; Weight Gain - drug effects; premature; intestine; glucagon-like peptide-2; neonatal short bowel syndrome
• ISSN: 0193-1857; 1522-1547
• DOI: 10.1152/ajpgi.00064.2013

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.