The effect of glucagon-like peptide 2 on intestinal permeability and bacterial translocation in acute necrotizing pancreatitis

• Published in: The American journal of surgery Vol. 181; no. 6; pp. 571 - 575
• Main Authors: Kouris, George J, Liu, Qiang, Rossi, H, Djuricin, Goldie, Gattuso, Paulo, Nathan, C, Weinstein, Robert A, Prinz, Richard A
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2001; Elsevier; Elsevier Limited
• Subjects: Analysis of Variance; Animals; Bacteria; Bacterial translocation; Bacterial Translocation - drug effects; Biological and medical sciences; Body weight; Cell culture; Digestive system; Edema; Gastroenterology. Liver. Pancreas. Abdomen; Glucagon; Glucagon - immunology; Glucagon-Like Peptide 2; Glucagon-Like Peptides; Gram-negative bacteria; Hemorrhage; Ileum; Ileum - drug effects; Ileum - metabolism; Inflammation; Inflammatory response; Intestinal Mucosa - drug effects; Intestinal Mucosa - metabolism; Intestinal permeability; Intestine; Jejunum; Jejunum - drug effects; Jejunum - metabolism; Laparotomy; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Lymph nodes; Lymphatic system; Male; Medical sciences; Necrosis; Necrotizing pancreatitis; Ohm's Law; Other diseases. Semiology; Pancreas; Pancreatitis; Pancreatitis, Acute Necrotizing - drug therapy; Pancreatitis, Acute Necrotizing - immunology; Pancreatitis, Acute Necrotizing - pathology; Peptides; Peptides - therapeutic use; Peritoneum; Permeability; Pharmacology. Drug treatments; Placebos; Rats; Rats, Sprague-Dawley; Small intestine; Translocation; Trypsin; Variance analysis; Weight Loss - drug effects; Glucagon-like peptide 2; Necrotizing pancreatitis; Bacterial translocation; Intestinal permeability; Translocation; Animal model; Peptides; Rat; Treatment efficiency; Rodentia; Gut; Pancreatitis; Permeability; Bacteriological investigation; Vertebrata; Chemotherapy; Microbiological investigation; Mammalia; Treatment; Glucagon like peptide; Animal; Digestive diseases; Pancreatic disease
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(01)00635-3

Background: Acute pancreatitis (AP) initiates a generalized inflammatory response that increases intestinal permeability and promotes bacterial translocation (BT). Impairment of the intestinal epithelial barrier is known to promote BT. Glucagon-like peptide 2 (GLP-2), a 33 residue peptide hormone, is a key regulator of the intestinal mucosa by stimulating epithelial growth. The purpose of this study was to determine whether GLP-2 decreases intestinal permeability and BT in AP. Methods: To examine whether GLP-2 can decrease intestinal permeability and thereby decrease BT in acute necrotizing pancreatitis, 34 male Sprague-Dawley rats (200 to 300 g) were studied. AP was induced in group I and group II by pressure injection of 3% taurocholate and trypsin into the common biliopancreatic duct (1 mg/kg of body weight). The potent analog to GLP-2 called ALX-0600 was utilized. Group I rats received GLP-2 analog (0.1 mg/kg, SQ, BID) and group II rats received a similar volume of normal saline as a placebo postoperatively for 3 days. Group III and group IV received GLP-2 analog and placebo, respectively. At 72 hours postoperatively, blood was drawn for culture of gram-negative organisms. Specimens from mesenteric lymph nodes (MLN), pancreas and peritoneum were harvested for culture of gram-negative bacteria. Intestinal resistance as defined by Ohm’s law was determined using a modified Ussing chamber to measure transepithelial current at a fixed voltage. A point scoring system for five histologic features that include intestinal edema, inflammatory cellular infiltration, fat necrosis, parenchymal necrosis, and hemorrhage was used to evaluate the severity of pancreatitis. Specimens from MLN, pancreas, jejunum, and ileum were taken for pathology. Results: All group I and group II rats had AP. The average transepithelial resistance in group I was 82.8 Ω/cm 2 compared with 55.9 Ω/cm 2 in group II ( P <0.01). Gram-negative BT to MLN, pancreas, and peritoneum was 80%, 0%, and 0%, respectively in group I compared with 100%, 30%, and 20% translocation in group II. Conclusion: GLP-2 treatment significantly decreases intestinal permeability in acute pancreatitis.