Document Detail


Short bowel syndrome: the role of GLP-2 on improving outcome.
MedLine Citation:
PMID:  19474717     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: The medical management of short bowel syndrome frequently requires lifelong parenteral nutrition. Methods of increasing intestinal absorption and reducing parenteral nutrition dependence, by improving postresection intestinal adaptation, are increasingly being explored. Glucagon-like peptide-2 (GLP-2) is an important intestinotrophic growth factor and mediator of intestinal adaptation. This review summarizes our current understanding of GLP-2 physiology and provides an update on clinical trials in short bowel syndrome and related conditions. RECENT FINDINGS: There is growing understanding how the effects of GLP-2 are mediated by downstream effectors such as insulin-like growth factor-1. In the treatment of short bowel syndrome, GLP-2 and the long-acting GLP-2 analogue teduglutide (Gattex) are effective in improving fluid absorption. A recent multicentre, placebo-controlled study demonstrates that this can translate into meaningful reductions in parenteral nutrition requirements. Treatment dose and timing of treatment initiation might influence the mucosal growth response. Most of the small intestine has to be preserved to facilitate the previously documented benefits of GLP-2 on bone metabolism. Therapeutic uses of GLP-2 in other gastrointestinal conditions are being explored. GLP-2 treatment appears well tolerated, although concerns about the long-term use of this growth-promoting agent remain. SUMMARY: GLP-2 therapy holds promise as an adjuvant treatment modality for short bowel syndrome and other gastrointestinal disorders.
Authors:
Katharina Wallis; Julian R F Walters; Simon Gabe
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in clinical nutrition and metabolic care     Volume:  12     ISSN:  1535-3885     ISO Abbreviation:  Curr Opin Clin Nutr Metab Care     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-04     Completed Date:  2009-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9804399     Medline TA:  Curr Opin Clin Nutr Metab Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  526-32     Citation Subset:  IM    
Affiliation:
Division of Medicine, Imperial College Healthcare, Hammersmith Hospital, London, UK. katharina.wallis@imperial.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological / drug effects*,  physiology
Glucagon-Like Peptide 2 / physiology*,  therapeutic use*
Humans
Intestinal Absorption / drug effects,  physiology
Intestinal Mucosa / drug effects,  growth & development,  pathology
Nutritional Requirements
Parenteral Nutrition
Peptides
Short Bowel Syndrome / drug therapy*,  physiopathology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Glucagon-Like Peptide 2; 0/Peptides; 0/teduglutide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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