The glucagon like peptide-2 'axis': Capacity for production and response following intestinal resection or repair of gastroschisis in infants

J Pediatr Surg. 2018 May;53(5):898-904. doi: 10.1016/j.jpedsurg.2018.02.012. Epub 2018 Feb 7.

Abstract

Purpose: This study investigates the relationship between the enteric hormone glucagon-like peptide 2 (GLP-2) production, sensitivity, and intestinal adaptation in infants following resection or repair of gastroschisis.

Methods: With IRB approval (UCalgary #10656), consent was obtained from families of infants undergoing surgery for prospective monitoring of nutritional status, GLP-2 levels, and where possible, tissue sampling.

Results: Infants who adapted and weaned from parenteral nutrition (PN) had increased GLP-2 (86±32) n=24 vs. controls: 45±20 n=10 and vs. patients on prolonged PN: 42±6 pM, n=10). This was maintained to one year: weaned patients: 72±49 vs. non-weaned: 35±15 pM (p<0.05). Infants with gastroschisis (n=33) had decreased GLP-2 levels until enteral function was achieved and then became elevated: (21±15 with first feeding vs. 102±60 at full feeds and 60±19 pM at one year). There were no changes in the density or distribution of GLP-2 producing L-cells related to gestational age, nor in the expression of the GLP-2 receptor.

Conclusion: GLP-2 levels correlate with intestinal adaptation in infants, and with recovery of intestinal function in gastroschisis. GLP-2 productive capacity (L-cell expression) and GLP-2 receptor expression do not vary with maturity. The findings support a role for GLP-2 in regulating intestinal function. Further study is suggested.

Keywords: Enteroendocrine; Intestinal failure; L-cell; Short bowel.

MeSH terms

  • Adaptation, Physiological*
  • Digestive System Surgical Procedures / methods*
  • Female
  • Gastroschisis / metabolism
  • Gastroschisis / physiopathology
  • Gastroschisis / surgery*
  • Gestational Age
  • Glucagon-Like Peptide 2 / biosynthesis*
  • Humans
  • Infant
  • Infant, Newborn
  • Intestine, Small / surgery*
  • Male
  • Nutritional Status
  • Prospective Studies

Substances

  • Glucagon-Like Peptide 2