Glucagon-like peptide-2 protects against TPN-induced intestinal hexose malabsorption in enterally refed piglets

Area of Science:

• Gastroenterology
• Pediatric Nutrition
• Endocrinology

Background:

• Premature infants on chronic total parenteral nutrition (TPN) often experience intestinal atrophy and impaired nutrient absorption.
• Glucagon-like peptide-2 (GLP-2), a trophic hormone, is known to improve intestinal growth and morphology but its effect on absorptive function remains unclear.

Purpose of the Study:

• To investigate whether GLP-2 administration during chronic TPN enhances intestinal absorptive function in piglets.
• To compare the effects of enteral formula (ENT), TPN alone, and TPN with GLP-2 on intestinal structure and digestive function.

Main Methods:

• Piglets received either ENT, TPN, or TPN plus GLP-2 for 6 days via catheters.
• Digestive function was assessed on day 7 using in vivo glucose absorption studies, in vitro lactase activity, and measurement of glucose transporter (SGLT-1, GLUT2) abundances.

Main Results:

• Both ENT and GLP-2 groups showed improved intestinal weight, villus length, lactose digestion, and net glucose/galactose absorption compared to TPN alone.
• GLP-2 treatment enhanced hexose absorption, increasing lactose digestion and apical glucose transport capacity, alongside higher SGLT-1 abundance.
• GLP-2 also reduced intestinal glucose metabolism to lactate, facilitating the transition to enteral feeding.

Conclusions:

• GLP-2 treatment during chronic TPN effectively preserves intestinal structure and function, including lactose digestion and hexose absorption.
• GLP-2 may play a crucial role in facilitating the transition from TPN to enteral feeding in vulnerable infants.
• Further research can explore optimizing GLP-2 dosage and timing for clinical application in TPN-dependent infants.