A pilot study examining the relationship among Crohn disease activity, glucagon-like peptide-2 signalling and
Insights
Pediatric Crohn disease (CD) patients show reduced postprandial glucagon-like peptide 2 (GLP-2) release and impaired nutrient absorption during active disease. These functions normalize with healing, suggesting GLP-2 therapy potential.
Area of Science:
- Gastroenterology
- Pediatric Medicine
- Endocrinology
Background:
- The role of glucagon-like peptide 2 (GLP-2) in intestinal inflammation is not fully understood.
- GLP-2 supports mucosal growth, reduces intestinal permeability, and has anti-inflammatory effects.
- Physiological GLP-2 release is stimulated by nutrient intake.
Purpose of the Study:
- To investigate the hypothesis that ileal Crohn disease (CD) impacts GLP-2 release in pediatric patients.
- To assess the relationship between GLP-2 levels, nutrient absorption, and intestinal permeability in active CD versus remission.
Main Methods:
- Pediatric patients with active CD (disease activity index >150) and healthy controls were studied.
- Fasting and postprandial GLP-2 levels were measured.
- Intestinal permeability and glucose absorption were assessed using oral lactulose/mannitol and 3-O-methyl-glucose tests.
Main Results:
- Active CD patients had stable fasting GLP-2 but reduced postprandial GLP-2 levels.
- Reduced glucose absorption and increased intestinal permeability (lactulose/mannitol ratio) were observed in active CD.
- These parameters normalized upon disease remission.
Conclusions:
- Acute ileal Crohn disease in children is associated with decreased postprandial GLP-2 release, impaired glucose absorption, and increased intestinal permeability.
- Disease remission leads to the normalization of GLP-2 release and mucosal function, likely due to increased mucosal surface area.
- Findings suggest potential therapeutic roles for GLP-2 and specific feeding strategies in managing CD.
Unlabelled:
BACKGROUND⁄
Objectives:
The relationship between the enteroendocrine hormone glucagon-like peptide 2 (GLP-2) and intestinal inflammation is unclear. GLP-2 promotes mucosal growth, decreases permeability and reduces inflammation in the intestine; physiological stimulation of GLP-2 release is triggered by nutrient contact. The authors hypothesized that ileal Crohn disease (CD) affects GLP-2 release.
Methods:
With ethics board approval, pediatric patients hospitalized with CD were studied; controls were recruited from local schools. Inclusion criteria were endoscopy-confirmed CD (primarily of the small intestine) with a disease activity index >150. Fasting and postprandial GLP-2 levels and quantitative urinary recovery of orally administered 3-O-methyl-glucose (active transport) and lactulose⁄mannitol (passive) were quantified during the acute and remission phases.
Results:
Seven patients (mean [± SD] age 15.3 ± 1.3 years) and 10 controls (10.3 ± 1.6 years) were studied. In patients with active disease, fasting levels of GLP-2 remained stable but postprandial levels were reduced. Patients with active disease exhibited reduced glucose absorption and increased lactulose⁄mannitol recovery; all normalized with disease remission. The change in the lactulose⁄mannitol ratio was due to both reduced lactulose and increased mannitol absorption.
Conclusions:
These findings suggest that pediatric patients with acute ileal CD have decreased postprandial GLP-2 release, reduced glucose absorption and increased intestinal permeability. Healing of CD resulted in normalization of postprandial GLP-2 release and mucosal functioning (nutrient absorption and permeability), the latter due to an increase in mucosal surface area. These findings have implications for the use of GLP-2 and feeding strategies as a therapy in CD patients; further studies of the effects of inflammation and the GLP-2 axis are recommended.
More Related Videos
09:44Evaluating Therapeutic Interventions in the SHIP-deficient Mouse Model of Crohn Disease-like Ileitis and Fibrosis
Published on: October 14, 2025
09:16Mixed Primary Cultures of Murine Small Intestine Intended for the Study of Gut Hormone Secretion and Live Cell Imaging of Enteroendocrine Cells
Published on: April 20, 2017
Related Concept Videos
01:25Inflammatory Bowel Disease III: Crohn's Disease
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:24Glucagon-like Receptor Agonists
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
01:21Chronic Pancreatitis II: Pathophysiology