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Advances in glucagon like peptide-2 therapy. physiology, current indications and future directions

D L Sigalet1

  • 1Department of Pediatric Surgery, Sidra Medical and Research Center, Doha, Qatar; Professor of Surgery, Weill Cornell Medical College, Doha, Qatar.

Seminars in Pediatric Surgery
|October 22, 2018
PubMed

Insights

Glucagon-like peptide 2 (GLP-2) is key for pediatric intestinal adaptation in short bowel syndrome (SBS). Teduglutide, a GLP-2 ligand, shows promise for enhancing nutrient absorption and reducing parenteral support in children with SBS and intestinal failure (IF).

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Physiology
  • Endocrinology

Background:

  • Short bowel syndrome (SBS) and intestinal failure (IF) in children have seen improved survival due to advancements in dedicated IF teams, parenteral nutrition (PN), and surgical interventions.
  • While many pediatric SBS patients achieve intestinal adaptation, allowing them to discontinue PN, the underlying mechanisms remain incompletely understood.
  • The enteric hormone Glucagon-like peptide 2 (GLP-2) is recognized as a critical regulator of this adaptive process.

Purpose of the Study:

  • To review the physiology of GLP-2, focusing on its established and potential roles in pediatric patients with SBS and IF.
  • To discuss the implications of current studies and approved indications for GLP-2 and its analogs in managing pediatric SBS and IF.
  • To explore future therapeutic applications of GLP-2 ligands in the pediatric population.

Main Methods:

  • Literature review of GLP-2 physiology and its role in intestinal adaptation.
  • Analysis of current clinical studies and approved indications for GLP-2 ligands (e.g., Teduglutide).
  • Discussion of potential future research and therapeutic strategies involving GLP-2 in pediatric SBS and IF.

Main Results:

  • GLP-2 plays a significant role in regulating intestinal adaptation, enhancing nutrient absorption in SBS.
  • Teduglutide, a long-acting GLP-2 analog, represents a novel therapeutic approach to improve adaptation and reduce reliance on PN.
  • Current data support the use of GLP-2 ligands in specific pediatric populations with SBS and IF, with ongoing research into broader applications.

Conclusions:

  • GLP-2 is a crucial mediator of intestinal adaptation in pediatric short bowel syndrome.
  • Teduglutide and similar GLP-2 ligands offer a promising therapeutic avenue to improve outcomes for children with intestinal failure.
  • Further research is warranted to fully elucidate the potential of GLP-2-based therapies in managing pediatric SBS and IF.

Keywords:
Intestinal adaptationIntestinal failureShort bowel syndromel-cell

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