Enterohormone therapy for short bowel syndrome

Area of Science:

• Gastroenterology
• Endocrinology
• Surgical Innovation

Background:

• Short bowel syndrome (SBS) leads to intestinal failure and dependence on parenteral support, significantly impacting patients' quality of life.
• Intestinal adaptation, a natural process of structural and functional changes, improves nutrient absorption in remaining bowel segments.
• Enterohormones like glucagon-like peptide (GLP)-2, GLP-1, and peptide YY (PYY) play a role in regulating intestinal adaptation.

Purpose of the Study:

• To review the role of spontaneous intestinal adaptation and disease-modifying therapies in managing short bowel syndrome (SBS) and intestinal failure.
• To evaluate the efficacy of glucagon-like peptide (GLP)-2 analogs in improving outcomes for SBS patients.
• To explore emerging therapies for further improving the management of SBS and reducing parenteral support.

Main Methods:

• Review of current literature on spontaneous intestinal adaptation in SBS.
• Analysis of studies investigating the effects of enterohormones, particularly GLP-2 analogs, on intestinal adaptation.
• Exploration of potential future therapeutic strategies for SBS.

Main Results:

• Spontaneous intestinal adaptation improves nutrient absorption but often insufficient to fully resolve intestinal failure.
• GLP-2 analogs have demonstrated effectiveness in promoting intestinal hyperadaptation, significantly reducing the need for parenteral support.
• While GLP-1 and PYY roles are under investigation, GLP-2 analogs offer a proven therapeutic avenue.

Conclusions:

• GLP-2 analogs represent a key disease-modifying therapy for SBS, enhancing adaptation and decreasing reliance on parenteral support.
• Further research into novel therapeutic combinations may offer additional benefits for SBS patients.
• Improving quality of life for SBS patients is achievable through enhanced intestinal adaptation and reduced parenteral support.