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Departments of 1 Physiology, 3 Medicine, and 2 Surgery, Mount Sinai Hospital and the Toronto General Hospital, Toronto M5G 2C4; and the 4 Banting and Best Diabetes Centre, University of Toronto, Toronto, Ontario, Canada M5S 1A8
Glucagon-like peptide-2 (GLP-2) is a recently
characterized intestine-derived peptide that exerts trophic activity in
the small and large intestine. Whether circulating levels of GLP-2 are
perturbed in the setting of human inflammatory bowel disease (IBD)
remains unknown. The circulating levels of bioactive GLP-2-(1
33) compared with its degradation product GLP-2-(3
33) were assessed using
a combination of RIA and HPLC in normal and
immunocompromised control human subjects and patients hospitalized for
IBD. The activity of the enzyme dipeptidyl peptidase IV (DP IV), a key determinant of GLP-2-(1
33) degradation was also assessed
in the plasma of normal controls and subjects with IBD. The circulating levels of bioactive GLP-2-(1
33) were increased in patients with either ulcerative colitis (UC) or Crohn's Disease (CD; to 229 ± 65 and 317 ± 89%, P < 0.05, of normal, respectively).
Furthermore, the proportion of total immunoreactivity represented by
intact GLP-2-(1
33), compared with GLP-2-(3
33), was increased from
43 ± 3% in normal healthy controls to 61 ± 6% (P < 0.01) and 59 ± 2% (P < 0.01) in patients with UC and CD,
respectively. The relative activity of plasma DP IV was
significantly reduced in subjects with IBD compared with normal
subjects (1.4 ± 0.3 vs. 5.0 ± 1.1 mU/ml, respectively; P < 0.05). These results suggest that patients with active IBD may
undergo an adaptive response to intestinal injury by increasing the
circulating levels of bioactive GLP-2-(1
33), facilitating enhanced
repair of the intestinal mucosal epithelium in vivo.
Crohn's disease; ulcerative colitis; short bowel syndrome; intestine
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