The effect of glucagon-like peptide-2 and intraluminal nutrients on intestinal adaptation in a rat model of short bowel syndrome

Abstract

This thesis highlights two strategies in the management of short bowel syndrome: hormonal therapy with exogenous glucagon-like peptide-2 (GLP-2) and intraluminal nutrient infusion. Both approaches trigger an adaptive response that yields structural and functional intestinal changes to improve nutrient absorptive capacity. This study investigates (1) the effects of massive distal bowel resection, alone and in combination with exogenous GLP-2, on intestinal adaptation, with special attention to the enteric nervous system as a potential mediator; and (2) the intestinotrophic effects of dietary sucralose, medium chain triglycerides (MCT) and long chain triglycerides (LCT) after distal resection. We conclude that (1) the native adaptive response to distal resection is not recapitulated by GLP-2 therapy; (2) structural intestinotrophic effects of exogenous GLP-2 are unlikely to be mediated by neuronal nitric oxide synthase and vasoactive intestinal peptide; and (3) MCT are superior to LCT in promoting intestinal adaptation after distal resection, independent of GLP-2.