Background
Short bowel syndrome (SBS) is characterized by malabsorption requiring parenteral nutrition. The intestinotrophic glucagon‐like peptide (GLP)‐2 receptor agonist, h[Gly2]GLP2, is used to treat patients with SBS. Evidence suggests that GLP‐1 receptor agonists such as exendin‐4 (Ex4) may be beneficial in SBS given their ability to increase intestinal growth and delay gastric emptying (GE).
Methods
Intestinal growth, body weight (BW), food intake (FI), GE, gastrointestinal (GI) transit, intestinal permeability, and glucose tolerance were investigated in male and female C57/BL6 mice following vehicle, h[Gly2]GLP2, or Ex4 treatment, alone or in combination at “low,” “medium,” and “high” doses (0.1, 0.5, 1.0 and 0.01, 0.05, 0.1 μg/g, respectively).
Results
Only the h[Gly2]GLP2 low/Ex4 high‐dose combination additively increased small intestinal (SI) weight compared with vehicle and both monoagonists (P < 0.01–0.001), via increased villus height (P < 0.01) and SI length (P < 0.05). This combination had no effects on BW; FI; and fat, liver, spleen, heart, and kidney weights but reduced GI transit (P < 0.001) versus low‐dose h[Gly2]GLP2 monotreatment and abrogated the inhibitory effects of high‐dose Ex4 on GE (P < 0.01) and of low‐dose h[Gly2]GLP2 on intestinal permeability (P < 0.05). Ex4‐induced improvements in glucose homeostasis were maintained upon combination with h[Gly2]GLP2 (P < 0.001).
Conclusions
These findings suggest that combining specific doses of GLP‐2‐ and GLP‐1 receptor agonists additively improves SI growth and GI transit without detrimental effects on BW, FI, GE, and glucose homeostasis, and may be useful for the treatment of patients with SBS.