Høyerup P, Hellström P M, Schmidt P T, Brandt C F, Askov-Hansen C, Mortensen P B, Jeppesen P B
Department of Gastroenterology CA-2121, Copenhagen University Hospital, Rigshospitalet, Denmark.
Regul Pept. 2013 Jan 10;180:12-6. doi: 10.1016/j.regpep.2012.10.002. Epub 2012 Nov 16.
In animal and human studies glucagon-like peptide-2 (GLP-2) has been shown to increase blood flow in the superior mesenteric artery and the portal vein. This study describes the effect of GLP-2 measured directly on the intestinal mucosal blood flow by laser Doppler flowmetry (LDF) in end-jejunostomy short bowel syndrome (SBS) patients.
In five SBS patients with end-jejunostomy a specially designed laser Doppler probe was inserted into the stoma nipple, and blood flow measured directly on the jejunal mucosa for 105 min in relation to no treatment, systemic saline infusion, topical adrenaline application and a subcutaneous injection of 800 μg native GLP-2.
The GLP-2 injection increased jejunal mucosal blood flow by 79±37% compared to conditions, where no treatment was given (p<0.001). The significant effect was present at least 105 min. Systemic saline infusion and topical, mucosal adrenaline application did not affect mucosal microcirculation.
GLP-2 raises jejunal microcirculation in SBS patients with end-jejunostomy. This may explain the redness and increase in the end-jejunostomy nipple size imminently after commencing GLP-2 injections. The potential beneficial effects of this GLP-2-mediated increase of blood flow in the mesenteric bed should be investigated in clinical conditions other than the short bowel syndrome.
在动物和人体研究中，胰高血糖素样肽-2（GLP-2）已被证明可增加肠系膜上动脉和门静脉的血流量。本研究描述了通过激光多普勒血流仪（LDF）直接测量GLP-2对空肠造口术短肠综合征（SBS）患者肠黏膜血流量的影响。
在5例空肠造口术的SBS患者中，将一个专门设计的激光多普勒探头插入造口乳头，在未治疗、全身输注生理盐水、局部应用肾上腺素和皮下注射800μg天然GLP-2的情况下，直接测量空肠黏膜血流量105分钟。
与未治疗的情况相比，注射GLP-2使空肠黏膜血流量增加了79±37%（p<0.001）。这种显著效果至少持续105分钟。全身输注生理盐水和局部黏膜应用肾上腺素均未影响黏膜微循环。
GLP-2可增加空肠造口术SBS患者的空肠微循环。这可能解释了开始注射GLP-2后空肠造口乳头立即出现发红和尺寸增大的现象。除短肠综合征外，还应在其他临床情况下研究GLP-2介导的肠系膜床血流量增加的潜在有益作用。
