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Roux-en-Y 胃旁路手术后肠道甜味感知通路和代谢变化。

Intestinal sweet-sensing pathways and metabolic changes after Roux-en-Y gastric bypass surgery.

机构信息

Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Investigative Medicine, Imperial College London, United Kingdom;

Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts;

出版信息

Am J Physiol Gastrointest Liver Physiol. 2014 Sep 1;307(5):G588-93. doi: 10.1152/ajpgi.00405.2013. Epub 2014 Jul 3.

Abstract

Studies suggest that improvements in type 2 diabetes (T2D) post- Roux-en-Y gastric bypass (RYGB) surgery are attributable to decreased intestinal glucose absorption capacity mediated by exclusion of sweet taste-sensing pathways in isolated proximal bowel. We probed these pathways in rat models that had undergone RYGB with catheter placement in the biliopancreatic (BP) limb to permit post-RYGB exposure of isolated bowel to sweet taste stimulants. Lean Sprague Dawley (n = 13) and obese Zucker diabetic fatty rats (n = 15) underwent RYGB with BP catheter placement. On postoperative day 11 (POD 11), rats received catheter infusions of saccharin [sweet taste receptor (T1R2/3) agonist] or saline (control). Jejunum was analyzed for changes in glucose transporter/sensor mRNA expression and functional sodium-glucose transporter 1 (SGLT1)-mediated glucose uptake. Saccharin infusion did not alter glucose uptake in the Roux limb of RYGB rats. Intestinal expression of the glucose sensor T1R2 and transporters (SGLT1, glucose transporter 2) was similar in saccharin- vs. saline-infused rats of both strains. However, the abundance of SGLT3b mRNA, a putative glucose sensor, was higher in the common limb vs. BP/Roux limb in both strains of bypassed rats and was significantly decreased in the Roux limb after saccharin infusion. We concluded that failure of BP limb exposure to saccharin to increase Roux limb glucose uptake suggests that isolation of T1R2/3 is unlikely to be involved in metabolic benefits of RYGB, as restimulation failed to reverse changes in intestinal glucose absorption capacity. The altered expression pattern of SGLT3 after RYGB warrants further investigation of its potential involvement in resolution of T2D after RYGB.

摘要

研究表明,胃旁路术后 2 型糖尿病(T2D)的改善归因于通过排除近端肠甜味感应途径来减少肠道葡萄糖吸收能力。我们在接受 RYGB 并在胆胰(BP)分支放置导管以允许术后 RYGB 暴露于分离肠的甜味刺激物的大鼠模型中探测了这些途径。瘦的 Sprague Dawley(n = 13)和肥胖 Zucker 糖尿病肥胖大鼠(n = 15)接受了 RYGB 并放置了 BP 导管。术后第 11 天(POD 11),大鼠接受了蔗糖(甜味受体(T1R2/3)激动剂)或盐水(对照)的导管输注。分析空肠葡萄糖转运体/传感器 mRNA 表达和功能性钠-葡萄糖转运体 1(SGLT1)介导的葡萄糖摄取的变化。蔗糖输注不会改变 RYGB 大鼠 Roux 分支的葡萄糖摄取。在两种大鼠的蔗糖与盐水输注大鼠中,葡萄糖传感器 T1R2 和转运体(SGLT1、葡萄糖转运体 2)的肠道表达相似。然而,在两种旁路大鼠的共同分支与 BP/Roux 分支中,假定的葡萄糖传感器 SGLT3b mRNA 的丰度更高,并且在蔗糖输注后在 Roux 分支中显著降低。我们得出结论,BP 分支暴露于蔗糖而不增加 Roux 分支的葡萄糖摄取表明,T1R2/3 的隔离不太可能参与 RYGB 的代谢益处,因为再刺激未能逆转肠道葡萄糖吸收能力的变化。RYGB 后 SGLT3 的改变表达模式需要进一步研究其在 RYGB 后 T2D 缓解中的潜在作用。

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