Said Hyder, Akiba Yasutada, Narimatsu Kazuyuki, Maruta Koji, Kuri Ayaka, Iwamoto Ken-Ichi, Kuwahara Atsukazu, Kaunitz Jonathan D
College of Arts and Sciences, University of California, Los Angeles, CA, USA.
Greater Los Angeles Veterans Affairs Healthcare System, 11301 Wilshire Boulevard, Bldg 115, Suite 217, Los Angeles, CA, 90073, USA.
Dig Dis Sci. 2017 Aug;62(8):1944-1952. doi: 10.1007/s10620-017-4600-4. Epub 2017 May 18.
Therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with enteropathy in humans and experimental animals, a cause of considerable morbidity. Unlike foregut NSAID-associated mucosal lesions, most treatments for this condition are of little efficacy. We propose that the endogenously released intestinotrophic hormone glucagon-like peptide-2 (GLP-2) prevents the development of NSAID-induced enteropathy. Since the short-chain fatty acid receptor FFA3 is expressed on enteroendocrine L cells and on enteric nerves in the gastrointestinal tract, we further hypothesized that activation of FFA3 on L cells protects the mucosa from injury via GLP-2 release with enhanced duodenal HCO secretion. We thus investigated the effects of synthetic selective FFA3 agonists with consequent GLP-2 release on NSAID-induced enteropathy.
We measured duodenal HCO secretion in isoflurane-anesthetized rats in a duodenal loop perfused with the selective FFA3 agonists MQC or AR420626 (AR) while measuring released GLP-2 in the portal vein (PV). Intestinal injury was produced by indomethacin (IND, 10 mg/kg, sc) with or without MQC (1-10 mg/kg, ig) or AR (0.01-0.1 mg/kg, ig or ip) treatment.
Luminal perfusion with MQC or AR (0.1-10 µM) dose-dependently augmented duodenal HCO secretion accompanied by increased GLP-2 concentrations in the PV. The effect of FFA3 agonists was inhibited by co-perfusion of the selective FFA3 antagonist CF3-MQC (30 µM). AR-induced augmented HCO secretion was reduced by iv injection of the GLP-2 receptor antagonist GLP-2(3-33) (3 nmol/kg), or by pretreatment with the cystic fibrosis transmembrane conductance regulator (CFTR) inhibitor CFTR-172 (1 mg/kg, ip). IND-induced small intestinal ulcers were dose-dependently inhibited by intragastric administration of MQC or AR. GLP-2(3-33) (1 mg/kg, ip) or CF3-MQC (1 mg/kg, ig) reversed AR-associated reduction in IND-induced enteropathy. In contrast, ip injection of AR had no effect on enteropathy.
These results suggest that luminal FFA3 activation enhances mucosal defenses and prevents NSAID-induced enteropathy via the GLP-2 pathway. The selective FFA3 agonist may be a potential therapeutic candidate for NSAID-induced enteropathy.
非甾体抗炎药(NSAIDs)治疗与人类和实验动物的肠病相关,这是相当高发病率的一个原因。与前肠NSAID相关的粘膜病变不同,针对这种情况的大多数治疗效果不佳。我们提出内源性释放的肠营养激素胰高血糖素样肽-2(GLP-2)可预防NSAID诱导的肠病的发生。由于短链脂肪酸受体FFA3在胃肠道的肠内分泌L细胞和肠神经上表达,我们进一步假设L细胞上FFA3的激活通过增强十二指肠HCO分泌并释放GLP-2来保护粘膜免受损伤。因此,我们研究了合成的选择性FFA3激动剂及其导致的GLP-2释放对NSAID诱导的肠病的影响。
我们在异氟烷麻醉的大鼠十二指肠环中测量十二指肠HCO分泌,该十二指肠环灌注选择性FFA3激动剂MQC或AR420626(AR),同时测量门静脉(PV)中释放的GLP-2。通过吲哚美辛(IND,10mg/kg,皮下注射)诱导肠道损伤,同时给予或不给予MQC(1-10mg/kg,灌胃)或AR(0.01-0.1mg/kg,灌胃或腹腔注射)治疗。
用MQC或AR(0.1-10µM)进行腔内灌注可剂量依赖性地增加十二指肠HCO分泌,并伴有PV中GLP-2浓度升高。选择性FFA3拮抗剂CF3-MQC(30µM)共同灌注可抑制FFA3激动剂的作用。静脉注射GLP-2受体拮抗剂GLP-2(3-33)(3nmol/kg)或用囊性纤维化跨膜传导调节因子(CFTR)抑制剂CFTR-172(1mg/kg,腹腔注射)预处理可降低AR诱导的HCO分泌增加。胃内给予MQC或AR可剂量依赖性地抑制IND诱导的小肠溃疡。GLP-2(3-33)(1mg/kg,腹腔注射)或CF3-MQC(1mg/kg,灌胃)可逆转AR相关的IND诱导的肠病减轻。相反,腹腔注射AR对肠病无影响。
这些结果表明腔内FFA3激活可增强粘膜防御,并通过GLP-2途径预防NSAID诱导的肠病。选择性FFA3激动剂可能是NSAID诱导的肠病的潜在治疗候选药物。