Bouvard Béatrice, Mabilleau Guillaume
Univ Angers, Nantes Université, ONIRIS, Inserm, RMeS UMR 1229, Angers, France.
CHU Angers, Service de Rhumatologie, Angers, France.
Nat Rev Endocrinol. 2024 Sep;20(9):553-564. doi: 10.1038/s41574-024-01000-z. Epub 2024 Jun 10.
Bone resorption follows a circadian rhythm, with a marked reduction in circulating markers of resorption (such as carboxy-terminal telopeptide region of collagen type I in serum) in the postprandial period. Several gut hormones, including glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide 1 (GLP1) and GLP2, have been linked to this effect in humans and rodent models. These hormones are secreted from enteroendocrine cells in the gastrointestinal tract in response to a variety of stimuli and effect a wide range of physiological processes within and outside the gut. Single GLP1, dual GLP1-GIP or GLP1-glucagon and triple GLP1-GIP-glucagon receptor agonists have been developed for the treatment of type 2 diabetes mellitus and obesity. In addition, single GIP, GLP1 and GLP2 analogues have been investigated in preclinical studies as novel therapeutics to improve bone strength in bone fragility disorders. Dual GIP-GLP2 analogues have been developed that show therapeutic promise for bone fragility in preclinical studies and seem to exert considerable activity at the bone material level. This Review summarizes the evidence of the action of gut hormones on bone homeostasis and physiology.
骨吸收遵循昼夜节律,餐后循环中的骨吸收标志物(如血清中I型胶原羧基末端肽区域)显著减少。包括葡萄糖依赖性促胰岛素多肽(GIP)、胰高血糖素样肽1(GLP1)和GLP2在内的几种肠道激素,在人类和啮齿动物模型中均与这种效应有关。这些激素由胃肠道中的肠内分泌细胞分泌,以响应各种刺激,并影响肠道内外的多种生理过程。已开发出单一GLP1、双重GLP1-GIP或GLP1-胰高血糖素以及三重GLP1-GIP-胰高血糖素受体激动剂用于治疗2型糖尿病和肥胖症。此外,单一GIP、GLP1和GLP2类似物已在临床前研究中作为改善骨脆性疾病骨强度的新型疗法进行了研究。已开发出双重GIP-GLP2类似物,在临床前研究中显示出对骨脆性的治疗前景,并且似乎在骨材料水平上发挥相当大的活性。本综述总结了肠道激素对骨稳态和生理作用的证据。
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