New approaches in modulating the GLP-1/GLP-2 AXIS: link between metabolic diseases and inflammatory bowel disease

Simona Georgiana Popa

Simona Georgiana Popa Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy, Craiova, Romania

Keywords: Glucagon-like peptide-1 (GLP-1), Glucagon-like peptide-2 (GLP-2), inflammatory bowel disease, intestinal neoplasia, preneoplastic intestinal lesions

Abstract

Glucagon-like peptides (GLP)-1 and GLP-2, currently approved as a therapy for diabetes, have gained interest as hormones with roles in maintaining intestinal architecture and homeostasis. The current review is an integrative model of the emerging data, aiming to investigate the impact of GLP-1/GLP-2 in inflammatory bowel diseases (IBD) pathogeny and as effective and safe therapy in patients with IBD and also proposes the following future research directions regarding the role and safety of incretins in IBD, and indicates their scientific relevance: Quantification of GLP-1, GLP-2 and DPP-IV expression on inflamed intestinal mucosa from patients with IBD, allowing the use of GLPs as markers of IBD phenotype;Mapping of GLP-1/GLP-2 receptors in different types of intestinal cells, allowing a better understanding of the intestinal effects mediated by GLPs; Assessment of the impact of GLP-1/GLP-2 receptor agonists, DPP-IV inhibitors and short chain fatty acids on intestinal cell proliferation and inflammation in patients with IBD, allowing the identification of the optimal therapeutic strategy to preserve the quiescent IBD phenotype; Quantifying GLP-1/GLP-2 expression from neoplastic or precancerous intestinal lesions and evaluating the intestinotrophic effects of incretins and their relation to intestinal neoplasia, allowing identification of a potential limitation of incretin therapy in IBD.