oxyntomodulin and Cholestasis

Topics: Acromegaly; Adenoma, Islet Cell; Cholestasis; Diverticulitis; Esophageal Achalasia; Esophageal Perforation; Glucagon; Glucagon-Like Peptides; Glycogen Storage Disease; Hepatitis; Humans; Hypoglycemia; Molecular Weight; Osteitis Deformans; Pancreas; Pheochromocytoma; Thyroid Neoplasms

Total parenteral nutrition (TPN) is essential for patients with impaired gut function but leads to parenteral nutrition-associated liver disease (PNALD). TPN disrupts the normal enterohepatic circulation of bile acids, and we hypothesized that it would decrease intestinal expression of the newly described metabolic hormone fibroblast growth factor-19 (FGF19) and also glucagon-like peptides-1 and -2 (GLP-1 and GLP-2). We tested the effects of restoring bile acids by treating a neonatal piglet PNALD model with chenodeoxycholic acid (CDCA). Neonatal pigs received enteral feeding (EN), TPN, or TPN + CDCA for 14 days, and responses were assessed by serum markers, histology, and levels of key regulatory peptides. Cholestasis and steatosis were demonstrated in the TPN group relative to EN controls by elevated levels of serum total and direct bilirubin and also bile acids and liver triglyceride (TG) content. CDCA treatment improved direct bilirubin levels by almost fourfold compared with the TPN group and also normalized serum bile acids and liver TG. FGF19, GLP-1, and GLP-2 were decreased in plasma of the TPN group compared with the EN group but were all induced by CDCA treatment. Intestinal mucosal growth marked by weight and villus/crypt ratio was significantly reduced in the TPN group compared with the EN group, and CDCA treatment increased both parameters. These results suggest that decreased circulating FGF19 during TPN may contribute to PNALD. Moreover, we show that enteral CDCA not only resolves PNALD but acts as a potent intestinal trophic agent and secretagogue for GLP-2.

Topics: Animals; Animals, Newborn; Atrophy; Chenodeoxycholic Acid; Cholestasis; Disease Models, Animal; Fibroblast Growth Factors; Glucagon-Like Peptides; Intestinal Mucosa; Liver Diseases; Parenteral Nutrition, Total; Swine; Treatment Outcome

A glucagon-like substance named biliary IRG2000 whose molecular weight is approximately 2,000 was isolated by gel filtration from rabbit bile. This substance showed a strong crossreactivity as equivalent to 25.7 +/- 5.1 ng/ml of porcine glucagon in RIA with antiserum 30K specificity. Biliary IRG2000 brought about a significant increase and delayed the response of blood glucose level in coexistence with porcine glucagon, though it has no appreciable effect on the glucose level when administered singly to the mouse intraperitoneally. The response with the coexistence of these materials was far greater than when porcine glucagon was given alone. In Mortimore's type rat liver perfusion, a significant rise in glucose concentration in effluent was also observed when a mixture of biliary IRG2000 and porcine glucagon was perfused. The rate of 125I-glucagon degradation was found delayed in the presence of biliary IRG2000 when examined in the rat. Thus the increase and delayed response of glucose level in coexistence of porcine glucagon with biliary IRG2000 may be explained by a suppressive effect of glucagon degradation due to biliary IRG2000.

Topics: Animals; Bile; Blood Glucose; Cholestasis; Glucagon; Glucagon-Like Peptides; Male; Mice; Mice, Inbred Strains; Peptides; Rabbits; Rats; Rats, Inbred Strains