Endocrine regulation of gut function - a role for glucagon-like peptide-1 in the pathophysiology of irritable bowel syndrome

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Date
2018-11-16
Authors
O'Malley, Dervla
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John Wiley & Sons, Inc.
Published Version
10.1113/EP087443
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Abstract
The prevalent and debilitating functional bowel disorder, irritable bowel syndrome (IBS), is characterized by symptoms that include abdominal pain, bloating, diarrhoea and/or constipation. The heterogeneity of IBS underscores a complex multifactorial pathophysiology, which is not completely understood but involves dysfunction of the bi‐directional signalling axis between the brain and the gut. This axis incorporates efferent and afferent branches of the autonomic nervous system, circulating endocrine hormones and immune factors, local paracrine and neurocrine factors and microbial metabolites. L‐cells, which are electrically excitable biosensors embedded in the gastrointestinal epithelium, secrete glucagon‐like peptide‐1 (GLP‐1) in response to nutrients in the small intestine. However, they appear to function in a different manner more distally in the gastrointestinal tract, where they are activated by luminal factors including short‐chain fatty acids, bile acids and microbial metabolic products, all of which are altered in IBS patients. Glucagon‐like peptide‐1 can also interact with the hypothalamic–pituitary–adrenal stress axis and the immune system, both of which are activated in IBS. Given that a GLP‐1 mimetic has been found to alleviate acute pain symptoms in IBS patients, GLP‐1 might be important in the manifestation of IBS symptoms. This review assesses the current knowledge about the role of GLP‐1 in IBS pathophysiology and its potential role as a signal transducer in the microbiome–gut–brain signalling axis.
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Keywords
Irritable bowel syndrome , Glucagon‐like peptide‐1 , L‐cells
Citation
O'Malley, D. (2018) 'Endocrine regulation of gut function - a role for glucagon-like peptide-1 in the pathophysiology of irritable bowel syndrome', Experimental Physiology, 104(1), pp. 3-10. doi:10.1113/EP087443
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https://hdl.handle.net/10468/7326
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Physiology - Journal Articles
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© 2018, the Author. Experimental Physiology © 2018, The Physiological Society. This is the peer reviewed version of the following article: O'Malley, D. (2018) 'Endocrine regulation of gut function - a role for glucagon-like peptide-1 in the pathophysiology of irritable bowel syndrome', Experimental Physiology, 104(1), pp. 3-10. doi:10.1113/EP087443, which has been published in final form at https://doi.org/10.1113/EP087443. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.