ADA 2018: Enteroendocrine Function of the Intestine
We were introduced to a relatively new concept in this lecture series about the fact that the intestine is the largest and one of the most important endocrine systems in the human body. We now know that most endocrine cells in the intestine have pluri-hormonal complexity and there are many hormones secreted by these cells aside from GLP-1 and GIP. In addition, we now understand that GLP-1 has many mechanisms of action which go beyond glucose control, which regulate appetite, obesity, and even the immune system. L cells are located in the distal intestine and can secrete GLP-1. We know through experiments that GLP-1 agonists increase local protein synthesis but also can increase the exocrine pancreas secretions. There is also increased intestinal cell proliferation regulated by GLP-1. Perhaps most interestingly, GLP-1 has recently been found to attenuate the inflammatory response in the distal intestine to certain types of bacteria.
It is important for clinicians to understand that GLP-1 agonists have actions beyond what they are prescribed for, and this may affect who these medications are prescribed for in the future and may even broaden their indications.
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