The paper by Jeppsen et al (see page559) shows that glucagon-like peptide-2 (GLP-2) concentrations are low in patients lacking an ileum and colon. This is not an unexpected finding as the L cells that produce GLP-2 are situated in the ileum and colon. GLP-2 is an enterocyte specific growth hormone that in mice causes small and large bowel villus/crypt growth and increases small and large bowel length and weight. In mice it also reduces body weight loss and restores mucosal integrity after dextran induced colitis. In pigs it reduces gastric antral motility.1 The deficiency of GLP-2 in patients with a jejunostomy may explain why these patients show no evidence of structural or functional intestinal adaptation over time.2-4

A distal ileal/colonic peptide with glucagon-like immunoreactivity has been recognised for many years and termed enteroglucagon. However, the molecular structure of enteroglucagon was originally unknown and serum concentrations were derived by subtracting pancreatic glucagon concentrations from …