@article{JurowichOttoRikkalaetal.2015,
  author    = {Jurowich, Christian Ferdinand and Otto, Christoph and Rikkala, Prashanth Reddy and Wagner, Nicole and Vrhovac, Ivana and Sabolić, Ivan and Germer, Christoph-Thomas and Koepsell, Hermann},
  title     = {Ileal interposition in rats with experimental type 2 like diabetes improves glycemic control independently of glucose absorption},
  series = {Journal of Diabetes Research},
  volume    = {2015},
  journal   = {Journal of Diabetes Research},
  number    = {490365},
  doi       = {10.1155/2015/490365},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-149166},
  year      = {2015},
  abstract  = {Bariatric operations in obese patients with type 2 diabetes often improve diabetes before weight loss is observed. In patients mainly Roux-en-Y-gastric bypass with partial stomach resection is performed. Duodenojejunal bypass (DJB) and ileal interposition (IIP) are employed in animal experiments. Due to increased glucose exposition of L-cells located in distal ileum, all bariatric surgery procedures lead to higher secretion of antidiabetic glucagon like peptide-1 (GLP-1) after glucose gavage. After DJB also downregulation of Na\(^{+}\)-D-glucose cotransporter SGLT1 was observed. This suggested a direct contribution of decreased glucose absorption to the antidiabetic effect of bariatric surgery. To investigate whether glucose absorption is also decreased after IIP, we induced diabetes with decreased glucose tolerance and insulin sensitivity in male rats and investigated effects of IIP on diabetes and SGLT1. After IIP, we observed weight-independent improvement of glucose tolerance, increased insulin sensitivity, and increased plasma GLP-1 after glucose gavage. The interposed ileum was increased in diameter and showed increased length of villi, hyperplasia of the epithelial layer, and increased number of L-cells. The amount of SGLT1-mediated glucose uptake in interposed ileum was increased 2-fold reaching the same level as in jejunum. Thus, improvement of glycemic control by bariatric surgery does not require decreased glucose absorption.},
  language  = {en}
}
@phdthesis{Rikkala2015,
  author    = {Rikkala, Prashanth Reddy},
  title     = {Regulation of the Na+-D-glucose cotransporter SGLT1 in the small intestine in response to bariatric surgery and peptides derived from protein RS1 (RSC1A1)},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-130608},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {Bariatric surgery represents the first-line treatment for morbid obesity, resulting in weight loss and improved diabetes control. The positive effect of bariatric surgery on type-2 diabetes is unclear. Increased secretion of insulin regulating enterohormone glucagon-like-peptide 1 (GLP-1) has been observed in rats with experimental type 2-like diabetes following duodenal-jejunal bypass (DJB) and ileal transposition (IT). Sodium dependent glucose co-transporter (SGLT1) is involved in the secretion of GLP-1 that in turn regulates insulin secretion. In the present study, an attempt was made to elucidate the impact of DJB and IT on SGLT1 mediated glucose transport. Transport measurements using phlorizin inhibited uptake of SGLT1-specific glucose analogue [14C] α-Methyl-D-glucopyranoside (AMG) were performed to determine the changes in SGLT1 transport upon these surgical procedures. The data indicated that DJB decreased SGLT1-mediated glucose absorption in the small intestine which contributes to the body-weight independent improvement of type 2 diabetes. However, IT did not change the SGLT1-mediated glucose transport. Immunohistochemical analysis revealed that in IT, the transposed ileum showed increased diameter, increased villi length and increased number of GLP-1 secreting L-cells. The weight-independent improvement in glycemic control after IT is not related to SGLT1-mediated glucose absorption but may be linked to increased GLP-1 secretion. Along with this, the study also focused on the regulation of SGLT1 by several RS1 derived tripeptides in mouse and human intestinal tissues (ex vivo). Phlorizin inhibited uptake of AMG was measured without and with tripeptides. QEP and thiophosphorylated QSP down-regulated SGLT1 activity in small intestine in a concentration-dependent manner. Among the tested tripeptides, QEP showed higher activity and further analysis in various species demonstrated its universal role in SGLT1 regulation. The data thus indicates that RS1 derived tripeptides QEP and thiophosphorylated QSP may be employed for the treatment of type 2 diabetes.},
  subject      = {Glucosetransportproteine},
  language  = {en}
}