Review: “Dorothy Hodgkin lecture 2023: The enteroendocrine system – sensors in your guts”

Abstract

Glucagon‐like peptide‐1 (GLP‐1) based medication is now widely employed in the treatment of type 2 diabetes and obesity. Like other gut hormones, GLP‐1 is released from eneteroendocrine cells after a meal and in this review, based on the Dorothy Hodgkin lecture delivered during the annual meeting of Diabetes UK in 2023, I argue that there is sufficient spare capacity of GLP‐1 and other gut hormone expressing cells that could be recruited therapeutically. Years of research has revealed several receptors expressed in enteroendocrine cells that could be targeted to stimulate hormone release: although from this research it seems unlikely to find agents that selectively boost GLP‐1, release of a mixture of hormones might be the more desirable outcome anyway, given the recent promising results of new peptides combining GLP1‐receptor with other gut hormone receptor activation. Alternatively, the fact that GLP‐1 and PeptideYY (PYY) expressing cells are found in greater density in the ileum might be exploited by increasing the delivery of chyme to the distal small intestine.