Glucagon-like peptide-1 is a marker of systemic inflammation in patients treated with high-dose chemotherapy and autologous stem cell transplantation

M S Ebbesen; H Kissow; B Hartmann; K Grell; J S Gørløv; K Kielsen; J J Holst; K Müller

doi:10.1016/j.bbmt.2019.01.036

Glucagon-like peptide-1 is a marker of systemic inflammation in patients treated with high-dose chemotherapy and autologous stem cell transplantation

M S Ebbesen, H Kissow, B Hartmann, K Grell, J S Gørløv, K Kielsen, J J Holst, K Müller

3 Citations (Scopus)

Abstract

Autologous stem cell transplantation (ASCT) is challenged by side effects that may be propagated by chemotherapy-induced mucositis, resulting in bacterial translocation and systemic inflammation. Because gastrointestinal damage appears as an early event in this cascade of reactions, we hypothesized that markers reflecting damage to the intestinal barrier could serve as early predictive markers of toxicity. Glucagon-like peptide-1 (GLP-1), a well-known regulator of blood glucose, has been found to promote intestinal growth and repair in animal studies. We investigated fasting GLP-1 plasma levels in 66 adults undergoing ASCT for lymphoma and multiple myeloma. GLP-1 increased significantly after chemotherapy, reaching peak levels at day +7 post-transplant (median, 8 pmol/L [interquartile range, 4 to 12] before conditioning versus 10 pmol/L [interquartile range, 6 to 17] at day +7; P = .007). The magnitude of the GLP-1 increase was related to the intensity of conditioning. GLP-1 at the day of transplantation (day 0) was positively associated with peak C-reactive protein (CRP) levels (46 mg/L per GLP-1 doubling, P < .001) and increase in days with fever (32% per GLP-1 doubling, P = .0058). Patients with GLP-1 above the median at day 0 had higher CRP levels from days +3 to +10 post-transplant than patients with lower GLP-1 (P ≤ .041) with peak values of 238 versus 129 mg/L, respectively. This study, which represents the first clinical investigation of fasting GLP-1 in relation to high-dose chemotherapy, provides evidence that GLP-1 plays a role in regulation of mucosal defenses. Fasting GLP-1 levels may serve as an early predictor of systemic inflammation and fever in patients receiving high-dose chemotherapy.

Original language	English
Journal	Biology of Blood and Marrow Transplantation
Volume	25
Issue number	6
Pages (from-to)	1085-1091
Number of pages	7
ISSN	1083-8791
DOIs	https://doi.org/10.1016/j.bbmt.2019.01.036
Publication status	Published - Jun 2019

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Ebbesen, M. S., Kissow, H., Hartmann, B., Grell, K., Gørløv, J. S., Kielsen, K., Holst, J. J., & Müller, K. (2019). Glucagon-like peptide-1 is a marker of systemic inflammation in patients treated with high-dose chemotherapy and autologous stem cell transplantation. Biology of Blood and Marrow Transplantation, 25(6), 1085-1091. https://doi.org/10.1016/j.bbmt.2019.01.036

Glucagon-like peptide-1 is a marker of systemic inflammation in patients treated with high-dose chemotherapy and autologous stem cell transplantation. / Ebbesen, M S; Kissow, H ; Hartmann, B et al.
In: Biology of Blood and Marrow Transplantation, Vol. 25, No. 6, 06.2019, p. 1085-1091.

Research output: Contribution to journal › Journal article › Research › peer-review

Ebbesen, MS, Kissow, H , Hartmann, B , Grell, K, Gørløv, JS, Kielsen, K, Holst, JJ & Müller, K 2019, 'Glucagon-like peptide-1 is a marker of systemic inflammation in patients treated with high-dose chemotherapy and autologous stem cell transplantation', Biology of Blood and Marrow Transplantation, vol. 25, no. 6, pp. 1085-1091. https://doi.org/10.1016/j.bbmt.2019.01.036

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title = "Glucagon-like peptide-1 is a marker of systemic inflammation in patients treated with high-dose chemotherapy and autologous stem cell transplantation",

abstract = "Autologous stem cell transplantation (ASCT) is challenged by side effects that may be propagated by chemotherapy-induced mucositis, resulting in bacterial translocation and systemic inflammation. Because gastrointestinal damage appears as an early event in this cascade of reactions, we hypothesized that markers reflecting damage to the intestinal barrier could serve as early predictive markers of toxicity. Glucagon-like peptide-1 (GLP-1), a well-known regulator of blood glucose, has been found to promote intestinal growth and repair in animal studies. We investigated fasting GLP-1 plasma levels in 66 adults undergoing ASCT for lymphoma and multiple myeloma. GLP-1 increased significantly after chemotherapy, reaching peak levels at day +7 post-transplant (median, 8 pmol/L [interquartile range, 4 to 12] before conditioning versus 10 pmol/L [interquartile range, 6 to 17] at day +7; P = .007). The magnitude of the GLP-1 increase was related to the intensity of conditioning. GLP-1 at the day of transplantation (day 0) was positively associated with peak C-reactive protein (CRP) levels (46 mg/L per GLP-1 doubling, P < .001) and increase in days with fever (32% per GLP-1 doubling, P = .0058). Patients with GLP-1 above the median at day 0 had higher CRP levels from days +3 to +10 post-transplant than patients with lower GLP-1 (P ≤ .041) with peak values of 238 versus 129 mg/L, respectively. This study, which represents the first clinical investigation of fasting GLP-1 in relation to high-dose chemotherapy, provides evidence that GLP-1 plays a role in regulation of mucosal defenses. Fasting GLP-1 levels may serve as an early predictor of systemic inflammation and fever in patients receiving high-dose chemotherapy.",

author = "Ebbesen, {M S} and H Kissow and B Hartmann and K Grell and G{\o}rl{\o}v, {J S} and K Kielsen and Holst, {J J} and K M{\"u}ller",

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year = "2019",

month = jun,

doi = "10.1016/j.bbmt.2019.01.036",

language = "English",

volume = "25",

pages = "1085--1091",

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T1 - Glucagon-like peptide-1 is a marker of systemic inflammation in patients treated with high-dose chemotherapy and autologous stem cell transplantation

AU - Ebbesen, M S

AU - Kissow, H

AU - Hartmann, B

AU - Grell, K

AU - Gørløv, J S

AU - Kielsen, K

AU - Holst, J J

AU - Müller, K

PY - 2019/6

Y1 - 2019/6

N2 - Autologous stem cell transplantation (ASCT) is challenged by side effects that may be propagated by chemotherapy-induced mucositis, resulting in bacterial translocation and systemic inflammation. Because gastrointestinal damage appears as an early event in this cascade of reactions, we hypothesized that markers reflecting damage to the intestinal barrier could serve as early predictive markers of toxicity. Glucagon-like peptide-1 (GLP-1), a well-known regulator of blood glucose, has been found to promote intestinal growth and repair in animal studies. We investigated fasting GLP-1 plasma levels in 66 adults undergoing ASCT for lymphoma and multiple myeloma. GLP-1 increased significantly after chemotherapy, reaching peak levels at day +7 post-transplant (median, 8 pmol/L [interquartile range, 4 to 12] before conditioning versus 10 pmol/L [interquartile range, 6 to 17] at day +7; P = .007). The magnitude of the GLP-1 increase was related to the intensity of conditioning. GLP-1 at the day of transplantation (day 0) was positively associated with peak C-reactive protein (CRP) levels (46 mg/L per GLP-1 doubling, P < .001) and increase in days with fever (32% per GLP-1 doubling, P = .0058). Patients with GLP-1 above the median at day 0 had higher CRP levels from days +3 to +10 post-transplant than patients with lower GLP-1 (P ≤ .041) with peak values of 238 versus 129 mg/L, respectively. This study, which represents the first clinical investigation of fasting GLP-1 in relation to high-dose chemotherapy, provides evidence that GLP-1 plays a role in regulation of mucosal defenses. Fasting GLP-1 levels may serve as an early predictor of systemic inflammation and fever in patients receiving high-dose chemotherapy.

AB - Autologous stem cell transplantation (ASCT) is challenged by side effects that may be propagated by chemotherapy-induced mucositis, resulting in bacterial translocation and systemic inflammation. Because gastrointestinal damage appears as an early event in this cascade of reactions, we hypothesized that markers reflecting damage to the intestinal barrier could serve as early predictive markers of toxicity. Glucagon-like peptide-1 (GLP-1), a well-known regulator of blood glucose, has been found to promote intestinal growth and repair in animal studies. We investigated fasting GLP-1 plasma levels in 66 adults undergoing ASCT for lymphoma and multiple myeloma. GLP-1 increased significantly after chemotherapy, reaching peak levels at day +7 post-transplant (median, 8 pmol/L [interquartile range, 4 to 12] before conditioning versus 10 pmol/L [interquartile range, 6 to 17] at day +7; P = .007). The magnitude of the GLP-1 increase was related to the intensity of conditioning. GLP-1 at the day of transplantation (day 0) was positively associated with peak C-reactive protein (CRP) levels (46 mg/L per GLP-1 doubling, P < .001) and increase in days with fever (32% per GLP-1 doubling, P = .0058). Patients with GLP-1 above the median at day 0 had higher CRP levels from days +3 to +10 post-transplant than patients with lower GLP-1 (P ≤ .041) with peak values of 238 versus 129 mg/L, respectively. This study, which represents the first clinical investigation of fasting GLP-1 in relation to high-dose chemotherapy, provides evidence that GLP-1 plays a role in regulation of mucosal defenses. Fasting GLP-1 levels may serve as an early predictor of systemic inflammation and fever in patients receiving high-dose chemotherapy.

U2 - 10.1016/j.bbmt.2019.01.036

DO - 10.1016/j.bbmt.2019.01.036

M3 - Journal article

C2 - 30731250

SN - 1083-8791

VL - 25

SP - 1085

EP - 1091

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

IS - 6

ER -

Glucagon-like peptide-1 is a marker of systemic inflammation in patients treated with high-dose chemotherapy and autologous stem cell transplantation

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