Teduglutide (brand names Gattex in the US and Revestive in Europe) is a 33-membered poly

peptide Peptides (, ) are short chains of amino acids linked by peptide bonds. Long chains of amino acids are called proteins. Chains of fewer than twenty amino acids are called oligopeptides, and include dipeptides, tripeptides, and tetrapeptides. ...

and glucagon-like peptide-2 (GLP-2) analog that is used for the treatment of

short bowel syndrome Short bowel syndrome (SBS, or simply short gut) is a rare malabsorption disorder caused by a lack of functional small intestine. The primary symptom is diarrhea, which can result in dehydration, malnutrition, and weight loss. Other symptoms may in ...

. It works by promoting mucosal growth and possibly restoring gastric emptying and secretion. In Europe it has been granted orphan drug status and is marketed under the brand Revestive by

Nycomed Nycomed is a Swiss pharmaceutical company. Nycomed was acquired by Takeda Pharmaceuticals in September 2011. Production was located in Norway, Denmark, Poland, Austria, Belgium, Germany, Estonia, India, Mexico, Brazil and Argentina. Head office i ...

. It was approved by the United States under the name Gattex on 21 December 2012, where it was given status as an orphan drug.

Medical uses

Up to a certain point, the gut can adapt to partial resections that result in short bowel syndrome. Still,

parenteral A route of administration in pharmacology and toxicology is the way by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. ...

substitution of water, minerals and vitamins (depending on which part of the gut has been removed) is often necessary. Teduglutide may reduce or shorten the necessity of such infusions by improving the

intestinal mucosa The gastrointestinal wall of the gastrointestinal tract is made up of four layers of specialised tissue. From the inner cavity of the gut (the lumen) outwards, these are: # Mucosa # Submucosa # Muscular layer # Serosa or adventitia The muco ...

and possibly by other mechanisms.

Adverse effects

Common adverse effects in clinical studies included abdominal discomfort (49% of patients),

respiratory infection Respiratory tract infections (RTIs) are infectious diseases involving the respiratory tract. An infection of this type usually is further classified as an upper respiratory tract infection (URI or URTI) or a lower respiratory tract infection (LRI ...

s (28%), nausea (27%) and vomiting (14%), local reactions at the injection site (21%), and headache (17%).

Chemistry and mechanism of action

Teduglutide differs from natural GLP-2 by a single

amino acid Amino acids are organic compounds that contain both amino and carboxylic acid functional groups. Although hundreds of amino acids exist in nature, by far the most important are the alpha-amino acids, which comprise proteins. Only 22 alpha a ...

: an

alanine Alanine (symbol Ala or A), or α-alanine, is an α-amino acid that is used in the biosynthesis of proteins. It contains an amine group and a carboxylic acid group, both attached to the central carbon atom which also carries a methyl group side ...

is replaced with a

glycine Glycine (symbol Gly or G; ) is an amino acid that has a single hydrogen atom as its side chain. It is the simplest stable amino acid ( carbamic acid is unstable), with the chemical formula NH2‐ CH2‐ COOH. Glycine is one of the proteinog ...

. This blocks breaking down of the molecule by dipeptidyl peptidase and increases its half-life from seven minutes (GLP-2) to about two hours, while retaining its biological actions. These include maintenance of the intestinal mucosa, increasing intestinal blood flow, reducing

gastrointestinal motility Gastrointestinal physiology is the branch of human physiology that addresses the physical function of the gastrointestinal (GI) tract. The function of the GI tract is to process ingested food by mechanical and chemical means, extract nutrients and ...

and secretion of gastric acid.

References

{{Other alimentary tract and metabolism products Drugs acting on the gastrointestinal system and metabolism Orphan drugs Peptides Takeda Pharmaceutical Company brands