글루카곤양펩티드-1의 췌장 외 효과
Extrapancreatic Effect of Glucagon like Peptide-1
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GLP-1은 장의 L-세포에서 분비되는 인크레틴 호르몬의 일종으로 췌장의 베타세포에서 인슐린 분비를 촉진하고 알파세포에서 글루카곤의 분비를 억제하는 것이 주작용이다. 하지만 GLP-1의 수용체가 췌장뿐 아니라 다른 여러 조직에서 발현되므로 GLP-1에 근거한 약물 치료는 다양한 작용을 하리라 생각된다. GLP-1의 췌장 외 효과를 요약해보면 위장 운동억제(위배출 지연), 내피세포 보호, 심박출 증가 및 허혈에 대한 심장세포 보호, 식욕억제, 체중감소, 뇌신경 보호, 신장 보호, 골밀도 증가 등에 다양한 작용이 있다. 앞으로도 GLP-1의 새로운 작용들이 더 밝혀지리라 기대된다. 또한 그 기전으로서 이런 다양한 효과가 GLP-1 수용체를통한 직접적인 효과인지 인슐린이나 글루카곤 조절을 통한간접적인 효과인지, 만일 직접적인 효과라면 GLP-1 수용체의존적인지 아니면 수용체와 무관하게 대사체나 다른 신호전달체계가 존재하는지 등에 대한 더 추가적인 연구가 필요하다.
Abstract
Glucagon like peptide-1 (GLP-1) is an intestinal L cell derived incretin hormone which stimulates insulin secretion of beta cell and inhibits glucagon secretion of alpha cell of pancreatic islets. GLP-1 receptors are located in pancreas as well as in a wide variety of tissue such as gastrointestinal tract, heart, blood vessel, lung, brain, kidney, and bone. Therefore GLP-1 and GLP-1 based treatment have multiple extrapancreatic effects which are inhibition of gastrointestinal motility, reduction of appetite, weight loss, increase of cardiac output, cardiovascular protection, neuroprotection, renoprotection, and increase of bone mineral density. Recently, besides GLP-1 receptor dependent pathway, GLP-1 receptor independent pathway has been identified in the extrapancreatic effect of GLP-1 in liver, adipose tissue, muscle, cardiovascular system. This review provides an overview of the pleiotropic effect of GLP-1 in the extrapancreatic organ through review of animal and clinical research.
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