O043 - APOB-48 SHOWS POTENTIAL AS A BIOMARKER TO EVALUATE TREATMENT RESPONSE WITH APRAGLUTIDE IN SHORT BOWEL SYNDROME, INTESTINAL FAILURE AND COLON-IN-CONTINUITY

O043

APOB-48 SHOWS POTENTIAL AS A BIOMARKER TO EVALUATE TREATMENT RESPONSE WITH APRAGLUTIDE IN SHORT BOWEL SYNDROME, INTESTINAL FAILURE AND COLON-IN-CONTINUITY

A. Verbiest^1,2,*, J. Tόth¹, P. Bekker Jeppesen³, F. Joly⁴, T. Vanuytsel^1,2

¹Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, ²Leuven Intestinal Failure and Transplantation Center (LIFT), University Hospitals Leuven, Leuven, Belgium, ³Department of Intestinal Failure and Liver Diseases, Rigshospitalet, Copenhagen, Denmark, ⁴Centre for Intestinal Failure, Department of Gastroenterology and Nutritional Support, Hôpital Beaujon, University of Paris, Clichy, INSERM UMR 1149, France

Rationale: Citrulline is frequently used as surrogate marker for enterocyte mass in short bowel syndrome (SBS), but also to assess response with analogs of glucagon-like peptide 2 (GLP-2) in intestinal failure (IF). However, in SBS with colon-in-continuity (CiC), citrulline might not be the best marker given the short lengths of preserved small intestine. Therefore, we aimed to identify more informative biomarkers for SBS-IF-CiC in relation to GLP-2 analog therapy.

Methods: STARS Nutrition was a 52-week multicenter, open-label, phase 2 study in adult patients with SBS-IF-CiC (n=9) receiving weekly subcutaneous injections with the novel, long-acting GLP-2 analog apraglutide. A fasting blood sample was collected at baseline and at 4, 24 and 48 weeks of treatment. Apolipoprotein B-48 (ApoB-48), intestinal fatty-acid binding protein (iFABP) and lipopolysaccharide-binding protein (LBP) concentrations were measured (ELISA). 

Results: At baseline, ApoB-48 levels correlated positively to the preserved small intestinal length (r=0.7983). With apraglutide, the ApoB-48 levels increased significantly at all timepoints (Figure 1). While iFABP concentrations remained stable at 4 weeks, a significant increase was observed at 24 weeks. At 48 weeks, iFABP levels continued to be elevated but failed to reach statistical significance. LBP concentrations were not significantly affected by apraglutide. 

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Conclusion: Apraglutide treatment resulted in distinct increases of ApoB-48, a protein synthesized by the enterocytes and involved in fat absorption. Our results suggest that ApoB-48 could be a suitable candidate as biomarker for treatment response as not only it reflects the number of enterocytes but also their ability to absorb and transport nutrients, especially lipids.

Disclosure of Interest: None declared