Effect of DPP4 inhibitor on EPC and SDF-1a in type 2 diabetes (IGLOOS)

• Research type

  Research Study

• Full title

  The impact of glucose lowering therapies including Dipeptidyl peptidase-4 inhibitor on circulating endothelial progenitor cells (EPCs) and its mobilising factor Stromal Derived Factor-1á (SDF-1á) in patients with type 2 diabetes (IGLOOS)

• IRAS ID

  158634

• Contact name

  Melanie Davies

• Sponsor organisation

  University of Leicester

• Duration of Study in the UK

  2 years, 0 months, 0 days

• Research summary

  This is a cross-sectional observational study aiming to examine and compare the effect of incretin based therapies i.e. DPP-4 inhibitors and GLP-1 analogues, on endothelial progenitor cells (EPCs) and its mobilising factor, stromal derived factor-1 á (SDF-1 á), in patients with type 2 diabetes mellitus (T2DM) who are well established on those treatments. EPCs provide vascular protection by means of endothelial new formation and repair. This endothelial protective effect may potentially benefit patients affected by complications arising from vascular injury e.g. cardiovascular disease in people with T2DM.

  Incretins are gut hormones, secreted from the small intestine in response to oral glucose ingestion and are potent stimulators of insulin secretion. These include glucose dependent insulinotropic polypeptide (GIP) and glucagon like peptide-1 (GLP-1). Physiologically, the action of GLP-1 is short-lived due to rapid inactivation by DPP-4 (Dipeptidyl peptidase 4)enzyme. In T2DM, the incretin effect (i.e. the higher insulin response to orally administered glucose than intravenously administered glucose) is deemed to be impaired.

  Recently, novel therapeutic agents based on enhancing the incretin effect have been developed and made available in the management of T2DM. In addition to their comparable glucose lowering effects to existing therapies, these new agents offer the advantage of having a low risk of hypoglycaemia and either weight loss (GLP-1 analogue) or weight neutral effects (DPP-4 inhibitor).

  The study is of particular interest as a small scale study in human has shown an increase in level of circulating EPC in patients treated with DPP-4 inhibitor, possibly mediated by increasing the level of its mobilising factor SDF-1 á.

• REC name

  East Midlands - Leicester Central Research Ethics Committee

• REC reference

  14/EM/1218

• Date of REC Opinion

  11 Nov 2014

• REC opinion

  Favourable Opinion