Published online Jul 7, 2020. doi: 10.3748/wjg.v26.i25.3562
Peer-review started: March 15, 2020
First decision: March 21, 2020
Revised: May 29, 2020
Accepted: June 18, 2020
Article in press: June 18, 2020
Published online: July 7, 2020
The gastrointestinal tract is the key interface between the ingesta and the human body. There is wide recognition that the gastrointestinal response to nutrients or bioactive compounds, particularly the secretion of numerous hormones, is critical to the regulation of appetite, body weight and blood glucose. This concept has led to an increasing focus on “gut-based” strategies for the management of metabolic disorders, including type 2 diabetes and obesity. Understanding the underlying mechanisms and downstream effects of nutrient-gut interactions is fundamental to effective translation of this knowledge to clinical practice. To this end, an array of research tools and platforms have been developed to better understand the mechanisms of gut hormone secretion from enteroendocrine cells. This review discusses the evolution of in vitro and in vivo models and the integration of innovative techniques that will ultimately enable the development of novel therapies for metabolic diseases.
Core tip: The development of platforms for investigating nutrient-gut interactions is critical to understanding how nutrients trigger the release of gut hormones and has the potential to yield novel targets for improved management of metabolic disorders. In addition to the use of endoscopic or surgical gut tissues or primary enteroendocrine cells, in vitro models now include enteroendocrine cell lines originating from rodent (STC-1 and GLUTag) or human (NCI-H716 and HuTo-80) intestinal tumours, and intestinal organoids differentiated from intestinal stem cells. The physiological relevance of these models has been challenged, but may be improved substantially by incorporating advanced biomedical techniques (e.g., microfluidic devices) into the culture system. These approaches have complemented clinical studies utilising intestinal intubation, often with integrated manometry and impedance recording, which have revealed gut region-specific responses to intraluminal contents. Newer clinical developments include the use of novel ingestible sensors.