Cited by 56Gallbladder and Bile Duct DisordersDiabetes Treatment and ManagementGastrointestinal motility and disorders

New Avenues in the Regulation of Gallbladder Motility—Implications for the Use of Glucagon-Like Peptide–Derived Drugs

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Gether, Ida M, Nexøe-Larsen, Christina, Knop, Filip K·2019·The Journal of Clinical Endocrinology & Metabolism

Abstract

CONTEXT: Several cases of cholelithiasis and cholecystitis have been reported in patients treated with glucagon-like peptide 1 (GLP-1) receptor agonists (GLP-1RAs) and GLP-2 receptor agonists (GLP-2RAs), respectively. Thus, the effects of GLP-1 and GLP-2 on gallbladder motility have been investigated. We have provided an overview of the mechanisms regulating gallbladder motility and highlight novel findings on the effects of bile acids and glucagon-like peptides on gallbladder motility. EVIDENCE ACQUISITION: The articles included in the present review were identified using electronic literature searches. The search results were narrowed to data reporting the effects of bile acids and GLPs on gallbladder motility. EVIDENCE SYNTHESIS: Bile acids negate the effect of postprandial cholecystokinin-mediated gallbladder contraction. Two bile acid receptors seem to be involved in this feedback mechanism, the transmembrane Takeda G protein-coupled receptor 5 (TGR5) and the nuclear farnesoid X receptor. Furthermore, activation of TGR5 in enteroendocrine L cells leads to release of GLP-1 and, possibly, GLP-2. Recent findings have pointed to the existence of a bile acid-TGR5-L cell-GLP-2 axis that serves to terminate meal-induced gallbladder contraction and thereby initiate gallbladder refilling. GLP-2 might play a dominant role in this axis by directly relaxing the gallbladder. Moreover, recent findings have suggested GLP-1RA treatment prolongs the refilling phase of the gallbladder. CONCLUSIONS: GLP-2 receptor activation in rodents acutely increases the volume of the gallbladder, which might explain the risk of gallbladder diseases associated with GLP-2RA treatment observed in humans. GLP-1RA-induced prolongation of human gallbladder refilling may explain the gallbladder events observed in GLP-1RA clinical trials.

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Crossref · 10.1210/jc.2018-01008

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  • GLP-1 hinders gallbladder motility and postpones gallbladder evacuation by inhibiting cholecystokinin secretion.

    “GLP-1 hinders gallbladder motility and postpones gallbladder evacuation by inhibiting cholecystokinin secretion [40-44].”

    From Exploring the Side Effects of GLP-1 Receptor Agonist: To Ensure Its Optimal Positioning (2025) · cites this paper as [41]

    The GLP-1 section reports reduced gallbladder emptying when a GLP-1 receptor agonist was given with intravenous CCK, and suggests that high-dose liraglutide may delay full contraction. It does not establish that GLP-1 inhibits CCK secretion; it proposes a delayed and prolonged CCK response, while noting that the mechanism remains unclear. Page numbers were not provided in our copy. (LLM, conf=0.88)

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Research works printed but not linked: 4

  1. [23]23. Ivy AC, Oldberg E. A hormone mechanism for gallbladder con- traction and evacuation. Am J Physiol. 1928;86:559-613.
  2. [31]31. Mawe GM, Talmage EK, Cornbrooks EB, Gokin AP, Zhang L, Jennings LJ. Innervation of the gallbladder: structure, neuro- chemical coding, and physiological properties of guinea pig gall- bladder ganglia. Microsc Res Tech. 1997;39(1):1-13.
  3. [42]42. Myant NB, Mitropoulos KA. Cholesterol 7 alpha-hydroxylase. J Lipid Res. 1977;18(2):135-153.
  4. [84]84. Hodge RJ, Nunez DJ. Therapeutic potential of Takeda-G-protein- receptor-5 (TGR5). Diabetes Obes Metab. 2016;5:439-443.

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Authors
Gether, I. M., Nexøe-Larsen, C., & Knop, F. K.
Affiliations
  • Gentofte Hospital (DK)
  • University of Copenhagen (DK)
Corresponding author
Knop, Filip K
Venue
The Journal of Clinical Endocrinology & Metabolism
Published
2018-08-20
Volume
104
Issue
7
Pages
2463-2472
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
OpenAlex
W2888209486
Cited by
56
References
95
Citations by year
2026: 11 · 2025: 11 · 2024: 13 · 2023: 2 · 2022: 9 · 2021: 4 · 2020: 5 · 2019: 1
FWCI
0.44
Type
journal article
Language
en
Open access
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Funders
  • Amgen
  • Eli Lilly and Company
  • AstraZeneca
  • Sanofi
  • Steno Diabetes Center Copenhagen (SDCC 3.F CMP)
  • Gentofte Hospital
  • Novo Nordisk
  • Novo Nordisk Fonden (NNF11OC1014545)
  • Norgine
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Gallbladder and Bile Duct Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords
gallbladder motility, GLP-1 receptor agonists, bile acids, TGR5, farnesoid X receptor, cholecystokinin, gallbladder contraction, enteroendocrine L cells, gallstones, cholecystitis
MeSH terms
Glucagon-Like Peptide-1 Receptor, Glucagon-Like Peptide-2 Receptor, Glucagon-Like Peptide-1 Receptor Agonists, Bile Acids and Salts, Cholecystitis, Cholecystokinin, Cholelithiasis, Diabetes Mellitus, Type 2, Glucagon-Like Peptides, Gallbladder, Humans, Muscle Contraction, Muscle, Smooth, Obesity, Gallbladder Emptying, Postprandial Period, Glucagon-Like Peptide 1, Glucagon-Like Peptide 2

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