New Avenues in the Regulation of Gallbladder Motility—Implications for the Use of Glucagon-Like Peptide–Derived Drugs
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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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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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- 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
- Publisher
- The Endocrine Society
- 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
- bronze
- doi.org
- 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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