# The role of enteroendocrine cell differentiation in the success of bariatric surgery

> **NIH NIH K01** · UNIVERSITY OF COLORADO DENVER · 2022 · $134,041

## Abstract

Project Abstract:
One of the most prominent reasons to study the mechanisms underlying the success of bariatric surgery is to
replicate surgery outcomes with non-invasive treatment(s). Vertical sleeve gastrectomy (VSG), one of the most
frequently performed bariatric surgeries in the world, results in substantial weight loss and dramatic remission
of T2DM within 1 year. The drastic postprandial increase in the levels of gut-secreted peptides, such as
glucagon-like peptide-1 (GLP-1), gastric inhibitory polypeptide (GIP), peptide YY (PYY), and cholecystokinin
(CCK), after VSG has been hypothesized to be a critical mechanism of surgical success because of their roles
in satiety and glucose homeostasis. The gut-peptides are made in the intestinal epithelium, and we (and others)
see that VSG increases the number of GLP-1-secreting enteroendocrine cells (EEC). A key question we wish
to address is what drives the EEC differentiation after VSG, whether this EEC differentiation limited to the GLP-
1-secreting cells or the other EECs, and whether this increase contributes to weight loss and improvements in
glucose homeostasis seen with VSG. Our preliminary data demonstrate that VSG alters explicitly intestinal
stem cell (ISC) expression of several genes that regulate intestinal secretory cell development including EEC
differentiation. Using a novel intestinal organoid model (enteroids), we next demonstrated that specific
subspecies of bile acids increase the GLP-1-secreting EECs. Hence, we hypothesize that the increased in bile
acid secretion after VSG impacts the ISC fate towards EECs and this is critical to bariatric surgery outcomes.
Here, we propose a combination of complementary in vitro and in vivo studies using human and mouse
enteroids and mouse genetic manipulation with VSG surgery to test the following specific aims: 1) test
hypothesis that bile acids drive EEC differentiation; 2) test hypothesis that modulation of ISC fate affects body
weight and glucose homeostasis; 3) test hypothesis that increased EEC differentiation is necessary for VSG
outcomes. This research plan is expected to make a significant contribution to the understanding of ISC
homeostasis and to determine the origin of the surgery-induced increase in gut-peptides levels with the
ultimate goal of developing an alternative strategy to bariatric surgery. During the grant period, Dr. Sandoval,
who is an expert in endocrinology and bariatric surgery, will provide an exceptional research environment and
resources at the University of Colorado Anschutz Medical Campus and also provide guidance in research
strategy, grant writing, lab management, and networking and communication. Drs. Inge, Dempsey (CU),
Samuelson, Spence (UM) and Sethupathy (Cornell University), who are experts in bariatric surgery,
developmental and/or stem cell biology, will provide additional guidance and training activities as detailed in
the Career development activity. Successfully achieved aims will lead me to a NI...

## Key facts

- **NIH application ID:** 10475802
- **Project number:** 5K01DK129367-02
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Ki Suk Kim
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $134,041
- **Award type:** 5
- **Project period:** 2021-09-01 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10475802

## Citation

> US National Institutes of Health, RePORTER application 10475802, The role of enteroendocrine cell differentiation in the success of bariatric surgery (5K01DK129367-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10475802. Licensed CC0.

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