Evidence map›Paper›PMID 40701790›Full record

ArticleGut2026

Insulin-like peptide 5 is released in response to bile acid in the rectum and is associated with diarrhoea severity in patients with bile acid diarrhoea.

Christopher A Bannon, Julian R F Walters, Tongzhi Wu, Richard G Kay, Austin Punnoose, Robin C Spiller, Jonathan Wilson, Petra Verdino, Peter Barker, Keith Burling and 5 more

Abstract read
In one paragraph

Article in Gut, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Christopher A BannonInstitute of Metabolic Science, Cambridge, UK.ORCID http://orcid.org/0000-0002-9108-2085
Julian R F WaltersDivision of Digestive Diseases, Imperial College London, London, UK.ORCID http://orcid.org/0000-0001-9720-5835
Tongzhi WuAdelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia.
Richard G KayInstitute of Metabolic Science, Cambridge, UK.
Austin PunnooseInstitute of Metabolic Science, Cambridge, UK.
Robin C SpillerNottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK.ORCID http://orcid.org/0000-0001-6371-4500
Jonathan WilsonEli Lilly and Company, Indianapolis, Indiana, USA.
Petra VerdinoEli Lilly and Company, Lilly Biotechnology Center, San Diego, California, USA.
Peter BarkerInstitute of Metabolic Science, Cambridge, UK.
Keith BurlingInstitute of Metabolic Science, Cambridge, UK.
Michael HorowitzAdelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia.
Christopher K RaynerAdelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia.
Alexander C FordLeeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.
Frank ReimannInstitute of Metabolic Science, Cambridge, UK fmg23@cam.ac.uk fr222@cam.ac.uk.
Fiona M GribbleInstitute of Metabolic Science, Cambridge, UK fmg23@cam.ac.uk fr222@cam.ac.uk.

Funding

Medical Research Council MC_UU_12012/3Medical Research Council MC_UU_12012/5Wellcome Trust 220271
6 · The paper itself

Abstract

backgroundInsulin-like peptide 5 (INSL5) is an enteroendocrine hormone expressed in distal colonic 'L cells'. Bile acid receptor agonists are known to stimulate INSL5 secretion in primary cell culture, and administration of an INSL5 analogue in animals promotes colonic motility.

objectiveThis study used a new immunoassay to measure INSL5 in human blood samples, enabling assessment of whether rectal bile acids stimulate INSL5 release in humans and whether INSL5 levels are altered in patients with chronic diarrhoea.

designSerum/plasma samples from previously performed studies were used, including healthy volunteers (n=7) who received a rectal enema of taurocholic acid (TCA); fasting and post prandial samples from healthy volunteers (n=10); patients with bile acid diarrhoea (BAD) (n=19) or irritable bowel syndrome with diarrhoea (IBS-D) (n=8); and patients with IBS-D (n=64) treated with ondansetron or placebo.

resultsRectal TCA but not a control enema promptly elevated plasma INSL5, with the increase in INSL5 correlating negatively with time to, and positively with desire to, defecate post enema. Healthy volunteers had low INSL5 levels (<100 pg/mL), with no change following a mixed meal. Patients with BAD had elevated INSL5 levels, with average stool consistency being positively correlated with serum INSL5 (p<0.001). In people with IBS-D, INSL5 was elevated (>100 pg/mL) in 42%, and this subgroup showed greater improvements in stool consistency with ondansetron therapy (p<0.05).

conclusionThe study highlights that rectal bile acids stimulate INSL5 secretion in humans, and that INSL5 levels are associated with a colonic pro-motility response and pathophysiology of chronic diarrhoea.

Indexed as

Bile Acids and SaltsDiarrheaInsulinProteinsRectumAdultFemaleHumansIrritable Bowel SyndromeMaleMiddle AgedSeverity of Illness IndexTaurocholic AcidBile Acids and SaltsInsulinLeydig insulin-like proteinProteinsTaurocholic AcidBILE ACIDCOLORECTAL MOTILITYDIARRHOEAGUT HORMONESIRRITABLE BOWEL SYNDROME

Identifiers

PMID40701790
PMCPMC7618615

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.