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. 2019 Mar 27;6:54. doi: 10.3389/fmed.2019.00054

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Copyright © 2019 Bar-Or, Rael, Madayag, Banton, Tanner, Acuna, Lieser, Marshall, Mains and Brody.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Importance of DPP4 in hyperglycemia. Dipeptidyl peptidase IV (DPP4), or CD26, is a cell surface and soluble peptidase that can cleave the first two N-terminal amino acids from specific proteins and peptides. DPP4 is up-regulated in immune and endothelial cells as a result of inflammation seen in critically ill patients. Of specific importance to hyperglycemia, DPP4 cleaves the N-terminus of glucagon-like peptide 1 (GLP-1). GLP-1 is important in the storage and regulation of blood glucose by promoting insulin and limiting glucagon release. This cleavage of GLP-1 causes the inactivation of GLP-1 contributing to hyperglycemia. Inhibitors of DPP4 could be important in glucose control in critically ill patients with hyperglycemia.