Division of Gastroenterology, Boston Children's Hospital, Boston, United States; Department of Pediatrics, Harvard Medical School, Boston, United States; Harvard Digestive Diseases Center, Boston, United States
Yvonne M te Welscher
Division of Gastroenterology, Boston Children's Hospital, Boston, United States
Rodrigo J Gonzalez
Department of Microbiology and Immunobiology, Harvard Medical School, Boston, United States; Center for Immune Imaging, Harvard Medical School, Boston, United States
Samir Softic
Joslin Diabetes Center and Harvard Medical School, Boston, United States
Michele Pacheco
Division of Gastroenterology, Boston Children's Hospital, Boston, United States
Randall J Mrsny
Department of Pharmacy and Pharmacology, Univeristy of Bath, Bath, United Kingdom
C Ronald Kahn
Joslin Diabetes Center and Harvard Medical School, Boston, United States
Ulrich H von Andrian
Department of Microbiology and Immunobiology, Harvard Medical School, Boston, United States; Center for Immune Imaging, Harvard Medical School, Boston, United States
Jesper Lau
Novo Nordisk, Måløv, Denmark
Bradley L Pentelute
Department of Chemistry, Massachusetts Institute of Technology, Cambridge, United States
Division of Gastroenterology, Boston Children's Hospital, Boston, United States; Harvard Digestive Diseases Center, Boston, United States; Department of Pediatrics, Harvard Medical School, Boston, United States
Transport of biologically active molecules across tight epithelial barriers is a major challenge preventing therapeutic peptides from oral drug delivery. Here, we identify a set of synthetic glycosphingolipids that harness the endogenous process of intracellular lipid-sorting to enable mucosal absorption of the incretin hormone GLP-1. Peptide cargoes covalently fused to glycosphingolipids with ceramide domains containing C6:0 or smaller fatty acids were transported with 20-100-fold greater efficiency across epithelial barriers in vitro and in vivo. This was explained by structure-function of the ceramide domain in intracellular sorting and by the affinity of the glycosphingolipid species for insertion into and retention in cell membranes. In mice, GLP-1 fused to short-chain glycosphingolipids was rapidly and systemically absorbed after gastric gavage to affect glucose tolerance with serum bioavailability comparable to intraperitoneal injection of GLP-1 alone. This is unprecedented for mucosal absorption of therapeutic peptides, and defines a technology with many other clinical applications.