Systemic treatment with recombinant human epidermal growth factor accelerates healing of sclerotherapy-induced esophageal ulcers and prevents esophageal stricture formations in pigs.
Human epidermal growth factor (EGF), a small polypeptide (6 kDa) with mitogenic properties, has been implicated in the protection of gastrointestinal mucosal integrity. The efficacy of EGF in the prevention and healing of sclerotherapy-induced esophageal lesions was investigated in 24 minipigs with surgically induced portal hypertension. In addition, the effect of EGF on intragastric acidity and pharmacokinetics was investigated as possible means to explain its protective mechanism of action. The animals underwent three weekly sessions of sclerotherapy with polidocanol 2% and were concomitantly and for an additional three weeks treated with either placebo or EGF administered paravenously in the esophagus and/or subcutaneously. The subcutaneous treatment with EGF significantly (P < 0.05) reduced esophageal stricture and scar formations associated with sclerotherapy. Gastric pH values were significantly (P < 0.01) elevated only in animals receiving subcutaneous injections of EGF. Furthermore, the subcutaneous administration of EGF was associated with unexpected prolonged plasma concentration of the peptide. These results suggest a possible clinical value of EGF as an adjunctive treatment with the sclerotherapy.
Juhl
C O
CO
Institute of Experimental Clinical Research, University Hospital of Aarhus, Section Skejby, Denmark.
Vinter-Jensen
L
L
Jensen
L S
LS
Nexø
E
E
Djurhuus
J C
JC
Dajani
E Z
EZ
D000818:Animals; D004815:Epidermal Growth Factor / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004935:Esophageal Diseases / Q000209:etiology / Q000628:therapy*; D004940:Esophageal Stenosis / Q000517:prevention & control*; D005750:Gastric Juice / Q000737:chemistry; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D012597:Sclerosing Solutions / Q000009:adverse effects / Q000627:therapeutic use; D015911:Sclerotherapy / Q000009:adverse effects*; D013552:Swine; D013556:Swine, Miniature; D014456:Ulcer / Q000209:etiology / Q000628:therapy
D011994:Recombinant Proteins; D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols; D004815:Epidermal Growth Factor