Epidermal Growth Factor and Postnatal Development of Intestinal Transport and Membrane Structure

Opleta-Madsen, K; Meddings, Jonathan B.; Gall, David

doi:10.1203/00006450-199110000-00010

Cited by 38 publications

(13 citation statements)

References 28 publications

(38 reference statements)

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“…EGF is acid stable and trypsin resistant, allowing it to survive passage through the gastrointestinal tract and to act directly on the intestinal cells (29). The predominant effects of EGF on the gastrointestinal tract have been reported and include suppression of gastric acid secretion, gastric cytoprotection; stimulation of intestinal DNA synthesis, and cell division; regulation of intestinal brush-border disaccharidase activities; increased water, glucose, and sodium absorption; increased cellular calcium concentration; activation of ion transport; and modulation of prostaglandin synthesis and secretion (30,31). Our study suggests that EGF plays an important role in BMJ.…”

Section: Discussionmentioning

confidence: 99%

Breast Milk Jaundice Correlates With High Levels of Epidermal Growth Factor

et al. 2009

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ABSTRACT:Maternal milk plays an important role in breast milk jaundice (BMJ) development and is the major source of epidermal growth factor (EGF) for neonates. The aim of this study was to investigate whether there is a relationship between EGF levels in the infant serum and in the milk of nursing mothers and BMJ. Two groups were defined: study group (n ϭ 30), newborns who were followed up for BMJ without any identifiable pathologic cause; control group, healthy newborns whose serum total bilirubin levels were Ͻ10 mg/dL. Milk and infant plasma samples were collected between the third and the fourth postpartum week. EGF concentrations in all of the samples were determined by using ELISA. The infants with BMJ had higher concentrations of EGF in the serum and in the breast milk compared with that of the infants without BMJ. The milk concentrations of EGF were significantly correlated with neonatal bilirubin and blood EGF concentrations. The degree of BMJ was associated with the increased levels of milk borne EGF. Although the exact mechanisms of the hyperbilirubinemic action of EGF are not completely known, the inhibition of gastric motility, increased absorption, and activation of bilirubin transport have been suggested as possible mechanisms. (Pediatr Res 66: 218-221, 2009) L ate onset breast milk jaundice (BMJ), also called BMJ syndrome, after the fifth day, a majority of breastfed infants either maintain a stable, but elevated serum bilirubin level, or have a second rise in bilirubin, which generally peaks on approximately 10th to 15th days of life. In some infants, these elevated levels may continue for many weeks, whereas in others, the levels decline during the third and fourth weeks. During the third week of life, among the two thirds or more with elevated levels, 2 to 4% of infants have a bilirubin level Ͼ10 mg/dL (170 mM) at 3 wks of age. Rarely do the levels in healthy term infants rise beyond 25 mg/dL (425 mM) or place the infant at risk for bilirubin encephalopathy. Ultimately, serum bilirubin levels return to normal in all infants with BMJ. Persistence of hyperbilirubinemia beyond 3 mo would suggest an etiology other than breast milk. The jaundice of breastfed infants is commonly of undetermined etiology (1-11). As reviewed elsewhere (12), many pathophysiologic theories have arisen to explain this prolonged nonconjugated hyperbilirubinemia associated with human milk feedings in otherwise healthy infants. The most attractive and convincing evidence regarding the mechanism of BMJ has come from studies of the effect of human milk on the intestinal absorption of bilirubin with resultant increase in enterohepatic circulation of bilirubin. Milk from mothers of infants with classical BMJ inhibited intestinal absorption of bilirubin only for the first 2 h and was then followed by a dramatic increase in absorption, which continued for at least an additional 14 h and resulted in a total absorption of 60% of the intestinal bilirubin dose. A subsequent study by other investigators confirmed the role of human milk...

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Section: Discussionmentioning

confidence: 99%

Breast Milk Jaundice Correlates With High Levels of Epidermal Growth Factor

et al. 2009

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“…In an animal model of NEC, we have recently shown that milk-borne EGF reduces the incidence and severity of NEC-like injury in neonatal rats (41). In suckling animals, supplementation of EGF into formula enhances the growth of stomach and the small intestine (42), induces precocious maturation of intestinal brush-border disaccharidase activities (43), and modulates intestinal nutrient transport (44). Based on these clinical and experimental studies, we speculate that elevated levels of EGF in human milk of extremely prematurely born babies can be potentially responsible for the protective effect of maternal milk against neonatal diseases.…”

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confidence: 99%

Increased Epidermal Growth Factor Levels in Human Milk of Mothers with Extremely Premature Infants

et al. 2003

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Maternal milk is the major source of nutrients and growthpromoting substances in the first weeks of life for the majority of neonates. Epidermal growth factor (EGF) and transforming growth factor-␣ (TGF-␣) are trophic peptides present in human milk with significant healing effects on injured gastrointestinal mucosa. Decreasing gestational age of neonates is associated with higher risk of developing gastrointestinal disorders, and human milk provides better protection against these diseases compared with formula. The aim of this study was to evaluate the concentrations of EGF and TGF-␣ in human milk collected from mothers with infants born: extremely preterm, preterm, and full term. Milk samples were collected at the end of first, second, and fourth week postpartum from each mother of infants born in one of the three gestational age groups: extremely preterm (23-27 wk, n ϭ 16), preterm (32-36 wk, n ϭ 16), and full term (38 -42 wk, n ϭ 15). Milk concentrations of EGF and TGF-␣ were quantified with a homologous RIA in the milk aqueous fraction. Concentrations of EGF in human milk from the extremely preterm group (23-27 wk) were significantly higher compared with values from the preterm and full-term groups throughout the first month of lactation. A similar pattern was observed with human milk TGF-␣; however, milk TGF-␣ levels were lower than EGF.In conclusion, we have found higher concentrations of EGF and TGF-␣ in human milk of mothers with extremely preterm babies. These data may indicate the potential importance of milk-borne EGF and TGF-␣ for the development of extremely premature infants. (Pediatr Res 54: 15-19, 2003) Abbreviations EGF, epidermal growth factor EGF-R, epidermal growth factor receptor EPT, extremely preterm FT, full term PT, preterm NEC, necrotizing enterocolitis TGF-␣, transforming growth factor-␣ Human milk is a unique and well-balanced source of nutrition for the newborn. Milk contains not only major nutrients (proteins, carbohydrates, and lipids) but also a variety of components such as minerals, vitamins, enzymes, hormones, growth factors, and immunoglobulins important for growth and healthy development during the neonatal period (1-3). As advances in neonatal care have significantly increased, the survival of extremely prematurely born neonates have increased (4). Yet these infants have the highest incidence of morbid events, such as NEC (5). Questions have arisen about the most suitable and relevant nutritional support for these immature infants (6, 7).Within the last three decades, a large number of biologically active peptides have been identified in human milk (8 -10), and the list is continuously growing (11-13). Among these, EGF is one of the major peptide growth factors present both in colostrum and human milk (14 -17). Human milk EGF levels are highest in the first days after parturition and then gradually decrease during the first 2 wk of lactation (17). Another structural homolog of EGF, TGF-␣ is also present in human colostrum and milk (15, 18), but at much lower concentrations ...

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“…Epidermal growth factor is a potent mitogen and plays an integral part in mammalian growth and maturation [27]. Numerous studies have demonstrated a role for EGF in the regulation of SI absorptive function [13,[29][30][31]. Because EGF is heatstable and resistant to enzymatic digestion [28], it can be administered orogastrically and delivered to the brush border of the SI.…”

Section: Discussionmentioning

confidence: 99%