Keratinocyte growth factor (KGF) is a paracrine growth factor whose mRNA has been detected in human adult and rodent gut tissues together with its associated receptor. Our objectives were to assess the presence of immunoreactive KGF ligand and receptor proteins in human fetal gastrointestinal (GI) tract segments and to evaluate the role of exogenous KGF on cell proliferation and intestinal digestive functions. KGF (26 -28 kD doublet) was identified in esophagus, stomach, small intestine, and colon by Western blot. Its receptor (135 kD) was ubiquitously detected in proliferative and differentiated epithelial cells of each GI segment by use of indirect immunofluorescence (anti-bek, anti-K-sam). The addition of KGF to explants cultured in serum-free conditions greatly stimulated DNA synthesis in all GI tract tissues. The growth factor up-regulated intestinal sucrase-isomaltase and ␥-glutamyl-transpeptidase activities in jejunal explants, whereas it down-regulated these activities in colon explants. It is suggested that the KGF system likely represents an important paracrine pathway that is able to stimulate cell proliferation in all segments of the human fetal GI tract and to differentially regulate intestinal digestive functions. KGF or FGF-7 is a member of the heparin-binding growth factor family [reviewed by Baird and Klagsbrun (1)]. This growth factor is able to stimulate the proliferation of epithelial cells and to positively influence their polarization/differentiation status in culture (2-4). Its associated receptor (KGF-R) is virtually identical to the K-sam protein found in KATO-III cells and gastric carcinomas (5, 6), which is the product of an alternative transcript of the FGFR-2/bek gene. Splicing of the mRNA alters a small region of the extracellular domain of the receptor and confers increased capacity for KGF binding (7). One study (8) clearly demonstrated that the bek gene is expressed in great amounts in diverse epithelia (skin, intestine, stomach, kidney) of the mouse embryo and that the alternative transcript encoding the KGF-R represents the major form found in these tissues. Some other important features characterize this growth factor: 1) KGF is exclusively synthesized by mesenchymal cells and exerts its action on epithelial cells (9, 10) via KGF-R, and 2) as opposed to other growth factor receptors [epidermal growth factor/transforming growth factor (EGF/TGF␣), hepatocyte growth factor (HGF), insulin-like growth factor (IGF) associated with basolateral membranes of epithelial cells, KGF-R is also present in the cytoplasm (6).During the last years, attention has been focused on the possible implication of this paracrine growth factor in the regulation of GI physiology. Indeed, the observations that KGF and KGF-R mRNA are present in all segments of the adult rat GI tract and hepatocytes (11) as well as in fetal rat stomach (12) supported the concept that the KGF system could be involved in normal development and maintenance of digestive organs. When administered parenterally to adult animals, K...