Systemic treatment with recombinant human epidermal growth factor accelerates healing of sclerotherapy-induced esophageal ulcers and prevents esophageal stricture formations in pigs

Abstract

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.

Reduction of peritoneal adhesions by sustained and local administration of epidermal growth factor

“…Subcutaneously administrated EGF was detectable in serum up to 12 h after the administration [28]. Efficiency of sustained release of EGF has also been shown in the other previous studies [14,23].…”

The effect of epidermal growth factor on circulating levels of IGF and IGF-binding proteins in adult Goettingen minipigs

“…Systemic administration with EGF represents therefore a pharmacological condition. When human recombinant EGF is administered intravenously to pigs, it is rapidly cleared from plasma (Vinter-Jensen et al 1995a), but when administered subcutaneously in the doses employed in this study, it is detectable for up to 12 h after a single injection (Juhl et al 1994). It is therefore expected that high diurnal circulating levels of EGF are achieved and thereby exert nearly constant effects on the IGF system.…”

Systematic review: the prevention of oesophageal stricture after endoscopic resection

“…Of the 461 hits, 131 publications were duplicates, 63 studies were excluded because of an irrelevant study topic, 191 were excluded because the data presented were not compatible with the scope of the review (mainly studies either dealing with the curative treatment of post‐endoscopic oesophageal strictures, or only mentioning oesophageal stricture as a complication after endoscopic resection), and 16 were an irrelevant publication type. One additional study was identified by searching through the reference lists of the articles, and two publications from the authors’ library were added to the studies included …”