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 gastroi ntestinal 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 additio n, 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 w ith 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 E GF significantly (P < 0.05) reduced esophageal stricture and scar form ations associated with sclerotherapy. Gastric pH values were significa ntly (P < 0.01) elevated only in animals receiving subcutaneous inject ions of EGF. Furthermore, the subcutaneous administration of EGF was a ssociated with unexpected prolonged plasma concentration of the peptid e. These results suggest a possible clinical value of EGF as an adjunc tive treatment with the sclerotherapy.