INCREASED GASTRIC-JUICE EPIDERMAL GROWTH-FACTOR AFTER NONSTEROIDAL ANTIINFLAMMATORY DRUG INGESTION

Epidermal growth factor (EGF), present in saliva and gastric juice, is a potent mitogen and an important element of mucosal defence. Changes in salivary and gastric juice epidermal growth factor in response to non-steroidal antiinflammatory drug (NSAIDs) ingestion were measured t o assess the role of EGF in gastric mucosal adaptation to NSAIDs. Pati ents with arthritis underwent endoscopy with collection of saliva and gastric juice for EGF measurement, before and two weeks after continuo us NSAID ingestion. During this period patients also received either t he prostaglandin analogue misoprostol or placebo in addition to their NSAID. In the misoprostol group (n=5) there was no observed mucosal da mage and no change in either salivary or gastric juice EGF. In the pla cebo group (n=10) three patients developed erosions. Salivary EGF did not change (mean (SEM) 3.02 (0.54) ng/ml upsilon 2.80 (0.41) ng/ml) bu t gastric juice EGF increased from 0.42 (0.12) ng/ml to 0.69 (0.14) ng /ml (p<0.05). This increased EGF could contribute to the increased cel lular proliferation observed during NSAID ingestion and may represent an important mechanism underlying gastric mucosal adaptation.