IDENTIFICATION OF EPIDERMAL GROWTH-FACTOR, TRANSFORMING GROWTH-FACTOR-ALPHA, AND EPIDERMAL GROWTH-FACTOR RECEPTOR IN SURGICALLY INDUCED PELVIC ADHESIONS IN THE RAT AND INTRAPERITONEAL ADHESIONS IN THE HUMAN

OBJECTIVE: Our purpose was to determine the presence and cellular dist ribution of epidermal growth factor, transforming growth factor-alpha, and epidermal growth factor receptor in surgically induced pelvic fib rous adhesions in rat uterine horns subjected to burn, crush, and debr idement injury and intraperitoneal fibrous adhesions formed to various organs in the human. STUDY DESIGN: A total of 15 injured and five uni njured rats were used in this study, and fibrous adhesions and intact peritoneum were removed for processing 2 weeks after surgery. Fibrous adhesions formed to uterine, ovarian, and oviductal tissues and the pe ritoneal wall from eight patients who had gynecologic surgery were als o collected. The tissues were processed for immunohistochemical locali zation of epidermal growth factor, transforming growth factor-alpha, a nd epidermal growth factor receptor with specific antibodies to human and rat epidermal growth factor and transforming growth factor-alpha a nd the extracellular binding domain of the epidermal growth factor rec eptor. RESULTS: All the cell types in the rat fibrous adhesion immunos tained for epidermal growth factor, transforming growth factor-alpha, and epidermal growth factor receptor. The highest immunostaining inten sity for epidermal growth factor was associated with inflammatory cell s infiltrated into the fibrous adhesion, followed by arteriole endothe lial and smooth muscle cells, fascial striated muscle, and fibroblasts of the fibrous adhesion. In the uterine tissue at the site of injurie s myometrial smooth muscle cells, in addition to inflammatory cells th at migrated among stromal cells, also immunostained for epidermal grow th factor. Fibrous adhesions also immunostained for transforming growt h factor-alpha with three separate polyclonal antibodies to the amino and carboxy termini of transforming growth factor-alpha precursor and the mature transforming growth factor-alpha, with no substantial diffe rences in their intensity and pattern compared with epidermal growth f actor. The pattern and cellular distribution of epidermal growth facto r receptor was similar to that seen for epidermal growth factor and tr ansforming growth factor-alpha. Fibrous adhesions from patients with i ntraperitoneal adhesions immunostained for epidermal growth factor, tr ansforming growth factor-alpha, and epidermal growth factor receptor w ith a pattern and intensity similar to that observed in fibrous adhesi ons in the rats. CONCLUSIONS: The data suggest that epidermal growth f actor and transforming growth factor-alpha may play a key role both in normal mechanism of peritoneal repair after injury and formation and maintenance of fibrous adhesions.