epidermal-growth-factor and Esophageal-and-Gastric-Varices

To investigate the role of epidermal growth factor (EGF), a small (relative molecular mass 6000) polypeptide with mitogenic properties in the protection of gastrointestinal mucosal integrity.. A prospective, randomized and blinded study.. Twenty-four minipigs with surgically induced portal hypertension underwent four consecutive weekly sessions of oesophageal sclerotherapy with 5 ml 1% polidocanol and were concomitantly treated with either a placebo or human recombinant EGF administered subcutaneously. Mucosal damage was evaluated on a weekly basis by endoscopic estimation of the size of the ulcerated area and by post-mortem morphometry. The EGF-induced morphological changes in the oesophageal epithelium were also evaluated histologically.. In sclerosed and non-sclerosed parts of the oesophagus EGF significantly increased the thickness of the oesophageal epithelium (P < 0.03), but failed to reduce significantly the degree of oesophageal damage associated with sclerotherapy (P = 0.11).. Systemic EGF treatment induces proliferation of the oesophageal mucosa, and EGF may therefore have the potential to reduce sclerotherapy-induced oesophageal damage.

Topics: Animals; Epidermal Growth Factor; Esophageal and Gastric Varices; Esophageal Diseases; Esophagoscopy; Female; Humans; Injections, Subcutaneous; Male; Mucous Membrane; Prospective Studies; Recombinant Proteins; Sclerotherapy; Swine; Swine, Miniature; Ulcer

The effect of epidermal growth factor (EGF) on the biomechanical properties of the oesophagus subjected to sclerotherapy was studied in Goettingen minipigs by means of impedance planimetry.. Seventeen animals underwent three sessions of weekly endoscopic sclerotherapy. During these 3 weeks and for the subsequent 2 weeks they were treated with either EGF or placebo. After another 3 weeks an impedance planimetric study was done. Ten healthy non-sclerosed pigs were studied as controls. Impedance planimetry was performed by stepwise pressure-induced balloon inflation for analysis of oesophageal cross-sectional area 5 and 10 cm above the gastro-oesophageal junction (GEJ).. Systemic treatment with EGF (total daily dose of 30 micrograms/kg/day, administered subcutaneously) for 3 to 7 days per week combined with a weekly paravenous injection of 20-40 micrograms/kg attenuated the oesophageal damage caused by sclerotherapy, implying less pronounced narrowing 5 cm above and less dilation 10 cm above the GEJ.. These observations suggest a potential therapeutic role for EGF in attenuating sclerotherapy-induced oesophageal injury.

Topics: Animals; Biomechanical Phenomena; Catheterization; Collagen; Disease Models, Animal; Electric Impedance; Epidermal Growth Factor; Esophageal and Gastric Varices; Esophagoscopy; Esophagus; Female; Male; Pressure; Recombinant Proteins; Sclerotherapy; Swine; Swine, Miniature