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Divisions of 1 Hematology/Oncology and 2 Pediatric Surgery, Children's Hospital Medical Center, Cincinnati, Ohio 45229
Several growth factors
are trophic for the gastrointestinal tract and able to reduce the
degree of intestinal damage caused by cytotoxic agents. However,
studies of epidermal growth factor (EGF) for chemotherapy-induced
intestinal injury are conflicting. The development of a transgenic
mouse that specifically overexpresses EGF in the small intestine
provided a unique opportunity to assess the contribution of EGF in
mucositis. After a course of fluorouracil, transgenic mice fared no
better than control mice. Weight recovery was inferior, and mucosal
architecture was not preserved. Apoptosis was not decreased and
proliferation was not increased in the crypts. To corroborate the
findings in transgenic mice, ICR mice were treated with exogenous EGF
after receiving fluorouracil. Despite ileal upregulation of native and
activated EGF receptor, the mice were not protected from intestinal
damage. No benefits were observed with different EGF doses or schedules
or routes of EGF administration. Finally, mucositis was induced in
mutant mice with specific defects of the EGF signaling axis. Compared
with control mice, clinical and histological parameters of intestinal
injury after fluorouracil were no different in waved-2 mice, which have
functionally diminished EGF receptors, or waved-1 mice, which lack
transforming growth factor-
, another major ligand for the EGF
receptor. These findings do not support a critical role for EGF or its
receptor in chemotherapy-induced intestinal injury.
intestinal mucosa; fluorouracil; enteritis; transgenic mouse; transforming growth factor-
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