As part of a nutritional strategy to impart improvements to mucosal barrier in compromised patients the use of a naturally occurring growth factor has been explored in many studies and in some supplements in clinical use. Glandular extract derived from bovine sources that contributes epithelial growth factor (EGF) offer an additional strategy for epithelial tissue repair. EGF is a normal constituent of saliva production during the act of eating, is also secreted into the gut lumen and found in colostrum and milk. The purpose is to aid in the management of epithelial tissue health and it is naturally degraded by pancreatic enzymes during digestion.
The amino acid L-Arginine is suspected through animal models to increase intraluminal production of EGF and may explain why this protein is a useful method for repairing intestinal damage.[1]
The act of licking a wound is known to be a route to transfer the EGF to damaged tissues and contributes to more rapid wound healing.[2]
Epidermal Growth Factor (EGF) is a polypeptide that stimulates growth and repair of epithelial tissue. It is widely distributed in the body, with high concentrations detectable in salivary and prostate glands and in the duodenum. Saliva can be a rich source of EGF, especially the saliva of certain non-poisonous snakes. The use of serpents in healing rituals may reflect the value of ophidian saliva in promoting the healing of wounds. Thorough mastication of food may nourish the gut by providing it with salivary EGF. Purified EGF has been shown to heal ulceration of the small intestine.[3]
Naturally occurring EGF is regarded as being a very safe ingredient and food concentrate. In numerous studies the absence of EGF contributes to altered cell division and mutation and the restoration of EGF reverses these changes.
There are many types of EGF and they have a complex range of roles in human physiology. The consumption of the small amount of glandular derived extract has been shown in numerous clinical experiments to be far more effective in supporting a return to normal barrier quality when combined with L-Glutamine, than when glutamine is consumed on its own. Adding L-Arginine may also aid repair.[4]
How much do we produce per day
EGF is found in varying concentrations in milk, saliva, urine (9-100 ng/mL).
When we are well we produce enough to maintain control over epithelial repair. In illness and disease including IBD and oral cancers we produce too little and this facilitates an increased reactive oxygen species development.
Regarded as a naturally occurring protector, the inclusion of glandular salivary EGF complexes bound to glandular complex’s represent a minimal supply of an essential tissue repair molecule.
It may act on the mucosa from the lumen as a surveillance peptide promoting mucosal repair, EGF may be a trophic substance for the gastrointestinal mucosa aiding in its management.[5],[6]
Salivary EGF acutely (within minutes) upregulates small intestinal absorption of electrolytes and nutrients, an effect which was shown to be related to a concurrent lengthening of the apical microvilli of enterocytes.[7],[8],[9]
Salivary and gastric EGF also inhibits pathogenic adherence to epithelial cells reducing adhesion and virulence factors and so contributes to healthy mucosal immunity. It is well documented that EGF is present in large amounts in, and has diversified biological activities on, the gastrointestinal tract.
Therefore, the inhibitory effect of EGF on pathogenic colonisation in this tract suggests that EGF may specifically recognise and interact with the epithelial cells in the gastrointestinal tract, thereby interfering with the interaction between pathogens and the epithelial cells. EGF can also inhibit pathogenic colonisation in other tissue and organ types, including bladder and kidney. EGF is an effective preventive or therapeutic agent against pathogenic infections in a wide variety of tissue and organ types, particularly the urogenital tract.[10],[11],[12],[13]
Salivary and gastric EGF upregulates function in the entire intestine, including the colon.[14]
Comment
The role of naturally occurring agents in a concentrated form for the benefit of human health is nothing new, but many people with compromised gut function are unable to masticate adequately. The result is a declining level of EGF and increased risk of colonisation and barrier defects. EGF alone imparts benefits but when used in conjunction with arginine and glutamine may be even more effective in increasing mucosal trophicity and health.
References
[1] Camli A, Barlas M, Yagmurlu A. Does L-arginine induce intestinal adaptation by epithelial growth factor? ANZ J Surg. 2005 Jan-Feb;75(1-2):73-5. View Abstract
[2] Jahovic N, Güzel E, Arbak S, Yeğen BC. The healing-promoting effect of saliva on skin burn is mediated by epidermal growth factor (EGF): role of the neutrophils. Burns. 2004 Sep;30(6):531-8. View Abstract
[3] Playford, R.J., et al., Effect of luminal growth factor preservation on intestinal growth. Lancet, 1993. 341(8849): p. 843-8 View Abstract
[4] Rao RK, Thomas DW, Pepperl S, Porreca F. Salivary epidermal growth factor plays a role in protection of ileal mucosal integrity. Dig Dis Sci. 1997 Oct;42(10):2175-81. View Abstract
[5] Egéa JC, Hirtz C, Valcarcel J, Deville De Périère D. Epidermal growth factor: a probable oral and digestive health protector. Pathol Biol (Paris). 2002 Dec;50(10):608-12. Review. French. View Abstract
[6] Konturek PC, Konturek SJ, Brzozowski T, Ernst H. Epidermal growth factor and transforming growth factor-alpha: role in protection and healing of gastric mucosal lesions. Eur J Gastroenterol Hepatol. 1995 Oct;7(10):933-7. Review. View Abstract
[7] Iannoli P, Miller JH, Ryan CK, Gu LH, Ziegler TR, Sax HC. Epidermal growth factor and human growth hormone accelerate adaptation after massive enterectomy in an additive, nutrient-dependent, and site-specific fashion. Surgery. 1997 Oct;122(4):721-8; discussion 728-9. View Abstract
[8] Dunn JC, Parungo CP, Fonkalsrud EW, McFadden DW, Ashley SW. Epidermal growth factor selectively enhances functional enterocyte adaptation after massive small bowel resection. J Surg Res. 1997 Jan;67(1):90-3. View Abstract
[9] Opleta-Madsen, K. (1991) “Epidermal Growth Factor Upregulates Intestinal Electrolyte and Nutrient Transport” Am. J. Physiol. 260:G807-G814 View Abstract
[10] Carpenter, G. (1993) “EGF: New Tricks for an Old Growth Factor” Curr. Opinion Cell Biol. 5:261-264 View Abstract
[11] Eppstein, D.A. et al. (1985) “Epidermal Growth Factor Receptor Occupancy Inhibits Vaccinia Virus Infection” Nature 318:663-665 View Abstract
[12] Galan, J.E. et al. (1992) “Involvement of the Epidermal Growth Factor Receptor in the Invasion of Cultured Mammalian Cells by Salmonella Typhimurium” Nature 357:588-589 View Abstract
[13] Strong, J.E. et al. (1993) “Evidence that Epidermal Growth Factor Receptor on Host Cells Confers Reovirus Infection Efficiency” Virology 197:405-411 View Abstract
[14] Goodlad RA, Raja KB, Peters TJ, Wright NA. Effects of urogastrone-epidermal growth factor on intestinal brush border enzymes and mitotic activity. Gut. 1991 Sep;32(9):994-8. View Abstract
