Salivary epidermal growth factor in patients with and without acid peptic disease

Epidermal growth factor inhibits gastric acid secretion and has a cytoprotective effect on the upper gastrointestinal tract. This study was undertaken to determine whether patients with endoscopically proven active peptic ulcer disease have a salivary deficiency of human epidermal growth factor (hEGF), compared to patients with a normal esophagogastroduodenoscopy (EGD). Saliva was collected from fasting subjects prior to EGD. The levels of EGF were measured by radioimmunoassay. Statistical evaluation was performed by analysis of variant followed by Student's t test. The concentrations of the peptide were lower in patients with active peptic ulcer disease (3.1 +/- 0.54 ng/ml, mean +/- SE, n = 25) compared with normal subjects (4.9 +/- 0.56 ng/ml, n = 58, p less than 0.03). No significant differences in salivary hEGF were noted between patients with a normal EGD and patients with gastritis (3.85 +/- .86 ng/ml, n = 13), esophagitis (4.5 +/- 1.3 ng/ml, n = 7), or Barrett's esophagus (5.3 +/- 1.5 ng/ml, n = 6). There were no differences in the salivary levels of hEGF between males and females, or between smokers and nonsmokers. There was no correlation of hEGF levels with age. The pathophysiologic significance of this finding is uncertain. Lower salivary hEGF may reduce one of the defensive mechanisms responsible for protecting the gastroduodenal mucosa from injury by physicochemical agents, thus contributing to ulcer development.