Scientific Abstract

Proposal No. IBD-0172R
Principal Investigator:  Stephen K. Tsao, MBChB
Applicant Organization:  University Hospitals of Leicester NHS Trust (United Kingdom)
Project Title:   Epidermal growth factor - an alternative therapy in ulcerative colitis
Period of Award:  December 1, 2006 – November 30, 2008

Ulcerative colitis (UC) is a relapsing disease of unknown cause and its exact aetiology is still unclear.  Treatment has remained largely unchanged over the past 50 years, and mainly revolves around suppressing inflammation and the body’s immune system.  Response rate varies between patients, and a proportion of patients will become refractory to these treatment.  New treatment is therefore needed.

Extensive in vitro and in vivo animal experiments have suggested that epidermal growth factor (EGF) is involved with the healing and maintenance of the gut mucosa.  To date there is no data regarding specific treatment that targets the healing process of the gut mucosa.  In our preliminary study we showed that EGF when given in the form of an enema is effective in bringing patients into remission when they have a flare-up of their UC.  For the first time we have demonstrated the potential for EGF to become an established treatment in UC.  This is certainly an innovative approach to the treatment of UC, and if EGF treatment results in a greater length of time between exacerbations, or if EGF aborts or shortens an exacerbation of UC there will be a considerable improvement in the quality of life of IBD patients.
 
In this current study, we hypothesise that EGF enema is more efficacious in the treatment of active left-sided UC to mesalamine enema (an established treatment of UC).  We aim to quantify the production of EGF from saliva and duodenal Brunner’s gland and will objectively assess the effect of EGF on the colonic mucosa.  This information will provide an important rationale to develop EGF as a novel treatment in UC; an approach which could greatly improve the lives of patients with UC.