Konturek J W, Brzozowski T, Konturek S J
Institute of Physiology, Academy of Medicine, Krakow, Poland.
J Clin Gastroenterol. 1991;13 Suppl 1:S88-97. doi: 10.1097/00004836-199112001-00015.
Gastrointestinal mucosa is one of the most rapidly proliferating tissues in the body and the alteration in the balance between cell regeneration and cell loss may lead to mucosal lesions and ulcerations. Mucosal growth is under the influence of various growth factors, among which epidermal growth factor (EGF) and polyamines seem to play a crucial role. EGF is produced in large quantities in salivary and pancreatic glands and secreted mainly into the gut lumen and partly released into the bloodstream from where it is cleared by the kidneys and excreted into the urine as urogastrone. The physiological role of EGF is still under active investigations but it appears that EGF may be required for the maintenance of mucosal integrity and healing of mucosal defects due to its accumulation in the lesion area and local stimulation of healing processes. The mechanism of protective and ulcer healing effects of EGF involves the activation of ornithine decarboxylase (ODC), the key enzyme in the biosynthesis of polyamines, which play a crucial role in the growth-promoting action of EGF. Substances that affect the generation and/or catabolism of polyamines affect the gastroprotective and ulcer healing effect of EGF but not that of exogenous polyamines. Mucosal generation of protective prostaglandins appears to be essential mainly for the gastro-protective effects of EGF but seem to be of little importance in the healing effects of EGF on acute and chronic gastroduodenal ulcerations.
胃肠道黏膜是体内增殖最迅速的组织之一，细胞再生与细胞丢失之间平衡的改变可能导致黏膜损伤和溃疡形成。黏膜生长受多种生长因子影响，其中表皮生长因子（EGF）和多胺似乎起着关键作用。EGF在唾液腺和胰腺大量产生，主要分泌到肠腔，部分释放入血，随后被肾脏清除并以尿抑胃素形式排泄到尿液中。EGF的生理作用仍在积极研究中，但由于其在病变区域积聚并局部刺激愈合过程，EGF似乎是维持黏膜完整性和黏膜缺损愈合所必需的。EGF的保护和溃疡愈合作用机制涉及鸟氨酸脱羧酶（ODC）的激活，ODC是多胺生物合成中的关键酶，多胺在EGF的促生长作用中起关键作用。影响多胺生成和/或分解代谢的物质会影响EGF的胃保护和溃疡愈合作用，但不影响外源性多胺的作用。保护性前列腺素的黏膜生成似乎主要对EGF的胃保护作用至关重要，但在EGF对急慢性胃十二指肠溃疡的愈合作用中似乎不太重要。
