Diminished epidermal growth factor levels in infants with necrotizing enterocolitis

Background/Purpose: Because epidermal growth factor (EGF) is trophic to the intestinal mucosa, and neonatal necrotizing enterocolitis (NEC) is associated with a disrupted intestinal mucosal barrier, the authors sought to determine whether diminished levels of EGF were present in infants with NEC. Methods: Saliva, serum, and urine specimens were obtained from infants with NEC during a 3-year period (February 1995 to May 1998). Control patients without NEC were chosen based on similar postnatal age and birthweight. EGF levels were determined by enzyme-linked immunosorbent assay (ELISA). Differences between groups were compared using Mann-Whitney Rank sum test with P less than .05 considered significant. Results are presented as mean values +/- SEM. Results: Twenty-five infants with NEC were compared with 19 control patients. Birth weight (1,616 +/- 238 g control v 1,271 +/- 124 g NEC) and postnatal age (23 +/- 6 days control v 22 +/- 3 days NEC) were similar. Infants with NEC had signifi cantly lower levels of EGF in both saliva (590 +/- 80 pg/mL control v 239 +/- 41 pg/mL NEC; P <.001) and serum (35 +/- 8 pg/mL control v 5.6 +/- 1.9 pg/mL NEC; P <.001). Urinary EGF was also lower in the NEC group, but was not statistically significant. Conclusions: Premature infants with NEC have significantly diminished levers of salivary and serum EGF. Reduced levels of this growth factor may distinguish infants at risk for NEC and play a pivotal role in the pathogenesis of the perturbed intestinal mucosal barrier that is central to th is condition. J Pediatr Surg 35:173-177 Copyright (C) 2000 by W.B. Saunders Company.