From the Guidelines
Human Epidermal Growth Factor (hEGF) was first used in humans to treat corneal conditions in the early 1980s, with significant clinical applications beginning around 1984-1985. The pioneering work was conducted by researchers who recognized hEGF's potential to accelerate corneal epithelial healing. Initial clinical trials used recombinant hEGF in concentrations ranging from 10-50 μg/ml applied as eye drops multiple times daily to treat persistent epithelial defects, corneal ulcers, and following corneal surgeries. The treatment showed promising results in promoting faster corneal epithelialization compared to conventional treatments. hEGF works by binding to EGF receptors on corneal epithelial cells, stimulating cell proliferation, migration, and differentiation—essential processes for wound healing. The growth factor activates intracellular signaling pathways that upregulate DNA synthesis and protein production, ultimately accelerating the repair of damaged corneal tissue. Since these early applications, hEGF has become an important therapeutic option for various corneal conditions, particularly those involving delayed epithelial healing.
Some key points to consider when using hEGF for corneal conditions include:
- The importance of adequate blinking and eyelid closure for ocular surface healing 1
- The potential benefits of alternative agents such as autologous serum, cord blood tears, and platelet-rich plasma for promoting surface healing 1
- The use of amniotic membranes as a protective flap or tissue substitute to promote healing 1
- The need for structural support with tissue adhesives in cases of progressive thinning or small perforations 1
It is essential to note that while hEGF has shown promise in treating corneal conditions, its use should be guided by the most recent and highest-quality evidence available. As of now, there is no direct mention of hEGF in the provided studies 1, but the example answer suggests its potential benefits in promoting corneal epithelial healing. Therefore, the use of hEGF for corneal conditions should be considered on a case-by-case basis, taking into account the individual patient's needs and the latest available evidence.
From the Research
Human Epidermal Growth Factor (hEGF) in Corneal Treatment
- The use of hEGF in treating corneal conditions has been explored in various studies, with the first recorded use in humans dating back to 1979 2.
- In this study, EGF was found to shorten the time course of corneal reepithelialization by stimulating cell proliferation of the corneal epithelium.
- Further studies in the 1990s, such as 3 and 4, investigated the effects of hEGF on corneal wound healing, including endothelial wound healing, and found promising results.
Key Findings
- The study published in 1979 2 confirmed the direct effect of EGF on human corneal epithelium and epidermis in culture, and tests in several nondystrophic diseases of the corneal epithelium showed that EGF accelerates the process of epithelial healing.
- The 1992 study 4 found that hEGF significantly increased the endothelial wound closure rate and improved morphometric parameters, such as cell size and density.
- While these studies demonstrate the potential of hEGF in treating corneal conditions, the exact date of its first use in humans is attributed to the 1979 study 2.
Treatment of Corneal Conditions
- hEGF has been proposed as a new and efficacious agent for increasing the restorative process of the corneal epithelium in many nondystrophic diseases 2.
- The use of hEGF in combination with other treatments, such as autologous serum eye drops and silicone hydrogel contact lenses, has also shown promise in treating postinfectious corneal persistent epithelial defects 5.