Facilitating Resolution of Life-Threatening Acute Graft-vs-Host Disease with Human Chorionic Gonadotropin and Epidermal Growth Factor

2019 ◽  
Author(s):  
Shernan Holtan ◽  
Andrea Hoeschen ◽  
Qing Cao ◽  
Mukta Arora ◽  
Veronika Bachanova ◽  
...  
Keyword(s):  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Host Disease ◽  
Graft Vs Host Disease ◽  
Life Threatening ◽  
Epidermal Growth ◽  
Acute Graft

scholarly journals Facilitating resolution of life-threatening acute GVHD with human chorionic gonadotropin and epidermal growth factor

2020 ◽  
Vol 4 (7) ◽  
pp. 1284-1295
Author(s):  
Shernan G. Holtan ◽  
Andrea L. Hoeschen ◽  
Qing Cao ◽  
Mukta Arora ◽  
Veronika Bachanova ◽  
...  
Keyword(s):  
Growth Factor ◽  
High Risk ◽  
Epidermal Growth Factor ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Immune Modulation ◽  
Second Line ◽  
Life Threatening ◽  
Epidermal Growth ◽  
High Risk Cohort

Abstract Acute graft-versus-host disease (aGVHD) is a potentially fatal complication of allogeneic hematopoietic cell transplantation that fails to improve with intense immunosuppression in some patients. We hypothesized that urinary-derived human chorionic gonadotropin (uhCG) could help facilitate resolution of life-threatening aGVHD when added as supportive care via 2 potential mechanisms: immunomodulation (akin to its role in pregnancy) and supplementation of epidermal growth factor (EGF; to aid in epithelial repair). In a phase 1 study, 26 participants received subcutaneous injections of uhCG in addition to standard immunosuppression (13 receiving initial therapy for high-risk aGVHD [according to the Minnesota criteria] and 13 receiving second-line therapy). Participants underwent serial blood testing for biomarkers of hormone response, immune modulation, and aGVHD activity on study. uhCG was well tolerated, with no dose-limiting toxicities. Sixty-two percent of patients in the high-risk cohort and 54% of patients in the second-line cohort had a complete response at study day 28. Plasma EGF was elevated sixfold (from 4 to 24 pg/mL; P = .02) at 6 hours postdose in the high-risk cohort, in contrast to no peak in plasma EGF in the more severe second-line cohort. After 1 week of uhCG, patients reported a twofold increase in the regulatory T cell to conventional T-cell ratio, suggesting immune modulation despite high-dose steroids. Responding patients reported significantly lower plasma amphiregulin and higher plasma butyrate levels at study completion, suggesting improvement in mucosal damage over time. uhCG is a novel, safe, supportive therapy, proceeding to phase 2 testing at 2000 units/m2 in high-risk aGVHD. This study was registered at www.clinicaltrials.gov as #NCT02525029.

Epidermal growth factor contamination and concentrations of intact human chorionic gonadotropin in commercial preparations

2004 ◽  
Vol 82 (1) ◽  
pp. 232-233 ◽  
Author(s):  
Sarah J Yarram ◽  
Julian Jenkins ◽  
Lawrence A Cole ◽  
Nathan L Brown ◽  
Jonathan R Sandy ◽  
...  
Keyword(s):  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Epidermal Growth
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