trier's

trier's disease in one patient.

By | December 7, 2000

A drug therapy seems to have been effective in reversing the symptoms of Ménétrier's disease in a man from Texas, a report in the 7 December New England Journal of Medicine reveals.

Ménétrier's disease is quite rare and causes a thickening of the stomach lining, and a complete absence of parietal cells, which produce stomach acid. This results in symptoms of persistent vomiting and swelling in the legs. Robert Coffey and colleagues from Vanderbilt-Ingram Cancer Center, Texas, have been researching the role of the epidermal growth factor (EGF) receptor and one of the factors that binds to it — transforming growth factor-α (TGFα) — in the stomach. They have found that the EGF receptor is involved in the growth of cells in the stomach characteristic of this premalignant stomach disorder. Enhanced EGF signalling seems to cause excessive amounts of TGFα in Ménétrier's patients.

The authors treated a 48-year-old man with a new drug, a monoclonal antibody that blocks activation of the EGF receptor, called C225. The effect of the drug was quick and impressive. Dr Coffey commented: "By the day after his first injection, he was already feeling better." His vomiting virtually ceased, and gastric biopsies taken the day before and after revealed a marked reduction in proliferation of surface mucous cells and an increase in levels of gastrin, which prompts development of acid-producing parietal cells.

Dr Coffey concludes: "It seems clear that Ménétrier's disease results because of enhanced signalling of the EGF receptor. We think it's TGFα, but other ligands for the EGF receptor may also have this effect. We'll now be able to go back to the mouse model and address these issues."

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