Epidermal growth factors
Epidermal growth factors play a fundamental role in wound healing through stimulating epidermal and dermal regeneration,which participates in dermal wound healing and dermal regeneration through stimulation, proliferation, and migration of keratinocyte, endothelial cells, and fibroblast. 43 Several clinical trials have shown that epidermal growth factor is an important cytoprotective factor against injuries, and contributes to wound healing and maintenance of mucosal integrity in the oral cavity and the gastrointestinal tract.82 Topical application of epidermal growth factor on the oral mucosa in combination with other conventional treatments may promote mucosal healing, reduce the severity of intraoral manifestations, and is therefore an effective treatment option in paraquat induced mucositis and ulcerations. 44 We recognized two studies that used recombinant human epidermal growth factor spray in the management of paraquat induced oral mucositis. The first study used recombinant human epidermal growth factor spray 3 times a day in conjunction with other intervention. It was noted that the incidence of oral mucositis decreased by 12.8%. 18The second trial used recombinant human epidermal growth factor spray two times a day for patients who presented with no oral mucosal erosions or ulcerations and three times a day for patients who presented with ulcerations. It was evident that recombinant human epidermal growth factor improved healing time and therefore reduced the severity of symptoms of oral mucositis.