Early sucralfate investigations showed that undissolved (thus high dose concentration) sucralfate adherent to the human gastric mucosa caused rapid mucosal changes within 10-60 minutes. These changes included the release of mucus and bicarbonate as well as vacuolization and exfoliation of superficial enterocytes being replaced by newly regenerated cells. Laboratory animals given high doses of standard potency sucralfate (3-20 times the standard 14mg/kg dose) were observed to resist gastric injury, rapidly heal mucosal injuries and showed increased secretion of luminal prostaglandins, mucus and bicarbonate. These mucosal changes were shown to be linked to the local expression of growth factor receptors and the secretion of epidermal growth factor. Later research identified that sucralfate-mediated mucosal changes are growth factor dependent. Independently investigators have concluded that sucralfate accelerates growth-factor mediated mucosal healing, though the mechanism is unclear.