Low Dose G-CSF to Augment Host Defense and Counteract Progression of Sepsis
Multiple trauma patients and patients undergoing major surgical operations are predisposed to life-threatening sepsis by an apparently acquired immunological deficiency, which is accompanied by a high mortality rate (40 to 60%) . Neutrophils represent the first line of defense against invading bacteria. However, impaired neutrophil function has been reported in severely injured patients  and in patients during early septic shock . Surgery resulted in further depression of neutrophil function in patients with intra-peritoneal infections . In these patients, relapses of infections were associated with a diminution of neutrophil function prior to any clinical evidence for infection . Thus, patients at risk of sepsis or with sepsis might benefit from prophylactic augmentation and restoration of neutrophil function. Unfortunately, until recently, there has been no choice to counteract granulocyte dysfunctions which have been described in posttraumatic patients . However, in mice, recombinant human granulocyte colony-stimulating factor (rhG-CSF) improved survival in a well-established sepsis model . G-CSF is one of the important hemopoietic factors which plays a central role in precursor cell proliferation and differentiation into neutrophils . In addition to the stimulation of proliferation and maturation, G-CSF enhances a variety of functions of neutrophils, including chemotaxis , superoxide generation , bactericidal function  and phagocytic activity . Moreover, G-CSF may have beneficial effects on feedback regulation of cytokines [5, 10]. Thus, G-CSF might activate neutrophils on the one hand and provide an anti-inflammatory effect on the other.
KeywordsSeptic Shock Systemic Inflammatory Response Syndrome Adult Respiratory Distress Syndrome Neutrophil Function Membrane Attack Complex
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