Effect of granulocyte-macrophage colony-stimulating factor on leukocyte function in cirrhosis.
BACKGROUND
Cirrhotic patients have been reported to have leukocyte impaired function as well as a high incidence of infectious diseases. Granulocyte-macrophage colony-stimulating factor (GM-CSF) increases the number and function of phagocytic cells, and clinical applications are under study. We tested in vitro effects of GM-CSF on phagocytosis, phagocytic index, and chemotaxis in polymorphonuclear leukocytes from 21 cirrhotic patients (12 with compensated cirrhosis and 9 with spontaneous bacterial peritonitis).


METHODS
Polymorphonuclear leukocyte functions were tested under basal conditions and after incubation with GM-CSF (10 ng/mL). Phagocytosis was tested against a clinical strain of Candida albicans, and chemotaxis was evaluated using a Boyden chamber. Results were compared with those obtained from 14 healthy donors.


RESULTS
Leukocytes from cirrhotics displayed lower basal functional activity than control cells in phagocytosis (P < 0.01) and chemotaxis (P < 0.01). After GM-CSF stimulation, the percentage of phagocytic polymorphonuclear leukocytes in noninfected patients increased from 60% +/- 2.5% to 69.9% +/- 2.42% (P < 0.01), phagocytic index from 0.79 +/- 0.07 to 1.02 +/- 0.07 (P < 0.001), and chemotaxis from 61.2 +/- 12.6 to 82.3 +/- 10.2 cells/high power field (P < 0.05). In patients with peritonitis, the phagocytic index increased from 0.87 +/- 0.08 to 1.08 +/- 0.05 (P < 0.01), phagocytosis from 57.8 +/- 3.57 to 64.7 +/- 2.34 and chemotaxis from 83.3 +/- 17.8 to 110.2 +/- 24.1.


CONCLUSIONS
Our results indicate that a defective leukocyte function is present both in compensated and infected cirrhotic patients. An in vitro improvement was observed after GM-CSF stimulation.
Garcia-González
M
M
Servicio de Gastroenterologia, Hospital Ramón y Cajal, Madrid, Spain.
Boixeda
D
D
Herrero
D
D
Burgaleta
C
C
D000368:Aged; D001424:Bacterial Infections; D002634:Chemotaxis, Leukocyte / Q000187:drug effects; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000494:pharmacology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects* / Q000502:physiology; D010538:Peritonitis / Q000150:complications / Q000382:microbiology; D010587:Phagocytosis / Q000187:drug effects
D016178:Granulocyte-Macrophage Colony-Stimulating Factor