Differential alterations in plasma colony-stimulating factor concentrations in meningococcaemia.
To determine whether circulating levels of any of the colony-stimulating factors (CSF) might contribute to the host response in severe sepsis, plasma concentrations of granulocyte CSF (G-CSF), granulocyte-macrophage CSF (GM-CSF), and macrophage CSF (M-CSF) were measured by immunoassays in 20 subjects with meningococcaemia, a bloodstream infection caused by Neisseria meningitidis, that has proven to be a valuable model to study the responses of other inflammatory mediators during sepsis and septic shock in humans. Plasma G-CSF concentrations were transiently elevated in most subjects during the early phase of meningococcaemia, and were higher in subjects with septic shock (mean +/- s.d. = 165 +/- 142 ng/ml, n = 9) compared with those who remained normotensive (mean +/- s.d. = 7 +/- 2 ng/ml, n = 10) (P < 0.05). Peak plasma G-CSF concentrations > 10 ng/ml were associated with the development of septic shock (P < 0.01), disseminated intravascular coagulation (P < 0.01), fulminant infection (P < 0.05), and a fatal outcome (P < 0.01). Plasma GM-CSF concentrations > 1 ng/ml were briefly present in subjects with life-threatening septic shock (1-15 ng/ml, n = 5), and were strongly associated with fulminant meningococcaemia (P < 0.01). Plasma M-CSF concentrations were marginally elevated in all subjects, but were not associated with complications related to or arising from sepsis-induced organ injury. This study demonstrates that plasma levels of G-CSF, GM-CSF and M-CSF show very different responses during meningococcaemia, changes which presumably reflect the different roles played by these mediators in sepsis and, potentially, in septic shock.
Waring
P M
PM
Cancer Research Unit, Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.
Presneill
J
J
Maher
D W
DW
Layton
J E
JE
Cebon
J
J
Waring
L J
LJ
Metcalf
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003115:Colony-Stimulating Factors / Q000097:blood*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood / Q000502:physiology; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000097:blood / Q000502:physiology; D006801:Humans; D007223:Infant; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood / Q000502:physiology; D008297:Male; D008589:Meningococcal Infections / Q000097:blood*; D008875:Middle Aged; D012772:Shock, Septic / Q000209:etiology
D003115:Colony-Stimulating Factors; D016179:Granulocyte Colony-Stimulating Factor; D016173:Macrophage Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor