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.
Cancer Research Unit, Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.
P M
PM
Waring
J
J
Presneill
D W
DW
Maher
J E
JE
Layton
J
J
Cebon
L J
LJ
Waring
D
D
Metcalf
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