title: Granulocyte colony-stimulating factor worsens the outcome of experimental Klebsiella pneumoniae pneumonia through direct interaction with the bacteria.
abstract: Besides its well-established effects on granulocytopoiesis, granulocyte colony-stimulating factor (G-CSF) has been shown to have direct effects on the recruitment and bactericidal ability of neutrophils, resulting in improved survival of experimentally infected animals. We studied the effect of G-CSF on the course of experimental pneumonia induced by Klebsiella pneumoniae, an important gram-negative bacillary pulmonary pathogen. Using a highly reproducible murine model, we here show the paradoxical finding that mortality from infection was significantly increased when animals received G-CSF before induction of pneumonia. Administration of G-CSF promoted replication of bacteria in the liver and spleen, thus indicating an impairment rather than an enhancement of antibacterial mechanisms. By contrast, a monoclonal antibody against Klebsiella K2 capsule significantly reduced bacterial multiplication in the lung, liver, and spleen, and abrogated the increased mortality caused by G-CSF. In vitro studies showed a direct effect of G-CSF on K pneumoniae resulting in increased capsular polysaccharide (CPS) production. When bacteria were coincubated with therapeutically achievable concentrations of G-CSF, phagocytic uptake and killing by neutrophils was impaired. Western blot analysis showed three binding sites of G-CSF to K pneumoniae. Binding of 125I-G-CSF to K pneumoniae was displaced by an excess of unlabeled G-CSF, whereas an unrelated cytokine, interleukin-1alpha, did not compete with G-CSF binding to the bacteria. Thus, in this model, the direct effect of G-CSF on a bacterial virulence factor, CPS production, outweighed any beneficial effect of G-CSF on recruitment and stimulation of leukocytes.
authors.affiliation: Department of Hematology and Oncology, Virchow-Klinikum, Humboldt-University, Berlin, Germany.
authors.forename: T K
authors.initials: TK
authors.lastname: Held
authors.forename: M E
authors.initials: ME
authors.lastname: Mielke
authors.forename: M
authors.initials: M
authors.lastname: Chedid
authors.forename: M
authors.initials: M
authors.lastname: Unger
authors.forename: M
authors.initials: M
authors.lastname: Trautmann
authors.forename: D
authors.initials: D
authors.lastname: Huhn
authors.forename: A S
authors.initials: AS
authors.lastname: Cross
mesh_terms: D000818:Animals; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D007710:Klebsiella Infections / Q000401:mortality / Q000503:physiopathology*; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000378:metabolism; D008168:Lung / Q000382:microbiology / Q000503:physiopathology; D051379:Mice; D008807:Mice, Inbred BALB C; D018410:Pneumonia, Bacterial / Q000401:mortality / Q000503:physiopathology*; D011135:Polysaccharides, Bacterial / Q000096:biosynthesis; D016019:Survival Analysis
chemical_list: D011135:Polysaccharides, Bacterial; D016179:Granulocyte Colony-Stimulating Factor