Low plasma granulocyte-macrophage colony stimulating factor is an indicator of poor prognosis in sepsis.
OBJECTIVE
Monocyte dysfunction has been shown to be associated with adverse consequences in septic patients. The cytokine growth factor granulocyte-macrophage colony stimulating factor (GM-CSF) may be required for optimal monocyte function in these patients. The current study investigates whether plasma GM-CSF levels were significantly different in septic patients and whether there was an association with prognosis.


METHODS
Plasma samples were collected from all septic patients from day 1 of the diagnosis of sepsis for 3 days. Healthy volunteer plasma served as control samples. A novel enzyme-linked immuno-adsorbent assay was developed with suitable sensitivity for detection of GM-CSF in patient and normal plasma. APACHE II score, age, sex and outcome were determined for all patients.


METHODS
A single centre study at the Royal Liverpool University Hospital in a medico-surgical 13 bed intensive care unit.


METHODS
All septic patients (n = 53) fulfilling the criteria of the APCC for the diagnosis of sepsis, were recruited for the study with informed consent from day 1 of the diagnosis of sepsis and plasma GM-CSF measured on three consecutive days. Patients were excluded from the study if on immunosuppressive therapy. Normal healthy volunteers (n = 33) were included in the study to serve as controls.


RESULTS
Plasma GM-CSF levels were statistically significantly depressed in patients who died compared with those who survived, who had levels comparable with healthy controls.


CONCLUSIONS
The results indicate that low plasma GM-CSF is associated with adverse consequences for septic patients. The measurement of GM-CSF in the plasma of septic patients merits further study for use as a prognostic marker and also to identify the type of immunotherapy the patient may benefit from.
Department of Immunology, Third Floor, Duncan Building, Daulby Street, Liverpool, L69 3GA, UK.
Sara E
SE
Perry
Sobhy M
SM
Mostafa
Richard
R
Wenstone
Paul J
PJ
McLaughlin
D018806:APACHE; D000328:Adult; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018805:Sepsis / Q000097:blood* / Q000503:physiopathology; D006113:United Kingdom
D016178:Granulocyte-Macrophage Colony-Stimulating Factor