Granulocyte colony-stimulating factor therapy and systemic inflammation in critically ill patients.
OBJECTIVE
The effect of the granulocyte colony-stimulating factor filgrastim on systemic inflammation was investigated in a prospective, randomized, placebo-controlled, double-blind study in critically ill patients.


METHODS
59 critically ill patients were recruited within 48 h of intubation due to ventilatory insufficiency.


METHODS
Subcutaneous dosage of placebo or 300 microg filgrastim once daily.


METHODS
Serum samples were collected at study entry, and 1 and 3 days after the start (Day1 and Day3, respectively). Levels of soluble E-selectin (sE-selectin) and interleukin (IL)-10 were determined by ELISA, and those of IL-6, and soluble IL-2 receptor (sIL-2R) by Immulite chemiluminescence immunoassay.


RESULTS
The median sE-selectin level decreased by day 3 significantly in the control group but not in the filgrastim group. The difference in the change between the study groups was significant (p = 0.049). IL-10 levels decreased significantly in the filgrastim group, tended to decrease in controls (p = 0.052), and the difference in the change tended to be significant (p = 0.058). IL-6 levels decreased in both groups comparably. sIL-2R levels were elevated and stable.


CONCLUSIONS
Filgrastim prolongs endothelial activation and possibly inhibits development of immune suppression mediated by IL-10.
Takala
A
A
The Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Central Hospital, Helsinki, Finland. annika.takala@helsinki.fi
Pettilä
V
V
Takkunen
O
O
Rintala
E
E
Kautiainen
H
H
Repo
H
H
D000328:Adult; D000368:Aged; D015415:Biomarkers; D001772:Blood Cell Count; D016638:Critical Illness / Q000628:therapy*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged
D015415:Biomarkers; D016179:Granulocyte Colony-Stimulating Factor