title: Effects of G-CSF on systemic inflammation, coagulation and platelet activation in patients with acute myocardial infarction.
abstract: BACKGROUND
  In the prospective, randomised, double-blind, placebo-controlled Regenerate Vital Myocardium by Vigorous Activation of Bone Marrow Stem Cells (REVIVAL)-2 trial patients with acute myocardial infarction (AMI) and successful mechanical reperfusion received granulocyte-colony stimulating factor (G-CSF, 10 μg/kg KG s.c.) or placebo for 5 days. Aim of this substudy was to assess the impact of G-CSF on systemic inflammatory and procoagulant responses and platelet activation.
  
  
  RESULTS
  Before and five days after G-CSF (n=56) or placebo (n=58) circulating cytokine concentrations of interleukin (IL)-1ß, IL-6, IL-8, IL-10, IL-12 and Tumor-Necrosis Factor-α (TNF-α were measured. Prothrombin fragment F1+2 and Tissue Factor activity served as a measure for activated coagulation. Platelet activation was characterized by cell surface expression of the activated fibrinogen receptor (PAC-1), P-selectin and CD40L by flow cytometry. Administration of G-CSF was associated with elevated TNF-α and CRP concentrations compared to the placebo group after 5 days. Other cytokines (IL-1ß, IL-6, IL-8, IL-10, IL-12) were comparable after treatment with G-SCF or placebo. Similarly, circulating prothrombin fragments F1+2, TF activity and platelet activation did not differ in both groups.
  
  
  CONCLUSIONS
  Treatment with G-CSF in patients with AMI was associated with enhanced proinflammatory TNF-α and CRP levels but no activation of coagulation.
authors.affiliation: 1. Medizinische Klinik, Klinikums rechts der Isar der Technischen Universität München, Ismaninger Str 22, 81675 München, Germany.
authors.forename: Birgit A
authors.initials: BA
authors.lastname: Steppich
authors.forename: Gabriele
authors.initials: G
authors.lastname: Demetz
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schulz
authors.forename: Jasper
authors.initials: J
authors.lastname: von Wedel
authors.forename: Giesela
authors.initials: G
authors.lastname: Pogatsa-Murray
authors.forename: Siegmund-Lorenz
authors.initials: SL
authors.lastname: Braun
authors.forename: Andreas
authors.initials: A
authors.lastname: Stein
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
authors.forename: Albert
authors.initials: A
authors.lastname: Schömig
authors.forename: Ilka
authors.initials: I
authors.lastname: Ott
mesh_terms: D000208:Acute Disease; D001777:Blood Coagulation / Q000187:drug effects*; D016207:Cytokines / Q000097:blood; D004311:Double-Blind Method; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000188:drug therapy; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy*; D010919:Placebos; D015539:Platelet Activation / Q000187:drug effects*
chemical_list: D016207:Cytokines; D010919:Placebos; D016179:Granulocyte Colony-Stimulating Factor