title: Exploring Erythropoietin and G-CSF Combination Therapy in Chronic Stroke Patients.
abstract: Erythropoietin (EPO) and granulocyte-colony stimulating factor (G-CSF) are known to have neuroprotective actions. Based on previous reports showing the synergistic effects of EPO+G-CSF combination therapy in experimental models, we investigated the safety of EPO+G-CSF combination therapy in patients with chronic stroke. In a pilot study, 3 patients were treated with EPO and G-CSF for 5 consecutive days, with follow-up on day 30. In an exploratory double-blind study, 6 patients were allocated to treatment with either EPO+G-CSF or placebo. Treatment was applied once a day for 5 days per month over 3 months. Participants were followed up for 6 months. To substantiate safety, vital signs, adverse events, and hematological values were measured on days 0, 5, and 30 in each cycle and on day 180. Functional outcomes were determined on day 0 and 180. In the laboratory measurements, EPO+G-CSF combination therapy significantly elevated erythropoietin, CD34⁺ hematopoietic stem cells, white blood cells, and neutrophils on day 5 of each cycle. There were no observations of serious adverse events. In the functional outcomes, the grip power of the dominant hand was increased in the EPO+G-CSF treatment group. In conclusion, this exploratory study suggests a novel strategy of EPO+G-CSF combination therapy for stroke patients.
authors.affiliation: Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea. kyum309@hanmail.net.|Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea. kyum309@hanmail.net.
authors.forename: Yoon-Kyum
authors.initials: YK
authors.lastname: Shin
authors.affiliation: Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea. srcho918@yuhs.ac.|Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea. srcho918@yuhs.ac.|Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul 03722, Korea. srcho918@yuhs.ac.|Yonsei Stem Cell Research Center, Avison Biomedical Research Center, Seoul 03722, Korea. srcho918@yuhs.ac.
authors.forename: Sung-Rae
authors.initials: SR
authors.lastname: Cho
mesh_terms: D000328:Adult; D018952:Antigens, CD34 / Q000378:metabolism; D002908:Chronic Disease; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D000068817:Epoetin Alfa / Q000627:therapeutic use*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006412:Hematopoietic Stem Cells / Q000166:cytology / Q000378:metabolism; D006801:Humans; D007962:Leukocytes / Q000166:cytology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D009504:Neutrophils / Q000166:cytology / Q000378:metabolism; D010865:Pilot Projects; D015990:Placebo Effect; D020521:Stroke / Q000188:drug therapy*
chemical_list: D018952:Antigens, CD34; D018696:Neuroprotective Agents; D016179:Granulocyte Colony-Stimulating Factor; D000068817:Epoetin Alfa
keywords: combination therapy; erythropoietin; granulocyte-colony stimulating factor; neuroprotection; stroke