Is there a place for granulocyte colony-stimulating factor in non-neutropenic critically ill patients?

Intensive Care Med. 2004 Jan;30(1):10-7. doi: 10.1007/s00134-003-2049-8. Epub 2003 Oct 31.

Abstract

Immunoparalysis, characterised by impairments in neutrophil and monocyte/macrophage function, is common in critically ill patients. The theoretical ability of granulocyte colony-stimulating factor (G-CSF) to improve the functions of both neutrophils and monocytes/macrophages provides a rationale for G-CSF therapy in non-neutropenic critically ill patients with infection or a high risk of nosocomial infection. The expression of the receptors that mediate G-CSF effects in neutrophils and monocytes/macrophages is regulated by bacterial products, cytokines and endogenous G-CSF levels, accounting for the variables effects of G-CSF on the neutrophil functions of critically ill patients. This variability should be taken into account when designing studies on the use of G-CSF in ICU-patients. Studies are still needed to identify the subset of patients who may benefit from G-CSF therapy.

Publication types

  • Review

MeSH terms

  • Adjuvants, Immunologic / therapeutic use
  • Animals
  • Critical Care / methods*
  • Critical Illness / therapy*
  • Disease Models, Animal
  • Drug Evaluation, Preclinical
  • Granulocyte Colony-Stimulating Factor / immunology
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Humans
  • Infections / drug therapy
  • Macrophages / drug effects
  • Macrophages / immunology
  • Monocytes / drug effects
  • Monocytes / immunology
  • Neutropenia / complications
  • Neutrophils / drug effects
  • Neutrophils / immunology
  • Patient Selection*
  • Pneumonia / drug therapy
  • Safety
  • Treatment Outcome

Substances

  • Adjuvants, Immunologic
  • Granulocyte Colony-Stimulating Factor