Granulocyte colony-stimulating factor improves function of neutrophils from patients with acute liver failure

Objective To evaluate the in vitro effects of granulocyte colony-stimulatin g factor (G-CSF) on function of neutrophils in acute liver failure (ALF). Methods Neutrophil functions (superoxide and hydrogen peroxide production; phagocytosis and killing; complement receptor expression) were determined s imultaneously in 23 patients with ALF due to paracetamol overdose and compa red with 23 healthy control subjects. Results Phagocytosis was reduced in neutrophils from ALF patients compared to controls (P<0.005) and was significantly increased by incubation with 10 00 or 5000 IU/ml G-CSF (P<0.05), This correlated with increased expression of CD11b (r=0.93) and CD18 (r=0.98) after incubation with 5000 IU/ml G-CSF (P<0.05). Killing was reduced in ALF neutrophils compared to controls (P<0. 005) and was similarly restored by G-CSF (P<0.005). An increase in killing correlated with increases in production of superoxide (r=0.96) and hydrogen peroxide (r=0.97) by ALF neutrophils after incubation with 1000 and 5000 I U/ml of G-CSF when formylmethionyl-leucylphenylalanine (fMLP) was the stimu lant. G-CSF at 5000 IU/ml increased the production of hydrogen peroxide (P< 0.01) when zymosan was the stimulant conclusions G-CSF improves the neutrophil dysfunction of ALF. (C) 2000 Lipp incott Williams & Wilkins.