TY - JOUR
T1 - Perioperative Recombinant Human Granulocyte Colony-Stimulating Factor (Filgrastim) Treatment Prevents Immunoinflammatory Dysfunction Associated with Major Surgery
AU - Schneider, Christian
AU - Von Aulock, Sonja
AU - Zedler, Siegfried
AU - Schinkel, Christian
AU - Hartung, Thomas
AU - Faist, Eugen
PY - 2004/1
Y1 - 2004/1
N2 - Objective: To examine the effects of perioperative rhG-CSF administration on immune function in patients subjected to major surgery. Summary Background Data: Severe trauma, such as major surgery, initiates acute immunodysfunction which predisposes the patient towards infectious complications. Methods: Sixty patients undergoing elective surgery received either recombinant human granulocyte colony-stimulating factor/rh G-CSF (Filgrastim) or a placebo perioperatively. At several time points before and after the surgical intervention immunofunctional parameters were assessed. Results: Leukocyte counts and serum levels of anti-inflammatory mediators (IL-1ra and TNF-R) were increased in Filgrastim-treated patients, while the post-operative acute phase response was attenuated. Monocyte deactivation (reduced TNF-α release and HLA-DR expression) and lymphocyte anergy (impaired mitogenic proliferation and reduced TH1 lymphokine release) were blunted and the incidence and severity of infectious complications were reduced. Conclusions: These results suggest that Filgrastim treatment reinforces innate immunity, enabling better prevention of infection. Thus, this unique combination of hematopoietic, anti-inflammatory and anti-infectious effects on the innate immune system warrants further study of clinical efficacy and sepsis prophylaxis.
AB - Objective: To examine the effects of perioperative rhG-CSF administration on immune function in patients subjected to major surgery. Summary Background Data: Severe trauma, such as major surgery, initiates acute immunodysfunction which predisposes the patient towards infectious complications. Methods: Sixty patients undergoing elective surgery received either recombinant human granulocyte colony-stimulating factor/rh G-CSF (Filgrastim) or a placebo perioperatively. At several time points before and after the surgical intervention immunofunctional parameters were assessed. Results: Leukocyte counts and serum levels of anti-inflammatory mediators (IL-1ra and TNF-R) were increased in Filgrastim-treated patients, while the post-operative acute phase response was attenuated. Monocyte deactivation (reduced TNF-α release and HLA-DR expression) and lymphocyte anergy (impaired mitogenic proliferation and reduced TH1 lymphokine release) were blunted and the incidence and severity of infectious complications were reduced. Conclusions: These results suggest that Filgrastim treatment reinforces innate immunity, enabling better prevention of infection. Thus, this unique combination of hematopoietic, anti-inflammatory and anti-infectious effects on the innate immune system warrants further study of clinical efficacy and sepsis prophylaxis.
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U2 - 10.1097/01.sla.0000103062.21049.82
DO - 10.1097/01.sla.0000103062.21049.82
M3 - Article
C2 - 14685103
AN - SCOPUS:0842305744
SN - 0003-4932
VL - 239
SP - 75
EP - 81
JO - Annals of surgery
JF - Annals of surgery
IS - 1
ER -