Perioperative Recombinant Human Granulocyte Colony-Stimulating Factor (Filgrastim) Treatment Prevents Immunoinflammatory Dysfunction Associated with Major Surgery

Christian Schneider, Sonja Von Aulock, Siegfried Zedler, Christian Schinkel, Thomas Hartung, Eugen Faist

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)75-81
Number of pages7
JournalAnnals of Surgery
Volume239
Issue number1
DOIs
StatePublished - Jan 2004
Externally publishedYes

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Granulocyte Colony-Stimulating Factor
Anti-Inflammatory Agents
Interleukin 1 Receptor Antagonist Protein
Acute-Phase Reaction
Lymphokines
HLA-DR Antigens
Therapeutics
Leukocyte Count
Innate Immunity
Monocytes
Immune System
Sepsis
Placebos
Lymphocytes
Filgrastim
Incidence
Wounds and Injuries
Infection
Serum

ASJC Scopus subject areas

  • Surgery

Cite this

Perioperative Recombinant Human Granulocyte Colony-Stimulating Factor (Filgrastim) Treatment Prevents Immunoinflammatory Dysfunction Associated with Major Surgery. / Schneider, Christian; Von Aulock, Sonja; Zedler, Siegfried; Schinkel, Christian; Hartung, Thomas; Faist, Eugen.

In: Annals of Surgery, Vol. 239, No. 1, 01.2004, p. 75-81.

Research output: Contribution to journalArticle

Schneider, Christian ; Von Aulock, Sonja ; Zedler, Siegfried ; Schinkel, Christian ; Hartung, Thomas ; Faist, Eugen. / Perioperative Recombinant Human Granulocyte Colony-Stimulating Factor (Filgrastim) Treatment Prevents Immunoinflammatory Dysfunction Associated with Major Surgery. In: Annals of Surgery. 2004 ; Vol. 239, No. 1. pp. 75-81.
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