A team based at King's College School of Medicine & Dentistry, London, England evaluated the in vitro effects of granulocyte colony-stimulating factor (G-CSF) on the function of neutrophils in acute liver failure (ALF).
Neutrophil functions were determined in 23 patients with ALF due to paracetamol overdose and 23 healthy control subjects. Superoxide and hydrogen peroxide production; phagocytosis and killing; and complement receptor expression were assessed.
Phagocytosis was reduced in neutrophils from ALF patients compared to controls (P< 0.005). This was significantly increased by incubation with 1 000 or 5 000 IU/ ml G-CSF (P< 0.05).
Expression of CD11b (r= 0.93) and CD18 (r= 0.98) increased after incubation with 5,000 IU/ml G-CSF (P< 0.05).
Phagocytosis was reduced in neutrophils from ALF patients compared to controls.
The study also revealed that 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 1 000 and 5 000 IU/ml G-CSF. These effects were only observed when the stimulant formyl methionyl leucylphenylalanine was used. When zymosan was the stimulant, incubation with 5 000 IU/ml G-CSF increased the production of hydrogen peroxide (P< 0.01).
Dr Nancy Rolando concluded on behalf of the group that, "G-CSF improves the fuction of neutrophils from patients with acute liver failure."