Increased Granulocyte-Colony Stimulating Factor (G-CSF) and Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF) Levels in BAL Fluid from Patients with Sulfur Mustard Gas-Induced Pulmonary Fibrosis

Abstract

The objective of this article was to show the role of cytokines in the pathogenesis of pulmonary fibrosis due to sulfur mustard gas inhalation. Eighteen veterans with mustard gas-induced pulmonary fibrosis and 18 normal patients were used as controls. Bronchoalveolar larvage (BAL) and analyses of BAL fluids for cellular and cytokine levels were performed. There was a significant difference in granulocyte colony stimulating factor (G-CSF) level in the BAL fluid of patients and the controls (p < 0.0001). Granulocyte-macrophage colony stimulating pulmonary fibrosis (GM-CSF) BAL levels were significantly increased in patients with pulmonary fibrosis (PF) in comparison with controls (p < 0.0001). Patients with PF have highly significant increases in IL-8 level compared to controls (87.94 +/- 59.63 vs. 8.66 +/- 6.97 g/mL(1); p < 0.0001) as well. IL-8 and G-CSF levels in BAL fluid correlate only with the percentage and the absolute number of neutrophils of the BAL fluid in patients with PF (p = 0.02/p = 0.01; p = 0.01/p = 0.01; respectively). A significant correlation was found between GM-CSF BAL fluid level and the percentage and the absolute number of the BAL fluid eosinophils (p = 0.04 and p = 0.03). Neutrophils alveolitis, the presence of eosinophils, and higher concentrations of interleukin-8, G-CSF, and GM-CSF in BAL fluid are associated with the development of fibrosis in sulfur mustard victims.

Granulocyte-CSF links destructive inflammation and comorbidities in obstructive lung disease

“…While there have been no previous interventional studies investigating the role of G-CSF in COPD, there is some evidence to indicate that it can be a pathogenic factor in diverse respiratory conditions such as idiopathic pulmonary fibrosis (52), acute respiratory distress syndrome (53), acute chest syndrome (54), and sulfur-gas-induced fibrosis (55). With respect to COPD, it is well known that neutrophils are plentiful in the COPD lung (1) and their presence implicates G-CSF.…”

Serum levels of GM-CSF 20years after sulfur mustard exposure: Sardasht-Iran Cohort Study

“…A recent study by Emad and Emad reported significant increase in GM-CSF levels in bronchoalveolar (BAL) fluid of patients with SM gas-induced pulmonary fibrosis [22]. The present study included the SM exposed participants on the basis of history of exposure and comprised of the exposed people with normal criteria, mild, moderate or severe form of clinical complications.…”

Alterations in serum levels of inflammatory cytokines (TNF, IL-1alpha, IL-1beta and IL-1Ra) 20years after sulfur mustard exposure: Sardasht-Iran cohort study

“…Basic studies regarding immunological status of long term effect of mustard gas exposure are rare and major questions in this regard remain unanswered [3,4]. Although some recent studies indicating important alterations in immunological parameters including TCD4+, TCD8+, Natural Killer cells, immunoglobulins and cytokines [5][6][7][8][9][10]. Considering the importance of inflammatory cytokines in many delayed complications of skin and lung injuries [11][12][13], this study has focused on the serum concentrations of the most important inflammatory cytokines including TNF, IL-1α, IL-1β and IL-1Ra.…”