Use of granulocyte colony-stimulating factor in patients with severe sepsis or septic shock

Mohammad, Rima A.

doi:10.2146/ajhp090325

Cited by 16 publications

(9 citation statements)

References 50 publications

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“…Additionally, our findings differed from several trials in which G-CSF administered to patients with severe sepsis showed no clear survival benefit (14–17). A meta-analysis of these trials was recently published verifying a lack of a survival benefit for individuals receiving G-CSF (15).…”

Section: Discussioncontrasting

confidence: 99%

“…Though in prior mouse models of sepsis, treatment with antibiotic with G-CSF and novel antimicrobial peptide LL-37 did increase survival (13). Also, studies in septic patients who received G-CSF supplementation to bolster neutrophil function revealed no demonstrable benefit (14–17). Accordingly, sepsis has proven to be an extremely complex process wherein attempts to block specific signal pathways have proven unsuccessful, likely due to the redundancy inherent to the host immune system.…”

Section: Discussionmentioning

confidence: 99%

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Low-Dose Cyclophosphamide Improves Survival in a Murine Treatment Model of Sepsis

Brown

Bellevue

Shawo

et al. 2015

Shock

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Sepsis is a complex medical condition characterized by a systemic inflammatory response in the setting of infection. We hypothesized that combining antibiotics plus an immunosuppressant would protect against the morbidity and mortality of polymicrobial sepsis in mice better than antibiotics alone. We used a murine cecal ligation and puncture model in which mice were treated either with imipenem plus cyclophosphamide or imipenem alone. Titration to a low cyclophosphamide dose revealed that combination therapy increased survival by 20% compared to imipenem alone (56% v. 36%, p < 0.001). To investigate the mechanism by which combination therapy did this, we reviewed quantitative and qualitative markers of the systemic immune response, end-organ damage, and the local immune response at the site of injury. Cyclophosphamide treatment was not associated with depletion of peripheral leukocytes or differences in pulmonary damage. However, mice that received combination therapy had higher plasma G-CSF levels than those treated with antibiotics alone. Additionally, mice treated with cyclophosphamide had higher levels of bacterial colonization in intestinal Peyer’s patch lymph nodes at 72 hours after the septic insult. Intraperitoneal macrophage phenotypes and phagocytosis activity did not differ between groups. We conclude that the inflammatory response plays a significant role in the mortality of polymicrobial sepsis and that the regulation of this element is both feasible and beneficial in this disease model.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Low-Dose Cyclophosphamide Improves Survival in a Murine Treatment Model of Sepsis

Brown

Bellevue

Shawo

et al. 2015

Shock

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“…[64] Meta-analyses of human studies using granulocyte-colony stimulating factor (G-CSF) and GM-CSF for sepsis have shown no clear-cut benefit in terms of mortality but do demonstrate improved reversal rates from infection. [6566] Further studies looking at G-CSF or GM-CSF therapy based upon monocyte HLA-DR patterns in sepsis are needed. Similarly, studies on IFN-γ in carefully selected patients with low monocytic HLA-DR expression have shown improvement in the deficient HLA-DR expression and cytokine profile of septic patients.…”

Section: Immunomodulating Therapies In Sepsismentioning

confidence: 99%

Sepsis induced immunosuppression: Implications for secondary infections and complications

Sundar

Sires

2013

Indian Journal of Critical Care Medicine

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Sepsis is the commonest cause of admission to medical ICUs across the world. Mortality from sepsis continues to be high. Besides shock and multi-organ dysfunction occurring following the intense inflammatory reaction to sepsis, complications arising from sepsis-related immunoparalysis contribute to the morbidity and mortality from sepsis. This review explores the basis for sepsis related immune dysfunction and discusses its clinical implications for the treating intensivist. Recent trends indicate that a significant proportion of septic patients succumb to the complications of secondary infections and chronic critical care illness from the initial bout of sepsis. Therefore care-givers in the ICU need to be aware of the impediments posed by sepsis-related immune dysfunction that can impair recovery in patients with sepsis and contribute to sepsis-related mortality.

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“…135 However, a recent meta-analysis of the use G-CSF in patients with severe sepsis and septic shock showed no benefit. 136 Whether G-CSF has a special benefit in patients with cirrhosis remains unknown.…”

Section: Granulocyte Colony-stimulating Factormentioning

confidence: 99%

Life-threatening Infections in Medically Immunocompromised Patients

Al‐Dorzi

Khan

Arabi

2013

Critical Care Clinics

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Chronic medical diseases, such as diabetes, chronic obstructive pulmonary disease, chronic kidney disease, cirrhosis, and heart failure, are associated with various immune defects that make affected patients prone to specific infections. This review discusses the epidemiology, pathogenesis, antimicrobial and surgical management, supportive care, and outcome of life-threatening infections associated with common chronic medical diseases.

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Use of granulocyte colony-stimulating factor in patients with severe sepsis or septic shock

Cited by 16 publications

References 50 publications

Low-Dose Cyclophosphamide Improves Survival in a Murine Treatment Model of Sepsis

Low-Dose Cyclophosphamide Improves Survival in a Murine Treatment Model of Sepsis

Sepsis induced immunosuppression: Implications for secondary infections and complications

Life-threatening Infections in Medically Immunocompromised Patients

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