Chiu Tsung-Lang, Wang Ya-Jung, Chang Tze-Wei, Lin Shinn-Zong, Tsai Sheng-Tzung
Department of Neurosurgery, Hualien Tzu Chi Hospital/Tzu Chi University, Hualien 970, Taiwan.
Brain Sci. 2021 Oct 29;11(11):1441. doi: 10.3390/brainsci11111441.
Chronic traumatic brain injury (TBI) can cause permanent disability and thereby negatively affect patients, families, and society. Currently, there is no effective treatment for patients with chronic TBI. One possible option is granulocyte colony-stimulating factor (G-CSF), which has potential neuroregenerative and neuroprotective effects through its ability to mobilize hematopoietic stem cells and increase neurogenic growth factor levels. Previous studies have shown that G-CSF administration is safe for patients with neurological diseases such as stroke and dementia. The present study aimed to explore the safety and efficacy of G-CSF use in patients with chronic TBI.
38 patients with chronic TBI were administered 3-day rounds of G-CSF (10 μg/kg per day) once a month for 6 months. These patients were clinically evaluated using the modified Rankin scale (mRS) and Karnofsky Performance Score (KPS). Laboratory measures of the leucocyte counts and differential count percentage were also assessed.
At the 6-month follow-up, further assessment showed that patients tolerated the treatment well with only mild and transient side effects being observed. Further clinical evaluation showed significant improvements in mRS and KPS after G-CSF treatment. Laboratory results also confirmed the action of the medication, with increased leukocytosis and band forms.
The results suggest that 6-month chronic G-CSF treatment is safe for patients with chronic TBI and may provide clinical benefits and neurological improvements. The adverse effects of the treatment, however, are transient and usually tolerable. Thus, these preliminary findings suggest that future clinical trials of G-CSF use in patients with chronic TBI are warranted.
慢性创伤性脑损伤（TBI）可导致永久性残疾，从而对患者、家庭和社会产生负面影响。目前，对于慢性TBI患者尚无有效的治疗方法。一种可能的选择是粒细胞集落刺激因子（G-CSF），它通过动员造血干细胞和提高神经源性生长因子水平，具有潜在的神经再生和神经保护作用。先前的研究表明，G-CSF给药对患有中风和痴呆等神经系统疾病的患者是安全的。本研究旨在探讨G-CSF用于慢性TBI患者的安全性和有效性。
38例慢性TBI患者每月接受一次为期3天的G-CSF治疗（每天10μg/kg），共6个月。使用改良Rankin量表（mRS）和卡诺夫斯基功能状态评分（KPS）对这些患者进行临床评估。还评估了白细胞计数和分类计数百分比的实验室指标。
在6个月的随访中，进一步评估显示患者对治疗耐受性良好，仅观察到轻微和短暂的副作用。进一步的临床评估显示，G-CSF治疗后mRS和KPS有显著改善。实验室结果也证实了药物的作用，表现为白细胞增多和杆状核细胞增多。
结果表明，6个月的慢性G-CSF治疗对慢性TBI患者是安全的，可能带来临床益处并改善神经功能。然而，治疗的不良反应是短暂的，通常可以耐受。因此，这些初步发现提示，未来有必要对G-CSF用于慢性TBI患者进行临床试验。
