Wakiyama H, Tsuru S, Hata N, Shinomiya M, Shinomiya N, Noritake M, Umezawa Y, Rokutanda M
Department of Microbiology, National Defense Medical College, Saitama, Japan.
Clin Exp Immunol. 1993 May;92(2):218-24. doi: 10.1111/j.1365-2249.1993.tb03383.x.
Effects of recombinant human granulocyte colony-stimulating factor (rhG-CSF) against severe infections in cyclophosphamide (CY)-induced neutropenic mice were investigated by its single use or by its combination with cephem antibiotics. Treatment with rhG-CSF increased the number of peripheral blood leucocytes and strikingly shortened the duration of the neutropenic state. Most of the regained population in the peripheral blood leucocytes were neutrophils. Functions of neutrophils, such as phagocytic activity, superoxide release, and expression of Mac-1 molecules, were remarkably enhanced by administration of rhG-CSF. When rhG-CSF was administered to CY-induced neutropenic mice before infection, protective effects against various kinds of bacteria were remarkable. On the other hand, such remarkable effects were not observed when rhG-CSF was administered after infections. However, even in the case of post-infectious treatment, a combination therapy of rhG-CSF with cephem antibiotics, particularly with Cefodizime (CDZM), showed a significant improvement in the survival rate and a decrease in the number of viable bacteria in the liver. These results suggest that a combination therapy of rhG-CSF with cephem antibiotics, especially with CDZM, is an efficient regime against severe infections in patients with neutropenia induced by a heavy anti-tumour chemotherapy.
通过单独使用重组人粒细胞集落刺激因子(rhG-CSF)或其与头孢菌素类抗生素联合使用,研究其对环磷酰胺(CY)诱导的中性粒细胞减少小鼠严重感染的影响。rhG-CSF治疗可增加外周血白细胞数量,并显著缩短中性粒细胞减少状态的持续时间。外周血白细胞中恢复的细胞群体大多为中性粒细胞。给予rhG-CSF可显著增强中性粒细胞的功能,如吞噬活性、超氧化物释放和Mac-1分子的表达。在感染前给CY诱导的中性粒细胞减少小鼠施用rhG-CSF时,对各种细菌的保护作用显著。另一方面,在感染后施用rhG-CSF时未观察到这种显著效果。然而,即使在感染后治疗的情况下,rhG-CSF与头孢菌素类抗生素,特别是与头孢地嗪(CDZM)的联合治疗,也显示出存活率显著提高,肝脏中活菌数量减少。这些结果表明,rhG-CSF与头孢菌素类抗生素,尤其是与CDZM的联合治疗,是治疗重度抗肿瘤化疗诱导的中性粒细胞减少患者严重感染的有效方案。