Drossou-Agakidou V, Kanakoudi-Tsakalidou F, Sarafidis K, Taparkou A, Tzimouli V, Tsandali H, Kremenopoulos G
Department of Neonatology, Aristotle University of Thessaloniki, Greece.
Eur J Pediatr. 1998 Jul;157(7):583-8. doi: 10.1007/s004310050884.
The objective of this study was to investigate the effect of treatment with recombinant human granulocyte-colony stimulating factor (rhG-CSF) on the neutrophil count and function of preterm neonates with documented sepsis. For this purpose 62 preterm neonates with proven sepsis and 19 healthy preterm ones were studied. Of the 62 patients, 27 septic neonates had an absolute neutrophil count (ANC) > 5000/mm3 (group A) and were scheduled not to receive rhG-CSF and 35/62 had an ANC < 5000/mm3 (n=35) and were randomly assigned either to receive rhG-CSF (group B) or not to receive it (group C). rhG-CSF (10 microg/kg) was administered for 3 consecutive days (0, 1, 2). The ANC, plasma levels of G-CSF (ELISA), neutrophil respiratory burst activity (NRBA) and neutrophil expression of CD11a, CD11b and CD11c (flow cytometry) were measured in all septic neonates on days 0 (onset of sepsis), 1, 3 and 5 and in the healthy neonates once within the first 2 days of life. We found that on day 0, G-CSF levels of all groups of septic neonates were significantly higher than those of the healthy ones. The highest levels were observed in group A. NRBA was diminished only in groups B and C and the expression of CD11a and CD11c was reduced in all groups of septic neonates. Administration of rhG-CSF resulted in a rapid and significant increase in ANC, NRBA and CD11a, CD11b and CD11c expression that persisted throughout the follow up. CONCLUSION; The administration of granulocyte colony stimulating factor to septic neonates significantly increases the absolute granulocyte count and enhances the neutrophil respiratory burst and beta2 integrin expression.
本研究的目的是探讨重组人粒细胞集落刺激因子（rhG-CSF）治疗对确诊败血症的早产儿中性粒细胞计数及功能的影响。为此，对62例确诊败血症的早产儿和19例健康早产儿进行了研究。在62例患者中，27例败血症新生儿的绝对中性粒细胞计数（ANC）>5000/mm3（A组），计划不接受rhG-CSF治疗；35/62例ANC<5000/mm3（n = 35），随机分为接受rhG-CSF治疗组（B组）或不接受治疗组（C组）。rhG-CSF（10μg/kg）连续给药3天（第0、1、2天）。在所有败血症新生儿的第0天（败血症发作时）、第1、3和5天以及健康新生儿出生后2天内测量一次ANC、血浆G-CSF水平（酶联免疫吸附测定）、中性粒细胞呼吸爆发活性（NRBA）以及中性粒细胞CD11a、CD11b和CD11c的表达（流式细胞术）。我们发现，在第0天，所有败血症新生儿组的G-CSF水平均显著高于健康新生儿组。A组观察到的水平最高。仅B组和C组的NRBA降低，所有败血症新生儿组的CD11a和CD11c表达均降低。rhG-CSF给药导致ANC、NRBA以及CD11a、CD11b和CD11c表达迅速且显著增加，并在整个随访过程中持续存在。结论：对败血症新生儿给予粒细胞集落刺激因子可显著增加绝对粒细胞计数，并增强中性粒细胞呼吸爆发及β2整合素表达。
