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Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland 20892
We investigated whether decreases in circulating
polymorphonuclear neutrophils (PMN) during lethal Escherichia
coli (E. coli) sepsis in canines are related to
insufficient host granulocyte colony-stimulating factor (G-CSF).
Two-year-old purpose-bred beagles had intraperitoneal E. coli-infected or -noninfected fibrin clots surgically placed. By
10 to 12 h following clot, both infected survivors and
nonsurvivors had marked increases (P = 0.001) in serum
G-CSF levels (mean peak G-CSF ng/ml ± SE, 1,931 ± 364 and 2,779 ± 681, respectively) compared with noninfected controls (134 ± 79), which decreased at 24 to 48 h. Despite increases
in G-CSF, infected clot placement caused delayed (P = 0.06) increases in PMN (mean ± SE change from baseline in
cells × 103/mm3 at 24 and 48 h) in
survivors (+3.9 ± 3.9 and +13.8 ± 3.6) compared with
noninfected controls (+13.1 ± 2.8 and +9.1 ± 2.5).
Furthermore, infected nonsurvivors had decreases in PMN (
1.4 ± 1.0 and
1.1 ± 2.3, P = 0.006 compared with the
other groups). We next investigated whether administration of G-CSF
immediately after clot placement and continued for 96 h to produce
more rapid and prolonged high levels of G-CSF after infection would
alter PMN levels. Although G-CSF caused large increases in PMN compared
with control protein from 2 to 48 h following clot in noninfected
controls, it caused much smaller increases in infected survivors and
decreases in infected nonsurvivors (P = 0.03 for the
ordered effect of G-CSF comparing the three groups). Thus insufficient
host G-CSF is unlikely the cause of decreased circulating PMN in this
canine model of sepsis. Other factors associated with sepsis either
alone or in combination with G-CSF itself may reduce increases or cause
decreases in circulating PMN.
granulocyte colony-stimulating factor; infection
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