Granulocyte colony-simulating factor and neutrophil-related changes in local host defense during recovery from shock and intra-abdominal sepsis

Background. We have reported that treatment with exogenous granulocyte colony-stimulating factor (G- CSF) improves abscess localization and reduces mortality without aggravating neutrophil (PMN)-mediated reperfusion injury in a model of septic abdominal trauma. The purpose of this study was to determine actions of G-CSF on PMN function in the peritoneum. Methods. Anesthetized swine were pretreated with broad-spectrum antibiotics and underwent cecal ligation We have reported that treatment with exogenous and incision and 35 % hemorrhage (trauma). After 1 hour thy were resuscitated with shed blood, crystalloid, and either G-CSF (n = 10) or saline solution vehicle (n - 9). The animals were observed for 72 hours. Results. After trauma, saline solution treatment increased PMN infiltration into the peritoneum within 2 hours (P = .035), increased peritoneal PMN elastase production (ie, cytotoxicity) by 24 hours (P = .004), and decreased adherence of peritoneal pMNs to an artificial substrate from 4 to 72 hrs (P = .043). The mean autopsy score was 7.0 +/- 0.5. With G-CSF treatment peritoneal neutrophilia was enhanced (maximum 48 hours, P = .002) and PMN cytotoxicity was augmented and delayed (maximum 48 hours, P = .004). Despite these changes, adherence of peritoneal PMNs was not significantly changed and there was no evidence for PMV-mediated damage in the lung as judged by bronchoalveolar lavage protein, bronchoalveolar lavage PMNs, lung tissue myeloperoxidase, or histologic changes. The mean autopsy score was improved to 4. 1 +/- 0.3 (P < .001). Conclusions. G-CSF in resuscitation fluids improved localization of an intra-abdominal septic focus by increased production of circulating PMNs, increased PMN extravasation into the peritoneal cavity, and increased PMN cytotoxicity at the abdominal septic focus, without exaggerating PMN-dependent reperfusion injury in the lung. Therefore these data further support the idea that G-CSF in resuscitation fluids might reduce septic complications in the multiply injured trauma patient.