Changes in granulocyte colony-stimulating factor concentration in patients with trauma and sepsis

Objective: To better understand the role of granulocyte colony-stimulating factor (G-CSF) after the inflammatory response, Design: Serum G-CSF concentrations were measured serially in 19 trauma and 15 sepsis patients, Changes in G-CSF concentration were compared,vith those in the neutrophil ratio, phagocytic and bactericidal activities, and other cytokines, Measurements and Main Results: G-CSF concentrations in trauma patients were elevated on day 1, but quickly decreased within 7 days, G-CSF reached its maximum 3 hours after injury, parallel with peaks of interleukin-6 (IL-6) and IL-8, but not of tumor necrosis factor-alpha (TNF-alpha). In sepsis patients, G-CSF as well as TNF-alpha, IL-6, and IL-8 concentrations were markedly elevated at diagnosis and remained high during the course of the illness, These levels decreased significantly in the 11 survivors, Up to 3 days after the trauma, nonsegmented neutrophil ratios were higher than those thereafter, Neutrophil phagocytic and bactericidal activities remained normal during the course of disease in both conditions, Conclusions: These results suggest that G-CSF plays an important role in the maturation and maintenance of function of neutrophils during the inflammatory response to trauma and sepsis.