SERUM LEVELS OF GRANULOCYTE-COLONY-STIMULATING FACTOR (G-CSF) IN BACTERIAL AND VIRAL-INFECTIONS, AND IN ATYPICAL PNEUMONIA

Serum granulocyte-colony stimulating factor (G-CSF) was measured with an ELISA method in patients with acute bacterial and viral infections, or with an atypical pneumonia. Before initiation of antibiotic treatment, G-CSF was found to be significantly increased (799 +/- 1501 ng/l) in sera from 34 patients with an acute bacterial infection compared with the 27 patients with a viral infection (58 +/- 34 ng/l; P < 0.001) and with the eight patients with an atypical pneumonia (60 +/- 33) ng/l; P < 0.001). No significant difference in G-CSF levels was seen between gram-positive and gram-negative bacterial infections. In septic shock, increased G-CSF levels were seen both in patients with leucocytosis and leucopenia. In uncomplicated bacterial infections, both G-CSF and IL-6 were increased on day O, and decreased rapidly after initiation of antibacterial therapy and before the patients became afebrile. In bacterial infections on day O, G-CSF levels correlated with mononuclear cells (r(s) = -0.62, P < 0.001), IL-6 (r(s) = 0.40, P < 0.05) and S-MPO (r(s) = -0.5, P < 0.01). In viral infections, G-CSF was correlated with mononuclear cells (r(s) = 0.41, P < 0.05), white blood cell counts (r(s) = 0.56, P < 0.01), neutrophils (r(s) = 0.41, P < 0.05) and. CRP (r(s) = 0.47, P < 0.05). We conclude that G-CSF is rapidly raised in the blood in acute bacterial infections but not in acute viral infections or in infections with Mycoplasma pneumonia. Our results also support the theory that G-CSF is involved in the mechanisms of mobilization of neutrophils into the peripheral circulation.