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 with 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.