Granulocyte colony-stimulating factor and other cytokines in antifungal therapy

Invasive fungal infections (IFIs) have emerged as a serious threat in immunocompromised patients during the last two decades. Host defenses including appropriate cytokine responses and intact phagocytic function are necessary to combat IFIs. Several cytokines have been investigated and developed for preventive and therapeutic use. Among them, granulocyte colony-stimulating factor (G-CSF) has been mostly studied and used for various purposes, the most important being the faster recovery from neutropenia. Other cytokines with potential clinical significance in relation to IFI are granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-gamma (IFN-gamma) and macrophage colony-stimulating factor. Supported by a large number of preclinical studies but limited clinical results their potential utility against IFI has been suggested. In this review, certain questions related to this issue are discussed based on data already available and an attempt to consider future research is made.