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The effects of granulocyte-colony stimulating factor on chronic liver disease: a meta-analysis
Pei Shi1, Jianguo Zhang2, Min Wu3
1Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, Nanchang, China. cherishild@163.com.
Insights
Granulocyte-colony stimulating factor (G-CSF) improves long-term survival and reduces disease severity in chronic liver disease patients. G-CSF demonstrates relative safety, suggesting its potential as a therapeutic option.
Area of Science:
- Hepatology
- Immunology
- Clinical Medicine
Background:
- The efficacy of granulocyte-colony stimulating factor (G-CSF) in treating chronic liver disease remains debated.
- This study systematically evaluates the impact of G-CSF on patients with chronic liver conditions.
Purpose of the Study:
- To assess the effects of granulocyte-colony stimulating factor (G-CSF) on survival rates and disease markers in chronic liver disease.
- To determine the safety profile of G-CSF in this patient population.
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed, Embase, Cochrane Library, CBM).
- Randomized-controlled trials investigating the efficacy of G-CSF for chronic liver disease were included in the meta-analysis.
Main Results:
- G-CSF significantly increased both long-term (RR 1.54) and short-term survival (RR 1.44).
- It notably reduced the Child-Turcotte-Pugh score (MD=-0.97) but did not significantly lower mortality from multiple organ failure, gastrointestinal bleeding, or sepsis.
- No severe adverse events were reported during the trials.
Conclusions:
- Granulocyte-colony stimulating factor (G-CSF) shows significant promise for improving 12-month survival and reducing disease severity in chronic liver disease.
- G-CSF appears to be a relatively safe therapeutic agent.
- Further clinical trials with established guidelines are recommended to solidify G-CSF's role in managing chronic liver disease.
Introduction:
The clinical application of granulocyte-colony stimulating factor on chronic liver disease is still controversial. The study aimed to evaluate the effects of granulocyte-colony stimulating factor on chronic liver disease.
Methodology:
A systematic literature search was performed in PubMed, Embase, Cochrane Library and Chinese Biomedical Literature database. Randomized-controlled trials assessing the efficacy of granulocyte-colony stimulating factor were selected.
Results:
Granulocyte-colony stimulating factor was associated with an increasing long-term survival (RR 1.54; 95% CI 1.22 to 1.94; p = 0.0003; heterogeneity: Q = 0.26, I2 = 25%) and an increasing short-term survival (RR 1.44; 95% CI 1.16 to 1.78; p = 0.0009; heterogeneity: Q < 0.00001, I2 = 80%). Granulocyte-colony stimulating factor failed to lower mortality secondary to multiple organ failure (RR 0.65; 95% CI 0.34 to 1.21; p = 0.17; heterogeneity: Q = 0.45; I2 = 0%), gastrointestinal bleeding mortality (RR 0.97; 95% CI 0.61 to 1.56; p = 0.91; heterogeneity: Q = 0.35; I2 = 11%) and sepsis mortality (RR 0.27; 95% CI 0.06 to 1.12; p = 0.07; heterogeneity: Q < 0.00001; I2 = 90%). It significantly lowered the Child-Turcotte-Pugh (MD=-0.97, 95% CI -1.48 to -0.45; p = 0.0003; heterogeneity: Q = 0.25; I2 = 28%). No serious adverse events were observed.
Conclusions:
Granulocyte-colony stimulating factor resulted in significantly improved 12-month survival and reduced Child-Turcotte-Pugh score with relative safety. Establishment of guidelines and protocols in future clinical trials will promote granulocyte-colony stimulating factor as an effective and safe therapy for chronic liver disease.
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