Effects of r-metHuG-CSF on polymorphonuclear leucocyte kinetics and function in patients on continuous ambulatory...

Area of Science:

• Nephrology
• Immunology
• Hematology

Background:

• End-stage renal failure (ESRF) patients on continuous ambulatory peritoneal dialysis (CAPD) are immunocompromised.
• These patients exhibit abnormal polymorphonuclear leucocyte (PMN) function, including reduced phagocytosis and intracellular killing.
• Understanding the impact of therapeutic interventions on PMN function in ESRF is crucial for patient management.

Purpose of the Study:

• To investigate the effects of granulocyte colony-stimulating factor (G-CSF) on PMN function in ESRF patients undergoing CAPD.
• To assess the safety and efficacy of G-CSF in modulating specific PMN functional parameters.

Main Methods:

• Six ESRF patients on CAPD received daily 300 microg G-CSF for 5 days.
• PMN function tests were conducted daily, including assessments of CD11b and L-selectin (CD62L) expression, superoxide anion production, and Fc gamma receptor (Fc gammaRI/CD64, Fc gammaRII/CD16) expression.
• Circulating white cell and PMN counts were monitored.

Main Results:

• G-CSF treatment led to a significant decrease in CD11b expression and L-selectin (CD62L) expression in response to stimulation.
• Superoxide anion production and Fc gammaRI (CD64) expression were significantly increased, while Fc gammaRII (CD16) expression was decreased.
• Circulating white cell and PMN counts were significantly elevated; however, phagocytosis and intracellular killing abnormalities were not corrected.

Conclusions:

• G-CSF influences uraemic PMN function in ESRF patients, with effects comparable to those observed in non-uraemic subjects.
• G-CSF administration did not appear to cause harm to ESRF patients.
• Further research is needed to fully elucidate the therapeutic potential of G-CSF in managing immune dysfunction in ESRF patients.