Administration of granulocyte colony stimulating factor after liver transplantation leads to an increased incidence and severity of ischemic biliary lesions in the rat model

AIM： Recently it has been reported that granulocyte colony stimulating factor （G-CSF） can induce hypercoagulability in healthy bone marrow donors. It is conceivable that the induction of a prothrombotic state in a recipient of an organ graft with already impaired perfusion might cause further deterioration in the transplanted organ. This study evaluated whether G-CSF treatment worsens liver perfusion following liver transplantation in the rat model. METHODS： A non-arterialized rat liver transplantation model was employed to evaluate the effect of G-CSF treatment on the liver in a syngeneic and allogeneic strain combination. Study outcomes included survival time and liver damage as investigated by liver enzymes and liver histology. Observation times were 1 d, 1 wk and 12 wk. RESULTS： Rats treated with G-CSF had increased incidence and severity of biliary damage following liver transplantation. In these animals, hepatocellular necrosis was accentuated in the centrilobular region. These lesions are indicative of impaired perfusion in G-CSF treated animals. CONCLUSION： G-CSF should be used with caution in recipients of liver transplantation, as treatment might enhance preexisting, undetected perfusion problems and ultimately lead to ischemia induced biliary complications .

The Role of C-Reactive Protein, Granulocyte Colony Stimulating Factor and Total Antioxidant Capacity in Diagnosis of Acute Appendicitis

Background and Aim: Despite the fact that acute appendicitis is the most common surgical emergency all around the world, its diagnosis is still based on clinical evaluation and accuracy of the diagnosis depending on experience. The aim of this study is to evaluate the role of inflammatory markers in diagnosis of acute appendicitis. Material and Method: The study includes 77 cases with histopathologically proven acute appendicitis and 17 control cases. Blood samples were obtained from all cases and C-reactive protein (CRP), Granulocyte Colony Stimulating Factor (G-CSF) and Total Antioxidant Capacity (TAC) were measured. Findings: In cases with acute appendicitis, CRP and G-CSF levels were found to be related to acute appendicitis;however, TAC was not affected by the disease process. Moreover, CRP and G-CSF levels were correlated with the disease severity. Conclusion: Both CRP and G-CSF can be used in diagnosis of acute appendicitis. Furthermore, increased CRP level can be a marker to show advanced cases. However, G-CSF is not an effective marker to show disease severity.

A pilot study on the combined therapy of granulocyte-macrophage colony-stimulating factor and hepatitis B vaccine on chronic hepatitis B virus carrier children

Objective To observe the efficacy of treating intrauterine infected chronic hepatitis B virus (HBV) carrier children with a combination of granulocyte macrophage colony stimulating factor (GM CSF) or hepatitis B immunoglobulin (HBIG) plus recombinant hepatitis B vaccine (rHBvac) Methods A total of 27 chronic HBV infected children, who were born to HBV carrier mothers and received hepatitis B immunoprophylaxis at birth, were randomized into 2 groups: one receiving a combined therapy of 50 μg of GM CSF plus 10 μg of rHBvac injected intramuscularly at the same location (GM CSF group, 14 children) or 200 IU HBIG and 10 μg rHBvac in different muscles (HBIG group, 13 children) on a monthly four dose schedule HBV DNA quantification and other HBV serological markers were tested before and after the four dose therapy Results Twelve children in each group completed the study Of them, 3 children in the GM CSF group and 4 in the HBIG group had elevated serum alanine transaminase (ALT) before the trial, and then 2 in each group became ALT normal after the treatment Before the therapy, hepatitis B e antigen (HBeAg) positivity was found in nine children in the GM CSF group and 10 in the HBIG group One from each group had an HBeAg/anti HBe seroconversion after the treatment The quantity of HBV DNA was significantly lower after the treatment ( P =0 023) in GM CSF group, but was not significantly reduced in HBIG group No subjects were found to be negative for hepatitis B surface antigen (HBsAg) after the treatment, and no serious adverse events occurred in either group Conclusion Combined GM CSF and rHBvac therapy inhibit HBV replication in carrier children who were not protected after treatment with immunoprophylaxis

Application of recombinant human granulocyte colony stimulating factor in children with acute myeloid leukemia

Objective To evaluate the effect of recombinant human granulocyte colon y stimulating factor (rhGCSF) on accelerating neutrophil recovery and decrease fatal infections for childhood acute myeloid leukemia (AML) Methods From November 1992 to March 1997, 45 patients wer e enrolled into our study and 15 were newly diagnosed All were treated with hi gh dose chemotherapy combined with rhGCSF Results Of 15 newly diagnosed patients, 13 achieved complete remission (CR) after one course of therapy and 2 achieved CR after two courses of therapy For newly diagnosed patients, the durations of absolute neutrophil counts (ANC ) <05109/L were 5 days and 10 days in rhGCSF group and control group res p ectively ( P <005) The incidences of infection of these two groups w ere 40% and 60% respectively ( P <005) As for patients who receive d intensive therapy, the durations of ANC <05109/L were 5 days and 8 days i n rhGCSF group and control group, respectively ( P <005), and the i ncidences of infection were 25% and 444% respectively ( P <005) Conclusions The application of rhGCSF in children with AML after chem otherapy may hasten the hematopoietic recovery The duration of neutropenia wa s shortened by 3-4 days, and the incidence of fatal infection was reduced rhG CSF does not stimulate AML growth in vivo

The relationship between the levels of granulocyte colony stimulating factor and leukocytosis induced by all trans retinoic acid in acute promyelocytic leukemia

Objective To explore the mechanism of leukocytosis Methods Enzyme linked immunosorbent assay (ELISA) method was used for detecting levels of serum granulocyte colony stimulating factor (G CSF) in 47 cases of acute promyelocytic leukemia (APL) during the treatment with all trans retinoic acid (ATRA) Results The peak of increased serum G CSF level occurred on the 9th day, and WBC number was the highest on the 11th day After ATRA treatment, both serum G CSF level and WBC number increased in 68 1% of the cases In 19 2% of the cases treated, serum G CSF level was increased but without obvious change in WBC number, and the reverse was true in 12 7% of the cases Conclusion Serum G CSF level was statistically correlated to the number of WBC, promyelocytes and its late stage by Spearman's rank order correlation coefficient

Efficacy and safety analysis of the combination of cladribine,cytarabine,granulocyte colony stimulating factor( CLAG ) regime in patients with refractory or relapsed acute myeloid leukemia

Objective To analyze efficacy and safety of CLAG regimen in patients with refractory or relapsed acute myeloid leukemia(AML).Methods Efficacy and adverse events of patients with refractory or relapsed AML who were treated with one course of CLAG from April 1st,2014 through December 9th,2015 in our hospital were retrospectively reviewed.Results Thirty-three

G-CSF in Peg-IFN induced neutropenia in liver transplanted patients with HCV recurrence

AIM:To evaluate the efficacy of granulocyte colony stimulating factors(G-CSF)in liver transplanted patients with hepatitis C(HCV)recurrence and Pegylated-IFN α-2b induced neutropenia,and to evaluate the impact of G-CSF administration on virological response. METHODS:Sixty-eight patients undergoing antiviral treatment for post-liver transplantation(OLT)HCV recurrence were enrolled.All patients developing neutropenia received G-CSF. RESULTS:Twenty three(34%)received G-CSF.Mean neutrophil count at the onset of neutropenia was 700/mmc(range 400-750/mmc);after 1 mo of G-CSF it increased to 1210/mmc(range 300-5590/mmc) (P<0.0001).Three patients did not respond to G-CSF. Treatment duration was similar in neutropenic and non-neutropenic patients.No differences in the rate of discontinuation,infections or virological response were observed between the two groups.G-CSF was protective for the onset of de novo autoimmune hepatitis(P<0.003). CONCLUSION:G-CSF administration is effective in the case of Peg-IFN induced neutropenia increasingneutrophil count,prolonging treatment and leading to sustained virological response(SVR)rates comparable to non-neutropenic patients.It prevents the occurrence of de novo autoimmune hepatitis.

Immune Responses of Dendritic Cells Loaded with Antigens from Apoptotic Cholangiocarcinoma Cells Caused by Y-Irradation

Objective To investigate the induction cytotoxic T cells (CTLs) with antitumor activity and therapeutic efficacy after dendritic cells(DCs) acquired antigen from apoptotic cholangiocarcinoma cells caused by y-irradiation.Methods DCs from peripheral blood mononuclear cells (PBMC) that maintain the antigen capturing and processing capacity charateristicof immature cells have been established in vitro, using granulocyte macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4). Then, in cholangiocarcinoma cells apoptosis was induced by J-irradiation. The experimental groups were as follows: (1) coculture ofDCs and apoptotic cancer cells and T cells; (2) coculture of DCs and necrotic cancer cells and T cells; (3) coculture of DCs, culturedcancer cell and T cells. They are cocultured for 7 days. DCs and T cells were riched, isolated and their antitumor response was tested.Results The cells had typical dendritic morphology, expressed high levels of GDI a and B7, acquired antigen from apoptotic cells causedby y-irradiation and induced an increased T cell stimulatory capacity in mixed lymphocyte reactions (MLR) .Conclusion DCs obtained from PBMCs using GM-CSF and IL-4 can efficiently present antigen derived from apoptotic cells caused by y-irradiation and efficiently induce T cells. This strategy, therefore, may present an effective approach to transduce DCs with antigen.

ANTITUMOR EFFECT OF INTRATUMORAL INJECTION OF LIPOSOME-ENCAPSULATED G-CSF GENE AND IN SITU BIOLOGICAL CHARACTERISTICS OF THE TREATED TUMOR CELLS

This word was supported by grant from Military Medical Research Foundation of china (96z032). ** To whom correspondence and requests for reprints should be addressed. This is one of papers of the special issue on gene therapy research (Chin J Cancer Res Vol. 9 No. 4 December, 1997). In order to investigate the antitumor effects of the in vivo G CSF gene therapy mediated by liposome and its mechanisms, human G CSF gene was encapsulated into liposome and was directly injected into tumor mass of C 26 colon adenocarcinoma bearing mice. After direct intratumoral injection of liposome encapsulated G CSF DNA, the subcutaneous tumor growth was dramatically inhibited and the survival time was prolonged signifi cantly. Tumor regression could be observed in about 30% of C 26 bearing mice. By the analysis of the antitumor mechanisms, we found that anti G 418 (600ug/ml) clone could be selected from the tumor cells freshly separated from the treated C 26 tumor mass, and secretion of G CSF in the supernatant could be detected. Northern blot also confirmed the expression of hG CSF by the tumor cells. Higher expressions of MHC class I(H 2k d) molecule and ICAM 1 on the tumor cells could be observed. The results demonstrated that liposome can effectively transfect G CSF gene into tumor cells in situ , and then increase the immunogenicity of the tumor cells which may contribute to the activation of the local antitumor immune responses effectively.

CONSTRUCTION AND EXPRESSION OF THE REPLICATION-DEFI-CIENT ADENONIRUS VECTOR OF HUMAN GM-CSF

The full-length cDNA encoding human Granulocyte macrophage colony stimulating factor (GM CSF) was cloned by RT PCR, placed under the control of CMV promoter, and inserted into adenovirus vector of E1 substitution type, pAx1cw. Subsequently, the cassette cosmid was cotransfected into 293 cells together with EcoT22I digested Ad5 TPC, and the replication deficient recombinant adenoviruses(Ad) of human GM CSF were generated efficiently by homologous recombination, with the titers of 1.51×10 9pfu/ml. 48 hours after infection with prepared human GM CSF recombinant adenoviruses in vitro, HeLa cells and primary human skin fibroblasts expressed high levels of human GM CSF (80～400ng/ 10 6cells/24hr). These suggest that the recombinant Ad of human GM CSF prepared by COS/TPC method is effective in mediating GM CSF gene transfer and might be used in cancer gene therapy.

Expression of CD123 and CD114 on the bone marrow cells of patients with myelodysplastic syndrome

Background Recent studies have shown that interleukin-3 receptor α （CD123） is highly expressed on leukemia stem cells of patients with acute myeloid leukemia, and is correlated with tumor load and poor prognosis.The expression of CD123 may also be high in patients with myelodysplastic syndrome （MDS）.In this study, the expression and clinical significance of CD123 and granulocyte colony stimulating factor （G-CSF） receptor （CD114） on the bone marrow cells of patients with MDS were investigated to explore the molecular marker of the malignant clone of MDS.Methods Forty-two patients with MDS, who were diagnosed in the Hematological Department of General Hospital of Tianjin Medical University from 2008 to 2009, and twelve normal controls were enrolled in this study.Fluorescence activiated cell sorter （FACS） was used to measure the expression of CD123 on CD34＋CD38- cells and CD114 on CD34＋cells of the bone marrow of these patients and controls and the clinical significance was analyzed.The expression of CD114 on CD123＋CD34＋CD38- cells was further measured to explore the molecular marker of the malignant clone in MDS.Results MDS patients displayed significantly higher proportion of CD34＋CD38-/CD34＋ （（14.03±5.27）%） than normal controls （（7.70±4.36）%, P 〈0.05）.The expression rate of CD123＋CD34＋CD38-/CD34＋CD38- was significantly higher in MDS patients （（48.39±28.15）%） than that in normal controls （（8.75±11.71）%, P 〈0.01）.The expression level of CD123 was significantly correlated with the proportion of bone marrow blasts （r=0.457, P 〈0.05）.The expression rate of CD114＋CD34＋/CD34＋ was lower in MDS patients （（33.05±21.71）%） than that in normal controls （（38.99±19.07）%） but was not statistically significant （P 〉0.05）.The expression of CD114 on CD123＋CD34＋CD38- cells （（34.82±29.58）%） was significantly lower than that on CD123-CD34＋CD38- cells （（53.48±27.41）%） of M DS patients （P 〈0.05）.Conclusions MDS patients displayed higher proportion of CD34＋CD38-/CD34＋ than normal controls.CD123 was highly expressed in the bone marrow of the patients with MDS, significantly correlated with the proportion of bone marrow blasts, and thus might be the marker of MDS malignant clone.CD123＋CD34＋CD38- cells exhibited lower expression of G-CSF receptors, which might partly explain why MDS clone responds worse to G-CSF in vitro and in vivo.

CEACAM-1 Induced CSF3-receptor Downregulation in Bone Marrow Associated With Refractory Neutropenia in Advanced Cirrhosis

Background and Aims:Cirrhosis patients exhibit cyto-penia,and,at times refractory neutropenia to granulocyte colony-stimulating factor(G-CSF),which acts through the CSF3-receptor(CSF3R),and changes in CSF3R can affect the response.We conducted this study to assess the CSF3R status and its relevance in cirrhotic patients.Methods:Cirrhotic patients(n=127)and controls(n=26)with clini-cally indicated bone marrow(BM)examination were stud-ied.BM assessment was done by qRT-PCR and immunohis-tochemistry(IHC)for CSF3R.Circulating G-CSF,CSF3R,and carcinoembryonic antigen cell adhesion molecule-1(CEACAM1)were measured.BM hematopoietic precursor cells and their alterations were examined by flow cytom-etry.The findings were validated in liver cirrhosis patients who received G-CSF for severe neutropenia.Results:The mean age was 48.6±13.4 years,and 80.3%were men.Circulatory CSF3R reduction was noted with the advance-ment of cirrhosis,and confirmed by qRT-PCR and IHC in BM.CSF3R decline was related to decreased hematopoietic stem cells(HSCs)and downregulation of CSF3R in the re-maining HSCs.Cocultures confirmed that CEACAM1 led to CSF3R downregulation in BM cells by possible lysosomal degradation.Baseline low peripheral blood-(PB)-CSF3R also predisposed development of infections on follow-up.Decreased CSF3R was also associated with nonresponse to exogenous G-CSF treatment of neutropenia.Conclu-sions:Advanced liver cirrhosis was associated with low CSF3R and high CEACAM1 levels in the BM and circula-tion,making patients prone to infection and inadequate response to exogenous G-CSF.

Characteristics of ovarian cancer cells transduced by the bicistronic retroviral vector containing GM-CSF and HSV-TK genes

Objectives To explore whether HSV-TK (herpes simplex virus thymidine kinase) and GM-CSF (granulocyte-macrophage colony-stimulating factor) genes could be linked by internal ribosome entry site (IRES) in one retroviral vector and expressed by ovarian cancer cells following transfection, and to observe the characteristics of the transduced cells.Methods Retroviral vector pLGM-I-TK was constructed by linking the HSV-TK gene and GM-CSF gene with the IRES sequence. By using the “ping-pong' technique, pLGM-I-TK was transfected into the packaging cell line, PA317, to produce a PA317/TK-GM cell line. Using the resulting viral supernatant to infect the ovarian cancer cell line SKOV3, PCR and RT-PCR were used to explore the integration and transcription of HSV-TK and GM-CSF genes. The cytotoxicity of GCV (gancyclovir) on SKOV3/TK-GM was determined by MTT assay and the bystander effect of the HSV-TK/GCV system was also assessed. ELISA was used to measure the expression of GM-CSF by the transgene cells.Results The bicistronic retroviral vector constructed could be successfully transduced into PA317 and the titer of the retroviral vector was about 8.6×105?cfu/ml. PCR and RT-PCR demonstrated the successful integration and transcription of HSV-TK and GM-CSF genes transduced into the SKOV3 cell. SKOV3/TK-GM cells could be killed by GCV, and the IC50 was 0.7?μg/ml. The bystander effect was demonstrated. The expression level of GM-CSF in SKOV3/TK-GM was 60.4?ng*ml-1*106 cells-1*2 days-1.Conclusion The IRES sequence can be used to construct retroviral vectors to facilitate co-transfection of two genes. SKOV3/TK-GM cells can simultaneously express the HSV-TK and GM-CSF genes with biological activities which could be useful for enhancing the function of immune cells on the basis of suicide gene therapy.