Heparin binding protein in patients with acute respiratory failure treated with granulocyte colony-stimulating factor (filgrastim) – a prospective, placebo-controlled, double-blind study

BMC Infectious Diseases

Ville Pettila²  Lennart Lindbom⁴  Heiko Herwald¹  Kirsi-Maija Kaukonen³ 

[1]Department of Clinical Sciences, Division of Infection Medicine, Lund University, Lund, Sweden

[2]Department of Clinical Sciences, University of Helsinki, Helsinki, Finland

[3]ANZIC Research Centre, Department of Epidemiology and Preventative Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia

[4]Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden

关键词: Acute respiratory failure;    Critically ill;    Heparin-binding protein;    G-CSF;    Filgrastim;   

Others  :  1158478
DOI  :  10.1186/1471-2334-13-51

 received in 2012-08-28, accepted in 2013-01-28,  发布年份 2013

【 摘 要 】

Background

Heparin Binding Protein (HBP) is released to blood circulation from activated neutrophils in bacterial infections. It is a potential inducer of vascular leakage and precludes the development of septic shock. Filgrastim induces the production of new neutrophils and modulates their bacterial-killing activity. We evaluated the effect of filgrastim on HBP –concentrations in critically ill patients with acute respiratory failure.

Methods

59 critically ill patients with acute respiratory failure were included in this randomised, double-blind, placebo-controlled study of filgrastim 300 micrograms/day or corresponding placebo for 7 days. Plasma samples were drawn on baseline, day 4 and day 7. HBP –concentrations, absolute leukocyte and neutrophil counts were measured.

Results

The median [IQR] HBP concentrations were 23.6 ng/ml [13.9-43.0 ng/ml], 25.1 ng/ml [17.7-35.5 ng/ml] and 15.9 ng/ml [12.6-20.7 ng/ml] in patients receiving filgrastim on baseline, day 4 and day 7, respectively. The HBP concentrations in placebo group were 21.6 ng/ml [16.9-28.7 ng/ml], 13.9 ng/ml [12.0-19.5 ng/ml] and 17.8 ng/ml [13.6-20.9 ng/ml]. At day 4, the filgrastim group had significantly higher HBP –concentrations when compared to placebo group (p < 0.05). No correlation between HBP –concentrations and absolute neutrophil count or P/F –ratios was found.

Conclusions

Filgrastim treatment is associated with increased circulating HBP levels compared to placebo, but the absolute neutrophil count or the degree of oxygenation failure did not correlate with the observed plasma HBP –concentrations.

Trial registration

Clinicaltrials.gov NCT01713309

【 授权许可】

   
2013 Kaukonen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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