Circulating levels of granulocyte macrophage colony-stimulating factor in patients with the systemic inflammatory response syndrome

Objectives. Granulocyte-macrophage colony stimulating factor (GM-CSF) is a key regulator cytokine that modulates the proliferation and maturation of polymorphonuclear and mononuclear progenitors. This study was designed to investigate and clarify the role of GM-CSF in 52 critically ill patients with systemic inflammatory response syndrome (SIRS). Methods. Serum levels of GM-CSF were detected by an immunoenzyme assay. Results. Our results clearly show that the serum concentrations of GM-CSF were significantly elevated in patients with infectious and noninfectious SIRS (33.2 +/- 45.7 pg/ml, controls: 17.2 +/- 9.8 pg/ml; p = 0.0303). In addition, GM-CSF Levels significantly decreased in patients with SIRS, particularly in patients with infectious SIRS, 5 and 7 days later. There was a clear tendency toward higher levels of GM-CSF in patients with poor, as compared with those having a good outcome of the disease. Conclusion. These results show that GM-CSF may play an important rote in patients with infectious and noninfectious SIRS, and that GM-CSF levels progressively and significantly decrease in patients with infectious SIRS. (C) 2003 The British Infection Society. Published by Elsevier Ltd. All rights reserved.