Treatment with granulocyte colony stimulating factor is associated with improvement in endothelial function

Primary objective: Granulocyte-colony stimulating factor (G-CSF) is used for the mobilization of bone marrow and endothelial progenitor cells, though G-CSF-induced inflammation may cause endothelial dysfunction. We examined the effects of G-CSF on endothelium, C-reactive protein (CRP), tumour necrosis factor-alpha (TNF-alpha) and anti-inflammatory cytokines namely interleukin 10 (IL-10). Research design: We studied 60 women with breast cancer, who were randomized to either subcutaneous G-CSF (5mg/kg), o.d. for 5 days after adjuvant chemotherapy (n=40) or placebo (n=20). Experimental interventions: We measured flow-mediated dilatation (FMD%) of the brachial artery by ultrasonography, CRP, TNF-alpha, IL-10 and the ratio TNF-alpha/IL-10 blood levels before, 2-h and 5-days after the G-CSF or placebo treatment. Main outcomes and results: There was a greater increase of FMD, IL-10 and reduction of TNF-alpha/IL-10, 2 h and 5 days after the G-CSF treatment compared to placebo. Although, CRP and TNF-alpha were higher, TNF-alpha/IL-10 was lower at the end of G-CSF treatment compared to placebo. Improvement of FMD was related to changes of IL-10 and TNF-alpha/IL-10. Conclusions: Treatment with G-CSF improves endothelial function in vivo, possibly by shifting the balance between the pro- and anti-inflammatory cytokines.