Treatment with granulocyte-colony stimulating factor in patients with acute myocardial infarction. Evidence for a stimulation of neovascularization and improvement of myocardial perfusion

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作者
Kuethe, F.
Krack, A.
Fritzenwanger, M.
Herzau, M.
Opfermann, T.
Pachmann, K.
Sayer, H. G.
Werner, G. S.
Gottschild, D.
Figulla, H. R.
机构
[1] Univ Jena, Innere Med Klin 1, D-07740 Jena, Germany
[2] Univ Jena, Klin Innere Med 2, D-07740 Jena, Germany
[3] Univ Jena, Radiol Klin, Abt Nukl Med, D-07740 Jena, Germany
来源
PHARMAZIE | 2006年 / 61卷 / 11期
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中图分类号
R914 [药物化学];
学科分类号
100701 ;
摘要
Background. Stem cell therapy has been suggested to be beneficial in patients after acute myocardial infarction (AMI). Strategies of treatment are either a local application of mononuclear bone marrow cells (BMCs) into the infarct-related artery or a systemic therapy with the granulocyte-stimulating factor (G-CSF) to mobilize BMCs. Nevertheless, the mechanisms responsible for improvement of cardiac function and perfusion are speculative at present. This study has been performed to investigate the effect of G-CSF on systemic levels of vascular growth factors and chemokines responsible for neovascularization, that might help to understand the positive effects of a G-CSF therapy after AMI. Methods and Results: Five patients in the treatment group and 5 patients in the control group were enrolled in this study. The patients in the treatment group received 10 mu g/kg bodyweight/day of G-CSF subcutaneously for a mean treatment duration of 6.6 +/- 1.1 days. In both groups, levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and monocyte chemotactic protein-1 (MCP-1) were measured on day 2 to 3 and day 5 after AMI. The regional wall perfusion and the ejection fraction (EF) were evaluated before discharge and after 3 months with ECG-gated MIBI-SPECT and radionuclide ventriculography, respectively. Significant higher levels of VEGF (p < 0.01), bFGF (p < 0.05) and MCP-1 (p < 0.05) were found in the treatment group compared to the control group. Levels of VEGF and bFGF remained on a plateau during the G-CSF treatment and decreased significantly in the control group. The wall perfusion improved significantly within the treatment group and between the groups (p < 0.05), respectively. The EF improved significantly within the treatment group (p < 0.05), but the change of the EF between the groups was not significant. Conclusion: In patients with AMI, the treatment with G-CSF modulates the formation of vascular growth factors that might improve neovascularization and result in an improved myocardial perfusion and function.
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页码:957 / 961
页数:5
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