EFFECT OF GRANULOCYTE-MACROPHAGE COLONY-STIMULATING FACTOR ON LEUKOCYTE FUNCTION IN CIRRHOSIS

Background: Cirrhotic patients have been reported to have leukocyte impaired function as well as a high incidence of infectious diseases. Granulocyte-macrophage colony-stimulating factor (GM-CSF) increases the number and function of phagocytic cells, and clinical applications are under study. We tested in vitro effects of GM-CSF on phagocytosis, phagocytic index, and chemotaxis in polymorphonuclear leukocytes from 21 cirrhotic patients (12 with compensated cirrhosis and 9 with spontaneous bacterial peritonitis). Methods: Polymorphonuclear leukocyte functions were tested under basal conditions and after incubation with GM-CSF (10 ng/mL). Phagocytosis was tested against a clinical strain of Candida albicans, and chemotaxis was evaluated using a Boyden chamber. Results were compared with those obtained from 14 healthy donors. Results: Leukocytes from cirrhotics displayed lower basal functional activity than control cells in phagocytosis (P < 0.01) and chemotaxis (P < 0.01). After GMCSF stimulation, the percentage of phagocytic polymorphonuclear leukocytes in noninfected patients increased from 60% ± 2.5% to 69.9% ± 2.42% (P < 0.01), phagocytic index from 0.79 ± 0.07 to 1.02 ± 0.07 (P < 0.001), and chemotaxis from 61.2 ± 12.6 to 82.3 ± 10.2 cells/high power field (P < 0.05). In patients with peritonitis, the phagocytic index increased from 0.87 ± 0.08 to 1.08 ± 0.05 (P < 0.01), phagocytosis from 57.8 ± 3.57 to 64.7 ± 2.34 and chemotaxis from 83.3 ± 17.8 to 110.2 ± 24.1. Conclusions: Our results indicate that a defective leukocyte function is present both in compensated and infected cirrhotic patients. An in vitro improvement was observed after GM-CSF stimulation. © 1992.