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Perioperative Recombinant Human Granulocyte Colony-Stimulating Factor (Filgrastim) Treatment Prevents Immunoinflammatory Dysfunction Associated With Major Surgery

Perioperative Recombinant Human Granulocyte Colony-Stimulating Factor (Filgrastim) Treatment Prevents Immunoinflammatory Dysfunction Associated With Major Surgery

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SCHNEIDER, Christian, Sonja von AULOCK, Siegfried ZEDLER, Christian SCHINKEL, Thomas HARTUNG, Eugen FAIST, 2004. Perioperative Recombinant Human Granulocyte Colony-Stimulating Factor (Filgrastim) Treatment Prevents Immunoinflammatory Dysfunction Associated With Major Surgery. In: Annals of surgery. 239(1), pp. 75-81

@article{Schneider2004Perio-6964, title={Perioperative Recombinant Human Granulocyte Colony-Stimulating Factor (Filgrastim) Treatment Prevents Immunoinflammatory Dysfunction Associated With Major Surgery}, year={2004}, number={1}, volume={239}, journal={Annals of surgery}, pages={75--81}, author={Schneider, Christian and Aulock, Sonja von and Zedler, Siegfried and Schinkel, Christian and Hartung, Thomas and Faist, Eugen} }

Objective: To examine the effects of perioperative rhG-CSF administration on immune function in patients subjected to major surgery.<br /><br />Summary Background Data: Severe trauma, such as major surgery, initiates acute immunodysfunction which predisposes the patient towards infectious complications.<br /><br />Methods: Sixty patients undergoing elective surgery received either recombinant human granulocyte colony-stimulating factor/rh G-CSF (Filgrastim) or a placebo perioperatively. At several time points before and after the surgical intervention immunofunctional parameters were assessed.<br /><br />Results: Leukocyte counts and serum levels of anti-inflammatory mediators (IL-1ra and TNF-R) were increased in Filgrastim-treated patients, while the post-operative acute phase response was attenuated. Monocyte deactivation (reduced TNF-α release and HLA-DR expression) and lymphocyte anergy (impaired mitogenic proliferation and reduced TH1 lymphokine release) were blunted and the incidence and severity of infectious complications were reduced.<br /><br />Conclusions: These results suggest that Filgrastim treatment reinforces innate immunity, enabling better prevention of infection. Thus, this unique combination of hematopoietic, anti-inflammatory and anti-infectious effects on the innate immune system warrants further study of clinical efficacy and sepsis prophylaxis. Zedler, Siegfried Faist, Eugen Aulock, Sonja von Faist, Eugen Schneider, Christian Aulock, Sonja von 2011-03-24T17:30:29Z application/pdf 2011-03-24T17:30:29Z Hartung, Thomas Zedler, Siegfried Schneider, Christian deposit-license Schinkel, Christian First publ. in: Annals of surgery 239 (2004), 1, pp. 75-81 Schinkel, Christian eng Hartung, Thomas Perioperative Recombinant Human Granulocyte Colony-Stimulating Factor (Filgrastim) Treatment Prevents Immunoinflammatory Dysfunction Associated With Major Surgery 2004

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