Differential alterations in plasma colony-stimulating factor concentrations in meningococcaemia

Abstract

SUMMARY: To determine whether circulating levels of any of the cotony-stimulating factors (CSF) might contribute to the host response in severe sepsis, plasma concentrations of granulocyte CSF (GCSF), granulocyte-macrophage CSF (GM-CSF), and macrophage CSF (M-CSF), were measured by immunoassays in 20 subjects with meningococcaemia, a bloodstream infection caused by Neisseria meningitidis, that has proven to be a valuable model to study the responses of other inflammatory mediators during sepsis and septic shock in humans. Plasma G-CSF concentrations were transiently elevated in most subjects during the early phase of meningococcaemia, and were higher in subjects with septic shock (mean ± s.d. = 165± 142 ng/ml, n = 9) compared with those who remained normotensive (mean ± s.d.=7±2ng/ml, ng/ml, n=10) (p10ng/ml were associated with the development of septic shock (P<0.01), disseminated intravascular coagulation (p<0.01). fulminant infection (P<0.05), and a fatal outcome (p 1 ng/ml were briefly present in subjects with life-threatening septic shock (1–15 ng/ml, n = 5). and were strongly associated with fulminant meningococcaemia (P <0.01). Plasma M-CSF concentrations were marginally elevated in all subjects, but were not associated with complications related to or arising from sepsis-induced organ injury. This study demonstrates that plasma levels of G-CSF, GM-CSF and M-CSF show very different responses during meningococcaemia, changes which presumably reflect the different roles played by these mediators in sepsis and, potentially, in septic shock.