ABSTRACT
GM-CSF Therapy Granulocyte-macrophage colony-stimulating factor (GM-CSF) has been studied as a means of correcting bum-induced impairment of cellular immunity. GM-CSF prolongs the life-span of neutrophils and macrophages; enhances the expression of cell surface HLA class II, CDllb, and CRl and CR3 receptors; and increases the PMN responsiveness to chemotactic agents. The agent, in addition, augments PMN phagocytic and bactericidal activities. Compared to controls, GM-CSF pretreatment improved survival and diminished bacterial translocation to the mesenteric nodes, spleen, and liver of burned mice subjected to blood transfusion and cecal ligation and puncture (69). These findings suggested that intact neutrophil and macrophage function were necessary to combat infection; however, the clinical relevance for these findings in critically ill patients is not clear. In addition, further activation of neutrophils prestimulated by bum injury could be detrimental to circulation-rich organs such as the lung, where PMN sequestration is thought to contribute to the development of adult respiratory distress syndrome.
