Effect of Granulocyte Colony-Stimulating Factor Treatment at a Low Dose but Long Duration in Patients with Coronary Heart Disease

在动物模型中，粒细胞集落刺激因子（G-CSF）可改善梗死后心功能。然而，在对心绞痛和急性心肌梗死（AMI）患者的初步研究中，高剂量的G-CSF经常引起冠状动脉闭塞或再狭窄，但低剂量的G-CSF没有显示出显著的有益作用。我们假设，一个低剂量，但持续时间长的G-CSF将有一个有益的效果，没有严重的并发症，患者顽固性心绞痛。方法和结果22例心绞痛患者随机分为G-CSF和非G-CSF对照组，分别。皮下注射重组G-CSF，每天一次，持续10天。外周血中的白细胞计数控制在约30，000/□l。一个月后，G-CSF治疗组患者的胸痛有所改善。T1 -201单光子发射计算机断层扫描（SPECT）显示G-CSF治疗组的%摄取增加，范围和严重程度评分降低。治疗前外周血CD_（34）阳性细胞数为0.6个/μl，治疗后增至3.9个/μl。

BackgroundIn animal models, granulocyte colony-stimulating factor (G-CSF) improves post-infarct cardiac function. However, in pilot studies of the patients with angina and acute myocardial infarction (AMI), G-CSF at a high dose frequently induced coronary occlusion or restenosis, but those at a low dose showed no significant beneficial effect. We hypothesized that a low dose but long duration of G-CSF will have a beneficial effect without serious complications to patients with intractable angina pectoris.Methods and Results22 patients with angina were randomly assigned into G-CSF and non-G-CSF control groups, respectively. Recombinant G-CSF was subcutaneously injected once a day for 10 days. The leukocyte counts in the peripheral blood were controlled at approximately 30,000/□l. One month later, chest pain in the patients improved in the G-CSF-treated group. Tl-201 single photon emission computed tomography (SPECT) revealed the increased %uptake and the reduced extent and severity scores in the G-CSF-treated group. The number of CD34 positive cells in the peripheral blood was 0.6/μl before treatment and increased to 3.9/μl after the therapy.ConclusionsA low dose but long duration of G-CSF treatment may have a beneficial effect without any serious complications in patients with angina pectoris.