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Relationship of granulocyte colony stimulating factor with other acute phase reactants in man

The non‐specific acute phase response in mice is associated with increased resistance to bacterial infection, which is critically mediated by granulocyte colony stimulating factor (G‐CSF), but the behaviour of G‐CSF in the human acute phase response is not known. Cardiothoracic surgery is a powerful acute phase stimulus and we show here that this procedure caused increased production of G‐CSF, in addition to increases in the circulating concentrations of the proinflammatory cytokine interleukin (IL)‐6 and the acute phase plasma proteins C‐reactive protein (CRP) and serum amyloid A protein (SAA). Values of G‐CSF correlated positively with IL‐6 concentrations and circulating neutrophil counts, but not with CRP values. These results confirm that G‐CSF is a physiological component of the acute phase response in humans that shares some of the same regulatory controls as IL‐6, but its downstream effects are on neutrophils, not hepatic acute phase protein synthesis. Our observations are compatible with a protective role against bacterial infection for G‐CSF in the human acute phase response, and support investigation of the prophylactic use of G‐CSF in at‐risk patients.