Document Detail

Treatment with granulocyte-colony stimulating factor in patients with acute myocardial infarction. Evidence for a stimulation of neovascularization and improvement of myocardial perfusion.
MedLine Citation:
PMID:  17152990     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Stem cell therapy has been suggested to be beneficial in patients after acute myocardial infarction (AMI). Strategies of treatment are either a local application of mononuclear bone marrow cells (BMCs) into the infarct-related artery or a systemic therapy with the granulocyte-stimulating factor (G-CSF) to mobilize BMCs. Nevertheless, the mechanisms responsible for improvement of cardiac function and perfusion are speculative at present. This study has been performed to investigate the effect of G-CSF on systemic levels of vascular growth factors and chemokines responsible for neovascularization, that might help to understand the positive effects of a G-CSF therapy after AMI. METHODS AND RESULTS: Five patients in the treatment group and 5 patients in the control group were enrolled in this study. The patients in the treatment group received 10 microg/kg bodyweight/day of G-CSF subcutaneously for a mean treatment duration of 6.6 +/- 1.1 days. In both groups, levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and monocyte chemotactic protein-1 (MCP-1) were measured on day 2 to 3 and day 5 after AMI. The regional wall perfusion and the ejection fraction (EF) were evaluated before discharge and after 3 months with ECG-gated MIBI-SPECT and radionuclide ventriculography, respectively. Significant higher levels of VEGF (p < 0.01), bFGF (p < 0.05) and MCP-1 (p < 0.05) were found in the treatment group compared to the control group. Levels of VEGF and bFGF remained on a plateau during the G-CSF treatment and decreased significantly in the control group. The wall perfusion improved significantly within the treatment group and between the groups (p < 0.05), respectively. The EF improved significantly within the treatment group (p < 0.05), but the change of the EF between the groups was not significant. CONCLUSION: In patients with AMI, the treatment with G-CSF modulates the formation of vascular growth factors that might improve neovascularization and result in an improved myocardial perfusion and function.
F Kuethe; A Krack; M Fritzenwanger; M Herzau; T Opfermann; K Pachmann; H G Sayer; G S Werner; D Gottschild; H R Figulla
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Die Pharmazie     Volume:  61     ISSN:  0031-7144     ISO Abbreviation:  Pharmazie     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-12-08     Completed Date:  2007-01-12     Revised Date:  2007-01-29    
Medline Journal Info:
Nlm Unique ID:  9800766     Medline TA:  Pharmazie     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  957-61     Citation Subset:  IM    
Friedhelm Küthe, MD, Friedrich-Schiller-Universität Jena, Klinik für Innere Medizin I, Erlanger Allee 101, D-07740 Jena, Germany.
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MeSH Terms
Acute Disease
Chemokine CCL2 / blood
Chemokines / biosynthesis
Coronary Circulation / drug effects*
Enzyme-Linked Immunosorbent Assay
Fibroblast Growth Factor 2 / blood
Granulocyte Colony-Stimulating Factor / pharmacology*
Intercellular Signaling Peptides and Proteins / metabolism
Middle Aged
Myocardial Infarction / drug therapy*,  pathology*,  radionuclide imaging
Neovascularization, Physiologic / drug effects*
Prospective Studies
Radionuclide Ventriculography
Radiopharmaceuticals / diagnostic use
Stroke Volume / physiology
Technetium Tc 99m Sestamibi / diagnostic use
Tomography, Emission-Computed, Single-Photon
Vascular Endothelial Growth Factor A / blood
Reg. No./Substance:
0/Chemokine CCL2; 0/Chemokines; 0/Intercellular Signaling Peptides and Proteins; 0/Radiopharmaceuticals; 0/Vascular Endothelial Growth Factor A; 103107-01-3/Fibroblast Growth Factor 2; 109581-73-9/Technetium Tc 99m Sestamibi; 143011-72-7/Granulocyte Colony-Stimulating Factor

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