Beneficial effect of recombinant human granulocyte colony-stimulating factor on fungicidal activity of polymorphonuclear leukocytes from patients with AIDS

The effect of recombinant human granulocyte colony-stimulating factor (rhG-CSF) adminis-tration on the functional status of polymorphonuclear leukocytes (PMNL) in neutropenic AIDS patients was investigated. PMNL destructive activity against Candida albicans or encapsulated or acapsular Cryptococcus neoformanswas significantly impaired with respect to control subjects before rhG-CSF treatment. After subcutaneous administration ofrhG-CSF (5 ~g/kg), neutrophil counts increased 3- to Ll-fold in 24 h and returned to baseline within 96 h. PMNL fungicidal activity showed significant enhancement 48-72 h after rhG-CSF administration that decreased to baseline within 96 h. Enhanced rhG-CSF-mediated destructive activity strictly correlated with augmented superoxide anion production by PMNL. These findings suggest that therapeutic use of rhG-CSF at appropriate schedules in neutropenic AIDS patients could decrease the risk of infection or, in association with antibiotic therapy, more rapidly resolve the occurring infections. The main feature of AIDS is the dramatic decrease in cell-mediated immunity ascribed to a severe depletion of CD4 cells [1,2]. In this condition, susceptibility to many opportu-nistic infections by T cell-mediated mechanisms increases