Granulocyte Stimulating Factor (G-Csf)

GRANULOCYTE STIMULATING FACTOR (G-CSF)


GRANULOCYTE COLONY-STIMULATING FACTOR

  • Granulocyte-colony stimulating factor (G-CSF or GCSF)/Colony-Stimulating Factor-3 (CSF 3).
    • A glycoprotein that stimulates bone marrow to produce granulocytes and stem cells.
  • Produced by endothelium, macrophages, and other immune cells in response to cytokines.
  • Recombinant G-CSFs include filgrastim, lenograstim, nartograstim & pegfilgrastim.
  • Normally present during pregnancy. 

Actions of G-CSF:

  • White blood cells
    • G-CSF-receptor present on precursor cells of bone marrow.
    • Initiates proliferation & differentiation into mature granulocytes
    • Stimulates survival, proliferation, differentiation and function of neutrophil precursors & mature neutrophils.
  • Hematopoietic system
    • Potent inducer of hematopoietic stem cell mobilization from bone marrow into bloodstream.
  • Neurons
    • Can also act on neuronal cells as neurotrophic factor.

Medical use:

  • Treatment of chemotherapy-induced neutropenia.
    • Also indicated for Kostmann’s syndrome (severe congenital neutropenia).
  • Used before blood donation.
    • Used to increase hematopoietic stem cells quantity in donor blood, before collection by leukapheresis.
    • This is particularly useful during hematopoietic stem cell transplantation.
  • During stem cell transplants
    • Given to receiver during hematopoietic stem cell transplantation, to compensate for conditioning regimens.
  • Fastens wound healing:
    • Systemic injection of G-CSF mobilizes hematopoietic stem cells to wound site and accelerate healing by clearing granulating bed.
  • Acts as reliable biomarker for Early-Late Onset Neonatal Sepsis (EOS).

Exam Important

  • Drug of choice for Neutropenia due to cancer chemotherapy is Filgrastim.
  • G-CSF stimulates production of a wider variety of hematopoietic stem cells.
  • Filgrastim is used in treatment of Neutropenia.
  • Treatment in a child with recurrent severe bacterial infections and diagnosed of having Kostmann’s syndrome is G-CSF.
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