Mobilizing the fountain of youth within

Excerpt

Toyama et al1 describe the favorable outcome of a 14-day course of granulocyte colony-stimulating factor (G-CSF) in patients, mean age 68, with chronic symptomatic ischemic heart disease who were not candidates for revascularization. Patients were randomized to either treatment with 1.5 μg/kg of G-CSF subcutaneously for 14 consecutive days (n = 20) or a saline control (n = 20). Prior to treatment G-CSF patients and controls had stress myocardial scintigraphy (exercise stress in 13 G-CSF and 12 control patients and ATP pharmacologic stress in 7 G-CSF and 8 control subjects). All subjects were assessed with cardiopulmonary exercise tests and Canadian Cardiovascular Society score (categorizing effort related angina). In addition, the investigators measured serial white blood cell (WBC) counts, brain natriuretic peptide (BNP), C-reactive protein (CRP), IL-6, and creatinine. The tests were repeated 3 months post-treatment. The total defect score of the stress perfusion abnormality in the G-CSF-treated group decreased from 20.4 ± 11.2 to 13.6 ± 11.0, while the control group defect score was essentially unchanged 21.7 ± 10.9 to 21.6 ± 10.5. LVEF and anaerobic threshold were unchanged, but peak VO₂ increased slightly in the G-CSF group. This improvement was also reflected by a significant decrease in the Canadian Cardiovascular Society score in the G-CSF group. There were no significant changes in BNP, CRP, or IL-6. As anticipated, the WBC count increased from ~5,000 at baseline to ~20,000 by the fourth day of treatment. There were no adverse events in the treatment or control subjects during the 3-month interval of observation. …