Effect of granulocyte macrophage colony stimulating factor on treatment of acute osteomyelitis

Abstract

Granulocyte macrophage-colony stimulating factor (GM-CSF) is a cytokine which effects the various developmental steps of hematopoietic cells and enhances the phagocytic activity of these cells. The effect of GM-CSF on acute osteomyelitis, which was developed in rats, was investigated. For this purpose, osteomyelitis was firstly developed through the direct inoculation of Staphylococcus aureus into rat tibial metaphysis. Twenty four 5 in which diagnosis of osteomyelitis was histopathologically established were divided into two groups. Antibiotic only was given to the first group, and antibiotic as well as GM-CSF to the second group. Rats were followed-up for 3 months with plain radiographs, and scintigraphic methods using Ga-67 citrate. Materials obtained from the rats that had been killed at the end of the third month were histopathologically investigated. One rat in the first group died. Chronic ostomyelitis developed and fracture was observed in another rat. In 12 rats of the second group physical examination, plain radiographs and histopathologic findings were normal. In scintigraphic studies with Ga-67 citrate in the second group, there was a decreased uptake. Consequently, in our study GM-CSF did not show a significant effect on the treatment of acute osteomyelitis. We think that GM-CSF may be theoretically helpful in this disease, and more comprehensive and large-scale studies can give more detailed information.

Özet

Granulocyte macrophagecolony stimulating factor (GM-CSF), hematopoietik hücrelere çeşitli kademelerde etki eden ve bu hücrelerin fagositik aktivitelerini artıran bir sitokindir. Bu çalışmada farelerin tibia metafizine stafilokokus aureusun direk inokulasyonu ile oluşturulan akut osteomyelitte GM-CSF nin etkisi araştırıldı. Stafilokokus aureusların, fare tibia metafiine direkt inokulasyonu yoluyla osteomyelit oluşturuldu. Biopsi parçalarında histopatolojik olarak osteomyelit tanısı konulan 24 fare iki eşit gruba ayrıldı. Birinci gruba sadece 3. kuşak Sefalosporin, ikinci gruba ise 3. kuşak Sefalosporin ve GM-CSF tedavisi uygulandı. Fareler, X-ray, Ga-67 Sitrat sintigrafik tetkikleri ile 3 ay takip edildi (takip sırasında birinci grupta 1 fare öldü, 1 farede ise kronik osteomiyelit gelişerek patolojik kırık oluştu). Üçüncü ayın sonunda öldürülen farelerden el-de edilen kemik materyaller histopatolojik incelemeye alındılar. İkinci grupta bulunan 12 farede fizik muayene ve X-ray normal sınırlar içerisinde idi. Ga-67 Sitratla yapılan kantitatif sintigrafik incelemelerde ikinci grupta, birinci gruba göre 48. saatte istatistiksel olarak anlamlı tutulum azlığı görüldü. Sonuç olarak GM-CSF nin, akut osteomyelit tedavisinde yararlı olabileceğini düşünmekteyiz. Bu faktörün daha geniş ve kapsamlı araştırmalar yapılması durumunda daha anlamlı bilgiler vereceği kanaatindeyiz.