Neuroprotective Therapy Using Granulocyte Colony-Stimulating Factor for Patients With Worsening Symptoms of Thoracic Myelopathy

作者：Sakuma Tsuyoshi; Yamazaki Masashi^*; Okawa Akihiko; Takahashi Hiroshi; Kato Kei; Hashimoto Mitsuhiro; Hayashi Koichi; Furuya Takeo; Fujiyoshi Takayuki; Kawabe Junko; Mannoji Chikato; Miyashita Tomohiro; Kadota Ryo; Someya Yukio; Ikeda Osamu; Yamauchi Tomonori; Hashimoto Masayuki; Aizawa Toshimi; Ono Atsushi; Imagama Shiro; Kanemura Tokumi; Hanaoka Hideki; Takahashi Kazuhisa; Koda Masao

来源：Spine, 2012, 37(17): 1475-1478.

DOI：10.1097/BRS.0b013e318260cc71

• neuroprotective therapy
• granulocyte colony-stimulating factor
• thoracic myelopathy
• clinical trial

Study Design. An open-labeled multicenter prospective controlled clinical trial. %26lt;br%26gt;Objective. To confirm the feasibility of granulocyte colony-stimulating factor (G-CSF) administration for patients with thoracic myelopathy. %26lt;br%26gt;Summary of Background Data. Although G-CSF is best known as an important cytokine commonly used to treat neutropenia, it also has nonhematopoietic functions. Previous experimental studies have shown that G-CSF can enhance tissue regeneration of several organs, such as the heart and the brain. We previously reported that G-CSF promotes functional recovery after spinal cord injury in rodents. On the basis of those findings, we started a clinical trial of neuroprotective therapy, using G-CSF for patients with worsening symptoms of thoracic myelopathy. %26lt;br%26gt;Methods. Patients whose Japanese Orthopaedic Association (JOA) score for thoracic myelopathy had decreased 2 points or more during a recent 1-month period were eligible for entry. After giving informed consent, patients were assigned to G-CSF and control groups. The G-CSF group (n = 10) received G-CSF 10 mu g/kg per day intravenously for 5 consecutive days. The control group (n = 14) received similar treatments as the G-CSF group except for G-CSF administration. The primary outcome was JOA recovery rate at 1 month after G-CSF administration or initial treatment. %26lt;br%26gt;Results. There was greater improvement in neurological functioning between baseline and 1-month follow-up in the G-CSF group (JOA recovery rate: 29.1 +/- 20.5%) than in the control group (JOA recovery rate: 1.1 +/- 4.2%) (P %26lt; 0.01). No serious adverse events occurred during or after the G-CSF administration. %26lt;br%26gt;Conclusion. The results provide evidence that G-CSF administration caused neurological recovery in patients with worsening symptoms of thoracic compression myelopathy.

• 出版日期2012-8-1