Enteral granulocyte colony-stimulating factor for the treatment of mild (stage I) necrotizing enterocolitis: a placebo-controlled pilot study

Abstract

Background/Purpose The presence of granulocyte colony-stimulating factor (G-CSF) in human milk and the expression of G-CSF receptors on intestinal villous enterocytes of neonates suggest that G-CSF has a role in the development and integrity of the gastrointestinal tract. We hypothesized that enteral recombinant human G-CSF (rhG-CSF) given to preterm infants with necrotizing enterocolitis (NEC) in the earlier stages could protect against disease progression and complications. Methods Preterm infants with mild (stage I) NEC (n = 18) were assigned to receive enteral rhG-CSF (n = 8) or placebo (n = 10) for 5 days from the first day of the diagnosis. Clinical and gastrointestinal parameters were followed during the whole period of hospitalization. Results In the study group, none of the infants with stage I NEC had a clinical progression to stage II or III, whereas in the control group, 5 (50%) infants with stage I NEC had a disease progression to stage II or III ( P < .05). In the study group, the time required for the resolution of clinical and radiological findings of NEC and the total duration of systemic therapy and hospitalization were significantly shorter than the control group ( P < .001). Conclusion Enteral rhG-CSF treatment could prevent the progression of mild (stage I) NEC to further stages and decrease the time required for the resolution of clinical and radiological signs of the disease.