Abstract

The administration of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) causes a transient leucopenia. Radionuclide labelling studies showed this to be due to margination of neutrophils and monocytes predominantly in the pulmonary vasculature. No evidence of complement activation was found. A rapid in-vivo rise in neutrophil cellular adhesion molecule (CAM) expression was observed paralleling the development of the neutropenia. Neutrophils exposed to rhGM-CSF in-vitro showed similar rapid increases in CAM expression. The adherence of chromium-labelled neutrophils to endothelial cell cultures was modestly but highly significantly increased by rhGM-CSF, an effect that was reduced by the binding of a monoclonal antibody to the beta chain of neutrophil CAM. The margination of phagocytic cells induced by rhGM-CSF administration is therefore likely to be due at least in part to increased expression of adhesion promoting glycoproteins. The demargination, however, occurred at a time when neutrophil CAM expression was still high, suggesting that dissociation of the neutrophil-endothelial cell interaction depends on factors other than downregulation of CAM expression. In-vivo modulation of phagocyte CAMS and adhesive properties by GM-CSF may be of importance in the normal inflammatory response.

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