Recombinant human granulocyte colony-stimulating factor (rhG-CSF) could be an effective adjuvant therapy for orthopedic implant-related infections (OIRI)

Abstract

Bone infections associated with foreign bodies are very difficult to treat satisfactorily. The tissue damage and circulation destruction caused by surgery make the organism susceptible to infection. Meanwhile, the presence of foreign body lowers the threshold of bacterial infection and often generates local immunosuppression. In such cases, antibiotic therapies are usually not efficacious and removing the implant is the only solution for completely eradicating the problem. Recombinant human granulocyte colony-stimulating factor (rhG-CSF) has been in clinical use for about two decades, most commonly adopted for treating of various types of neutropenia. Many studies have also demonstrated that rhG-CSF play important roles in nonneutropenic infections, angiogenic response and tissue repairing. In addition to increasing the number of neutrophils, rhG-CSF helps to enhance the neutrophil microbicidal functions. More importantly, orthopedic implant-related infections (OIRI) are especially good indications for the administration of rhG-CSF in therapeutic regimens. rhG-CSF may also play important roles in the process of postsurgery revascularization and tissue repairing, which would help a lot in treating infections and preventing implant failure. So far, there has been no report of such cases in this field. Therefore, a hypothesis is put forward in the paper that application of rhG-CSF may well be an effective adjuvant therapy for OIRI.