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C Denzlinger, W Tetzloff, HH Gerhartz, R Pokorny, S Sagebiel, C Haberl and W Wilmanns
Medizinische Klinik III, Ludwig-Maximilians Universitat, Munchen, Germany.
Results from in vitro investigations and recent data obtained in patients
with drug-induced cytopenia or myelodysplasia suggest that leukotrienes may
be involved in mediating some of the actions of granulocyte-macrophage
colony-stimulating factor (GM-CSF). In the present study, the possible role
of leukotrienes was further characterized in 21 healthy individuals to
avoid modification of response to GM-CSF by disease-specific variables. The
effects of two different preparations of human recombinant GM-CSF, ie,
glycosylated GM- CSF as expressed in a Chinese hamster ovary carcinoma
(CHO) cell line and nonglycosylated GM-CSF obtained from Escherichia coli,
were compared. GM-CSF was administered subcutaneously at a single dose of
0.7 nmol/kg body weight. Pharmacokinetic parameters and hematopoietic and
adverse effects were monitored by blood analyses or physical examination,
respectively. Leukotriene generation in vivo was evaluated by determination
of leukotriene E4 and N-acetyl-leukotriene E4 in urine. After the injection
of GM-CSF from E coli, serum concentrations increased and decreased more
rapidly and reached a 2.3-fold higher maximum compared with GM-CSF from
CHO. GM-CSF induced a biphasic change in leukocyte counts that proceeded
considerably faster after the E coli preparation than after GM-CSF from
CHO. The urinary leukotriene concentration increased 1.3- to 14-fold or
2.1- to 44-fold after the administration of GM-CSF from CHO or E coli,
respectively. Urinary leukotriene concentrations correlated significantly
with the maximum of basophil counts and correlated with the occurrence of
some adverse reactions, ie, flu-like symptoms, bone pain, or dyspnoea. Our
data confirm the conception that leukotrienes may play a significant role
in GM-CSF action in vivo. They especially direct attention to the possible
relevance of leukotrienes to untoward effects of GM-CSF treatment.
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