European Spine Journal

, Volume 21, Issue 12, pp 2580–2587

Neuroprotective therapy using granulocyte colony-stimulating factor for acute spinal cord injury: a phase I/IIa clinical trial

  • Hiroshi Takahashi
  • Masashi Yamazaki
  • Akihiko Okawa
  • Tsuyoshi Sakuma
  • Kei Kato
  • Mitsuhiro Hashimoto
  • Koichi Hayashi
  • Takeo Furuya
  • Takayuki Fujiyoshi
  • Junko Kawabe
  • Tomonori Yamauchi
  • Chikato Mannoji
  • Tomohiro Miyashita
  • Ryo Kadota
  • Masayuki Hashimoto
  • Yasuo Ito
  • Kazuhisa Takahashi
  • Masao Koda
Original Article

DOI: 10.1007/s00586-012-2213-3

Cite this article as:
Takahashi, H., Yamazaki, M., Okawa, A. et al. Eur Spine J (2012) 21: 2580. doi:10.1007/s00586-012-2213-3

Abstract

Objective

Granulocyte colony-stimulating factor (G-CSF) is a cytokine that is clinically used to treat neutropenia. G-CSF also has non-hematopoietic functions and could potentially be used to treat neuronal injury. To confirm the safety and feasibility of G-CSF administration for acute spinal cord injury (SCI), we have initiated a phase I/IIa clinical trial of neuroprotective therapy using G-CSF.

Methods

The trial included a total of 16 SCI patients within 48 h of onset. In the first step, G-CSF (5 μg/kg/day) was intravenously administered for 5 consecutive days to 5 patients. In the second step, G-CSF (10 μg/kg/day) was similarly administered to 11 patients. We evaluated motor and sensory functions of patients using the American Spinal Cord Injury Association (ASIA) score and ASIA impairment scale (AIS) grade.

Results

In all 16 patients, neurological improvement was obtained after G-CSF administration. AIS grade increased by one step in 9 of 16 patients. A significant increase in ASIA motor scores was detected 1 day after injection (P < 0.01), and both light touch and pin prick scores improved 2 days after injection (P < 0.05) in the 10 μg group. No severe adverse effects were observed after G-CSF injection.

Conclusion

These results indicate that intravenous administration of G-CSF (10 μg/kg/day) for 5 days is essentially safe, and suggest that some neurological recovery may occur in most patients. We suggest that G-CSF administration could be therapeutic for patients with acute SCI.

Keywords

Spinal cord injuryNeuroprotective therapyG-CSFClinical trial

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Hiroshi Takahashi
    • 1
  • Masashi Yamazaki
    • 1
  • Akihiko Okawa
    • 1
  • Tsuyoshi Sakuma
    • 1
  • Kei Kato
    • 1
  • Mitsuhiro Hashimoto
    • 1
  • Koichi Hayashi
    • 1
  • Takeo Furuya
    • 1
  • Takayuki Fujiyoshi
    • 1
  • Junko Kawabe
    • 1
  • Tomonori Yamauchi
    • 1
  • Chikato Mannoji
    • 1
  • Tomohiro Miyashita
    • 1
  • Ryo Kadota
    • 1
  • Masayuki Hashimoto
    • 1
  • Yasuo Ito
    • 2
  • Kazuhisa Takahashi
    • 1
  • Masao Koda
    • 1
  1. 1.Spine Section, Department of Orthopaedic SurgeryChiba University Graduate School of MedicineChibaJapan
  2. 2.Department of Orthopaedic SurgeryKobe Red Cross HospitalKobeJapan