Granulocyte-colony stimulating factor in experimental stroke and its effects on infarct size and functional outcome: a systematic review

England, Timothy J.; Gibson, Claire L.; Bath, Philip M.W.

Abstract

Background
Granulocyte-colony stimulating factor (G-CSF) shows promise as a treatment for stroke. This systematic review assesses G-CSF in experimental ischaemic stroke.

Methods
Relevant studies were identified with searches of Medline, Embase and PubMed. Data were extracted on stroke lesion size, neurological outcome and quality, and analysed using Cochrane Review Manager using random effects models; results are expressed as standardised mean difference (SMD) and odds ratio (OR).

Results
Data were included from 19 publications incorporating 666 animals. G-CSF reduced lesion size significantly in transient (SMD -1.63, p<0.00001) but not permanent (SMD -1.56, p=0.11) focal models of ischaemia. Lesion size was reduced at all doses and with treatment commenced within 4 hours of transient ischaemia. Neurological deficit (SMD -1.37, p=0.0004) and limb placement (SMD -1.88, p=0.003) improved with G-CSF; however, locomotor activity (>4 weeks post ischaemia) was not (SMD 0.76, p=0.35). Death (OR 0.27, p<0.0001) was reduced with G-CSF. Median study quality was 4 (range 0-7/8); Egger’s test suggested significant publication bias (p=0.001).

Conclusions
G-CSF significantly reduced lesion size in transient but not permanent models of ischaemic stroke. Motor impairment and death were also reduced. Further studies assessing dose-response, administration time, length of ischaemia and long-term functional recovery are needed.

Citation

England, T. J., Gibson, C. L., & Bath, P. M. (2009). Granulocyte-colony stimulating factor in experimental stroke and its effects on infarct size and functional outcome: a systematic review. Brain Research, 62(1), 71-82. https://doi.org/10.1016/j.brainresrev.2009.09.002

• Journal Article Type: Article
• Acceptance Date: Sep 4, 2009
• Online Publication Date: Sep 12, 2009
• Publication Date: Dec 11, 2009
• Deposit Date: Sep 22, 2009
• Publicly Available Date: Sep 22, 2009
• Journal: Brain Research
• Print ISSN: 0006-8993
• Electronic ISSN: 1872-6240
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 62
• Issue: 1
• Pages: 71-82
• DOI: https://doi.org/10.1016/j.brainresrev.2009.09.002
• Public URL: https://nottingham-repository.worktribe.com/output/705627
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0165017309000848?via%3Dihub
• Contract Date: Sep 22, 2009