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Semin Liver Dis 2021; 41(01): 067-078
DOI: 10.1055/s-0040-1719177
Review Article

Insights into the Role of Granulocyte Colony-Stimulating Factor in Severe Alcoholic Hepatitis

Chandan Kumar Kedarisetty
1   Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
2   Department of Hepatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
,
Anupam Kumar
3   Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
,
Shiv Kumar Sarin
1   Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
3   Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
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Abstract

Alcohol use disorder is the predominant cause of chronic liver disease globally. The standard of care for the treatment of alcoholic hepatitis, corticosteroids, has been shown to provide a therapeutic response in ∼60% of carefully selected patients with a short-term survival benefit. The patients who do not respond to steroids, or are ineligible due to infections or very severe disease, have little options other than liver transplantation. There is, thus, a large unmet need for new therapeutic strategies for this large and sick group of patients. Granulocyte colony stimulating factor (G-CSF) has been shown to favorably modulate the intrahepatic immune milieu and stimulate the regenerative potential of the liver. Initial studies have shown encouraging results with G-CSF in patients with severe alcoholic hepatitis. It has also been found to help steroid nonresponsive patients. There is, however, a need for careful selection of patients, regular dose monitoring and close observation for adverse events of G-CSF. In this review, we analyze the basis of the potential benefits, clinical studies, cautions and challenges in the use of G-CSF in alcoholic hepatitis.

Keywords

G-CSF - liver regeneration - chronic liver disease - fibrosis - liver transplant

Financial Disclosures

None.




Publication History

Article published online:
09 February 2021

© 2021. Thieme. All rights reserved.

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