The Structure Of Human GM CSF Biology Essay

Granulocyte-macrophage colony-stimulating factor is a haematopoietic and inflammatory cytokine, which influences the ripening, distinction and stimulates the functional activity of, eosinophils, monocytes/ macrophages and neutrophils.[ 2 ]In add-on to GM-CSF playing as a pleiotrophic growing factor for haematopoietic cells, it can besides impact the growing of cells of non-hematopoietic beginning ( dendritic antigen-presenting cells, placental trophoblasts, osteoblastic cells and endothelial cells ) .[ 3 ]The synthesis of GM-CSF protein occurs in a assortment of cells such as mast cells, T cells, endothelial cells and macrophages, as a consequence of specific triping signals.

[ 4 ]“ Furthermore, GM-CSF acts as an autocrine- paracrine growing factor for tumour cell lines of different histogenesis, including myeloid leukaemia, glioma, prostate and epithelial neoplastic cells. ”[ 5 ]

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The complementary DNA of human GM-CSF codifications for a protein with 144 aminic acids. However, hGM-CSF is a secreted as a 127 amino acid glycoprotein ( Ala 18 – Glu 144 ) as a consequence of cleavage to the taking 17 aminic acids peptide.

[ 6 ]Human GM-CSF has been shown to hold two N-linked glycosylation sites at N27 & A ; N37 with four possible O-linked glycosylation sites situated in the N-terminal sphere at S5, S7, S9 and T10 ( where amino acid-1 corresponds to the first amino acid of the 127 amino acid protein ) ,[ 7 ]and two disulphide bonds linked between C54-C96 and C88-C121 which determine the third construction of the protein.[ 8 ][ 9 ]The glycosylation of human GM-CSF is the footing for the heterogeneousness of the molecular weight ( 18-32 kDa ) of the protein. The extent of glycosylation of GM-CSF may impact the toxicity, antigenecity and pharmacokinetics.[ 10 ]Examination of the third construction of GM-CSF shows the protein to be an unfastened package of four I±-helices ( named A-D ) with two anti-parallel I?-sheets.

Residues 13-28 represents the A spiral, residues 55-64 the B spiral, residues 74-87 the C spiral and residues 103-116 the D spiral.[ 11 ]The construction of human GM-CSF[ 12 ]As a consequence of word picture of GM-CSF, residues 21-31 and 78-94 have been indicated to be responsible for the biological activity and the binding to its receptors.[ 13 ]Based on site-directed mutagenesis and multiple biological & A ; adhering checks of human GM-CSF, the informations collected showed residue 21 ( Glu-21 ) of GM-CSF is critical to the map of the protein due to its high affinity adhering to its receptor.[ 14 ]

Production of Recombinant GM-CSF

The production of recombinant GM-CSF involves its look in three different systems. Sargramostim is a recombinant human GM-CSF produced in the barm Saccharomyces cerevisiae. Recombinant human GM-CSF produced in barm is marketed by Bayer HealthCare Pharmaceuticals as leukine. The amino acerb sequence sargramostim is indistinguishable to that of endogenous human GM-CSF, with the exclusion that sargramostim contains a leukine amino acid alternatively of proline at place 23.

[ 15 ]Other rhuGM-CSF merchandises are expressed in Escherichia coli ( molgramostim ) or Chinese hamster ovary cells ( regramostim ) , recombinant human GM-CSF mimics the action of endogenous GM-CSF.[ 16 ]

Current Clinical usage of GM-CSF – Neutropenia

Recombinant GM-CSF ( sargramostim ) has made momentous parts in the supportive attention of malignant neoplastic disease patients.[ 17 ]Sargramostim is a myeloid growing factor that is normally used as adjunctive support in patients with neutropenia. Neutropenia is the decrease of neutrophil leukocytes in the blood to a degree below that found in a healthy person.

[ 18 ]Chemotherapy-induced neutropenia is a primary inauspicious consequence of myelosuppressive chemotherapeutic drugs.[ 19 ]It can compromise the efficaciousness of chemotherapy by ensuing in decrease of dosage or holds in intervention, therefore negatively impacting chemotherapy dose strength.[ 20 ]Cytotoxic chemotherapy increases the susceptibleness of serious infections to malignant neoplastic disease patients both by halting the production of neutrophils and by the cytotoxic effects on cells that line the alimental piece of land. Neutrophils are the first line of defense mechanism against infection as the first cellular constituent of the inflammatory response and a cardinal constituent of unconditioned unsusceptibility.[ 21 ]Myeloid growing factors have become an progressively critical constituent of supportive attention to either dainty or prevent neutropenia in malignant neoplastic disease patients traveling through intensive chemotherapy. In the United States, other commercially available myeloid growing factors include peg-filgrastim and filgrastim, which are granulocyte-colony-stimulating factors ( G-CSFs ) . GM-CSF differs from G-CSF in that, in add-on to exciting the production of neutrophils, it besides stimulates other myeloid cells including monocyte/macrophages and dendritic cells, potentially confabulating broader immune-stimulatory belongingss.

Therefore, GM-CSF may offer extra protection against infections compared with the G-CSFs.[ 22 ]

Pharmacokinetic of GM-CSF

For optimum effectivity, day-to-day injection of GM-CSF is administered to patients, due to the short circulating half life. Further development of GM-CSF is required to cut down sum of day-to-day injections which would be good to patients and healthcare suppliers.[ 23 ]The dosage, grade of glycosylation and path of disposal ( endovenous or hypodermic extract ) affects the pharmacokinetics of recombinant GM-CSF.[ 24 ]Leukine is formulated as liquid and lyophilised pulverization.

Liquid Leukine is formulated as a sterile, injectable solution ( 500 mcg/mL ) . While lyophilised Leukine is a unfertile, white free pulverization ( 250 microgram ) that requires reconstitution with 1 milliliters Sterile Water for Injection. Reconstituted lyophilised Leukine and liquid Leukine are clear, colourless liquids suited for either endovenous extract ( IV ) or hypodermic injection ( SC ) . Intravenous disposal of Leukine ( either lyophilized or liquid ) over 2 hours to normal voluntaries, showed the average beta half life was about 1 hr.

Consequences besides showed an immediate peak concentration of GM-CSF in blood samples after Leukine was wholly infused. On the other manus, hypodermic disposal of Leukine to normal voluntaries showed the average beta half life was about 2 hours and 42 proceedingss. At 15 proceedingss GM-CSF was detected in the blood serum. While at 1 to 3 hours after injection, the peak concentration was observed and the sensing of Leukine in the blood lasted up to 6 hours station injection.[ 25 ]Cancer and GM-CSF – Cellular ImmunotherapyChangeless probe in malignant neoplastic disease immunology has generated interventions, which are geared towards the stimulation of the immune system to destruct malignant neoplastic disease cells.

[ 26 ]The function of GM-CSF in exciting autologous immune responses has been investigated in different types of malignant neoplastic disease, such as prostate malignant neoplastic disease, nephritic cell malignant neoplastic disease and melanoma.[ 27 ]GM-CSF has been combined in several ways with malignant neoplastic disease vaccinums, hence moving as a vaccinum adjuvant ; for illustration, GM-CSF has been administered with irradiated autologous or allogeneic melanoma cells and transduced into these cells. The function of GM-CSF in exciting autologous unsusceptibility to malignant neoplastic disease has been studied extensively in prostate malignant neoplastic disease.[ 28 ]Annually, about 27,050 work forces die from metastatic hormone-refractory prostate malignant neoplastic disease ( HRPC ) . Although the survival HRPC is prolonged by chemotherapy with docetaxel, options such as immunotherapy are of great involvement to doctors and patients.

Immunotherapy involves the presentation of one or more tumour antigens to the immune systems of patient ‘s.[ 29 ]The purpose of malignant neoplastic disease immunotherapy is to arouse cellular and/or humoral immune responses against tumour rejection antigens, lending to the riddance of disseminated tumours, and to bring on tumor-specific immunologic memory to avoid disease return.[ 30 ]Cellular immunotherapy is a fresh attack targeted to handle and forestall malignant neoplastic disease, in this case it involves the usage of granulocyte macrophage colony-stimulating factor transduced whole cell immunotherapy.

The principle behind this attack is based on the of whole tumour cells moving as a supply of multiple tumor-associated antigens ( TAAs ) and to work the action of GM-CSF which induces ripening, growing and enlisting of dendritic cells. Dendritic cells, procedure and present antigens to the immunotherapy injection sites,[ 31 ]which so leads to activation of specific T cells ( CD4+ and CD8+ ) .[ 32 ]The GM-CSF secreting malignant neoplastic disease cell immunotherapy is based on the GVAX platform and consists of two prostate malignant neoplastic disease cell line LNCaP and PC-3, derived from lymph node metastasis.

The whole tumour cells are generated by antique vivo GM-CSF cistron transportation, and have shown to arouse potent, tolerance-breaking, durable, tumoricidal immune responses in a scope of ailing immunogenic animate being tumour theoretical accounts.[ 33 ]A clinical survey was carried out on 55 patients with metastatic hormone-refractory prostate malignant neoplastic disease. Each patient was injected intradermally in opposite limbs every two hebdomads for 6 months, with irradiated cells lines ( LNCaP and PC-3 ) to halt farther cell division. The consequences of the clinical survey showed 6 out of the 55 patients had a lessening greater than 25 % in prostate specific antigen, including a decrease greater than 50 % in one patient. The informations collected from this survey supports the anti-tumor activity of GM-CSF and besides allogeneic cellular immunotherapy is tolerated good in patients with metastatic hormone-refractory prostate malignant neoplastic disease.[ 34 ]It is clear that the usage allogeneic cells are good to handle malignant neoplastic disease as it provides entree to a sustained and illimitable supply of tumour associated antigens. The LNCaP and PC-3cell lines are selected on the belief the wide repertory of possible antigens would ensue in the presentation of antigens to the immune system, which would in bend generate T and B-cell immune responses.

Furthermore, the whole cell based scheme avoids the restriction of other schemes such as single-peptide vaccinums, in which metastatic cells are able to get away the immune targeting.[ 35 ]Bettering GM-CSF Delivery – Chitosan SolutionSeveral schemes have been carried out to accomplish sustained local bringing and a decrease in frequent injection of recombinant GM-CSF due to the rapid clearance of the cytokine when administered in a saline vehicle.[ 36 ],[ 37 ]One scheme employed in a peculiar survey evaluated whether chitosan solution would keep co-formulated recombinant GM-CSF at the injection. The principle behind the usage of chitosan solution was due to its high viscousness, therefore recombinant GM-CSF will stay at the site of injection for longer periods, which will take to an addition in the sum of antigen showing cells and dendritic cells and better antigen presentation. Such scheme would beef up the immune response to co-formulated vaccinum. The consequences collected showed that chitosan solutions increased the exposure to recombinant GM-CSF, while prolonging degrees of recombinant GM-CSF at the injection site for up to 9 Days.

In comparing to disposal of saline vehicle, recombinant GM-CSF was undetectable in merely 12-24 hours.[ 38 ]The informations clear indicates that disposal of GM-CSF with chitosan solutions is therapeutically advantageous.


Recombinant GM-CSF has shown a batch of promise as curative protein in a assortment of surveies. Despite the expiration of the stage III GVAX platform clinical tests for prostate malignant neoplastic disease, legion stage I/II tests of GM-CSF in malignant neoplastic disease immunotherapy and as an immunoadjuvant has yielded positive consequences. The anti-tumor activity of GM-CSF shown in several presymptomatic and clinical tests outlines it possible in the intervention and bar of the reoccurrence malignant neoplastic disease in patients. In add-on, to the surveies carried out on possible curative utilizations of GM-CSF, farther surveies into the pharmacokinetic profile will be good to both patients and doctors in the intervention of neutropenia.


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