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Novel insights in preventing Gram-negative bacterial infection in cirrhotic patients: review on the effects of GM-CSF in maintaining homeostasis of the immune system

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Abstract

Cirrhotic patients with dysfunctional and/or low numbers of leukocytes are often infected with bacteria, especially Gram-negative bacteria, which is characterized by producing lipopolysaccharide (LPS). Granulocyte–macrophage colony-stimulating factor (GM-CSF) is a pleiotropic cytokine that influences the production, maturation, function, and survival of various immune cells. In this paper, we reviewed not only Toll-like receptors 4 (TLR4) signaling pathway and its immunological effect, but also the specific stimulating function and autocrine performance of GM-CSF on hematopoietic cells, as well as the recent discovery of innate response activator-B cells in protection against microbial sepsis and the direct LPS–TLR4 signaling on hematopoiesis. Thus we concluded that GM-CSF might play important roles in preventing Gram-negative bacterial infections in cirrhotic patients through maintaining immune system functions and homeostasis.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (Grant No. 81270506).

Compliance with ethical requirements and Conflict of interest

This article does not contain any studies with human or animal subjects performed by any of the authors. Dong Xu, Manzhi Zhao, Yuhu Song, Jianxin Song, Yuancheng Huang and Junshuai Wang declare that they have no conflict of interest. There is no professional or other personal interest that could influence the position of authors presented in the manuscript.

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  1. Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Dong Xu, Manzhi Zhao, Jianxin Song & Yuancheng Huang

  2. Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Yuhu Song

  3. Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, China

    Junshuai Wang

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  1. Dong Xu
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Xu, D., Zhao, M., Song, Y. et al. Novel insights in preventing Gram-negative bacterial infection in cirrhotic patients: review on the effects of GM-CSF in maintaining homeostasis of the immune system. Hepatol Int 9, 28–34 (2015). https://doi.org/10.1007/s12072-014-9588-7

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