Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UNIPROT:P04141 (granulocyte-macrophage colony-stimulating factor)
 6,790 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ganciclovir is effective in halting or delaying the progression of cytomegalovirus (CMV) retinitis in patients with acquired immune deficiency syndrome (AIDS). However, the development of neutropenia necessitates the interruption of ganciclovir therapy in 40-50% of AIDS patients. In an ongoing randomized, controlled trial, AIDS patients with CMV retinitis are receiving standard ganciclovir therapy or ganciclovir plus recombinant human granulocyte-macrophage colony-stimulating factor (rHuGM-CSF). rHuGM-CSF is administered by daily subcutaneous injections and is given in ascending doses based on the neutrophil response in the individual patient. Preliminary data obtained from 36 evaluable patients (21 receiving ganciclovir alone, 15 receiving ganciclovir plus rHuGM-CSF) suggest that rHuGM-CSF administration is associated with a trend toward a decrease in the proportion of patients developing an absolute neutrophil count (ANC) of less than 750 cells/microliter (40% vs. 59%), in the overall incidence of such neutropenic episodes (20 vs. 68), and in the duration of ganciclovir treatment interruption due to the development of an ANC of less than 500 cells/microliter (5.5 days vs. 10.1 days). rHuGM-CSF administration has been generally well tolerated, and no consistent proliferative effect of this agent on human immunodeficiency virus infection has been observed. Definitive conclusions regarding the coadministration of rHuGM-CSF and ganciclovir await completion of the trial.
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PMID:Combined ganciclovir and recombinant human granulocyte-macrophage colony-stimulating factor in the treatment of cytomegalovirus retinitis in AIDS patients. 184 18

Ganciclovir currently is the only agent approved for use in the treatment of cytomegalovirus (CMV) retinitis in immunocompromised patients, including those with the acquired immune deficiency syndrome (AIDS). Its effect against CMV in vitro and in vivo suggests its usefulness in other types of CMV infection as well. Investigations of the use of this agent in the treatment of AIDS patients with CMV gastrointestinal disease and in the treatment or prevention of CMV disease in transplant recipients are ongoing. In other studies, issues important to the management of patients receiving ganciclovir therapy are being addressed. Particular objectives include characterizing the scope of ganciclovir resistance in CMV, detailing the prospects for the tolerance of coadministered ganciclovir and zidovudine, and determining the plausibility of enhancing drug delivery through the concomitant use of recombinant human granulocyte-macrophage colony-stimulating factor and through oral administration of the agent.
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PMID:Future directions in the management of cytomegalovirus infections. 184 23