Background: Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare pulmonary disease caused by functional deficiency of granulocyte-macrophage colony-stimulating factor (GM-CSF). GM-CSF therapy in aPAP has been reported effective in some studies. This meta-analyses aimed to evaluate whether GM-CSF therapy, including inhaled and subcutaneous GM-CSF have therapeutic effect in aPAP patients. Methods: We analyzed 10 studies searched from PubMed, EmBase, Web of Science, Wiley Online Library and Cochrane Collaboration databases to evaluate the pooled effects of GM-CSF treatment in aPAP patients. Results: Ten observational studies involving 115 aPAP patients were included. The pooled analyses of response rate (81%, p < 0.001), relapse rate (22%, p = 0.009), PaO2 (13.76 mmHg, p < 0.001) and P(A-a)O-2 (19.44 mmHg, p < 0.001) showed that GM-CSF treatment was effective on aPAP patients. Further analyses showed that inhaled GM-CSF treatment was more effective than subcutaneous GM-CSF therapy, including a higher response rate (89% vs. 71%, p = 0.023), more improvements in PaO2 (21.02 mmHg vs. 8.28 mmHg, p < 0.001) and P(A-a) O-2 (19.63 mmHg vs. 9. 15 mmHg, p < 0.001). Conclusions: As two routes of exogenous GM-CSF treatment, inhaled and subcutaneous were both proven to have effect on aPAP patients. Furthermore, inhaled GM-CSF therapy showed a higher response rate, more improvements on PaO2 and P(A-a) O-2 than subcutaneous GM-CSF treatment in aPAP patients, suggesting inhaled GM-CSF therapy could have more benefits on aPAP patients. Therefore, GM-CSF therapy, especially inhaled GM-CSF, might be a promising therapeutic option in treating aPAP.
第一作者单位：[1]Huazhong Univ Sci & Technol, Tongji Hosp, Dept Resp & Crit Care Med, Tongji Med Coll, 1095 Jie Fang Rd, Wuhan 430030, Hubei, Peoples R China
通讯作者：
推荐引用方式(GB/T 7714)：
Sheng Gaohong,Chen Peng,Wei Yanqiu,et al.Better approach for autoimmune pulmonary alveolar proteinosis treatment: inhaled or subcutaneous granulocyte-macrophage colony-stimulating factor: a meta-analyses[J].RESPIRATORY RESEARCH.2018,19:doi:10.1186/s12931-018-0862-4.
APA：
Sheng, Gaohong,Chen, Peng,Wei, Yanqiu,Chu, Jiaojiao,Cao, Xiaolei&Zhang, Hui-Lan.(2018).Better approach for autoimmune pulmonary alveolar proteinosis treatment: inhaled or subcutaneous granulocyte-macrophage colony-stimulating factor: a meta-analyses.RESPIRATORY RESEARCH,19,
MLA：
Sheng, Gaohong,et al."Better approach for autoimmune pulmonary alveolar proteinosis treatment: inhaled or subcutaneous granulocyte-macrophage colony-stimulating factor: a meta-analyses".RESPIRATORY RESEARCH 19.(2018)
