Getting Past Anarcho-Party-lines

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Written by Nick Ford
Originally written: 8/3/11
Revised: 8/3 and 8/4/11

Anarchist Black Flag

I figured I’d do one more follow up article to my Across Anarcho-Party-lines. I’d like to clarify some of my positions that weren’t addressed properly and bring more light on why the division among anarchists is a real problem. To expand on the notion of it being a problem I think it tends to lead to people breaking possibly meaningful alliances via a self-fulfilling prophecy of sorts. I’ll discuss some possible barriers to getting past the anarcho-party-lines as well as combining epistemological anarchism and anarchism without adjectives as one way of getting past those barriers.


Clarifications (Or; The Who, Why, Where, When and What of Showing Solidarity Across Anarcho-Part-lines)


I feel like my ending was a bit rushed and I could’ve elaborated more. For instance it was obvious that I was advocating for more solidarity across these so called “anarcho-party-lines” but in what sense? How could it be done? Why should it be done? And so on. These are all questions I feel I can now better answer and dedicate more time to in this particular section.

For one thing, I never exactly defined what solidarity is to me or how I was using it and so to start I shall define my terms:

Solidarity, as I am defining it, is simply showing concern towards people inside and outside your circles of usual concern. These concerns can manifest in many actions such as mutual aid, direct action, agitation for change through social networking (such as Facebook, Twitter, Youtube, etc.), raising awareness of someone else’s problem (again through social networks but also through personal communication or protests), education etc.

Now obviously who is inside and outside your “usual concern” is largely an individual matter. And while I advocate helping people who a libertarian might not normally think about helping (such as workers, minorities, immigrants, etc.) I’m certainly not advocating helping those who not only clearly go against shared principles (such as voluntarism, non-aggression, being against cultural oppression, etc.) but do so constantly and purposely.


As Charles Johnson has stated:


“The Tuckerite individualists saw the invasive powers of the State as intimately connected and mutually reinforcing with the exploitation of labor, racism, patriarchy, and other forms of oppression, with governments acting to enforce social privilege, and drawing ideological and material support from existing power dynamics. From their point of view, attacking statism alone, without addressing the broader social context, would be narrow and ultimately self-frustrating.”[2, Solidarity, paragraph 2, links are all my own editing to re-empathize Johnson's points]


This quote illustrates some of my own ideas as well and perhaps shows why we should show this sort of solidarity. In my last article I not only tried to show the problems of a lack of solidarity through the example of Liberty (Benjamin Tucker’s anarchist periodical) but perhaps what benefits we could have if we were more without such lack of solidarity. More solidarity and open conversation across anarcho-party-lines means clearer dialogues, discoveries and methods devised about what to do against the state. Now I’m not against conflict, dialogue, discussion and the like insofar as that discussion results in such a way that is actually conducive to productive action. However, often times it seems to me that libertarians get caught up in the planning of the new society (irony considering Hayek’s words on central planning as well as Carson’s) or other such things instead of things possible more productive.

What I think would be more useful is talking about how we’ll get there or what here is or questioning central concepts at the root of the discussion. I think if this were done more instead of planning out what’s going to happen or who’s side of the anarchist coin (or certain part of it) it would help move along discussion perhaps. This is mere conjecture on my part of course, but I think it’s fair to say that at the least that there’s definitely some room for improvement among anarchists insofar as dialogue is concerned. Which is one of the reasons why I think  that more solidarity is necessary. Namely because it improves the movement of anarchists and has been shown to do so.

And now I shall argue it’s been done through mutual aid and direct action. And though there are certainly other actions that’ve been used I shall for the sake of time and space just discuss these two factors.


Now how do we show more solidarity? I’ve already said some of the ways we can do it through but more than that what are some perhaps more concrete  examples? Some suggestions I have depend on many of your own conceptions, perceptions and presuppositions about what alliances are worthwhile in the first place. So really if you want to see what alliances are you’ll have to look inside your own objectives, perceptions and so on and see what’s what.

For instance do you want to help people who are trying to fight bosses and landlords? The organization I’ve just shown may not  be your style of activism but keep in mind that the model is what’s really important. After all, the objective you want can be molded. Other people such as George Donnelly had recommendations for bootstrapping a resilient mutual aid society as well as responses to some criticisms he faced. It’s my opinion that mutual aid is a pretty sound way to get things done if organized right and can and has be done in concrete ways in the past until government “fixed it”.

Another way to show solidarity is through direct action as I’ve said. But what sort of direct action and what is direct action to begin with?


Direct action  is (Taken from Voltairine de Cleyre’s essay on the matter):


“Every person who ever thought he had a right to assert, and went boldly and asserted it, himself, or jointly with others that shared his convictions, was a direct actionist.  … Every person who ever had a plan to do anything, and went and did it, or who laid his plan before others, and won their co-operation to do it with him, without going to external authorities to please do the thing for them, was a direct actionist.  … Every person who ever in his life had a difference with anyone to settle, and went straight to the other persons involved to settle it, either by a peaceable plan or otherwise, was a direct actionist.”


Direct action therefore relies on someone wanting to directly impact their lives without necessarily consulting the relevant authority in the relation. Cooperation with other individuals towards your own desired end is something that is direct action, as is handling the matter on your own. Direct action can be as de Cleyre says, ” …the extreme of violence, or it may be as peaceful as the waters of the Brook of Shiloa that go softly.”. Or in other words it can range from peaceful demonstrations to sabotage and so on.


I think (as de Cleyre did) that,


“Those who, by the essence of their belief, are committed to Direct Action only are — just who? Why, the non-resistants; precisely those who do not believe in violence at all! Now do not make the mistake of inferring that I say direct action means non-resistance; not by any means. … What I say is, that the real non-resistants can believe in direct action only, never in political action. For the basis of all political action is coercion; even when the State does good things, it finally rests on a club, a gun, or a prison, for its power to carry them through.”


I agree with these sentiments but what is to be done with these definitions? Well we should see quite quickly that almost all action is direct action and that life would be quite dull without it. Based on the definitions above provided by de Cleyre we can see that this is probably one of the main activities of the anarchist in his or her daily activities. For instance, workers may get at the heart of an issue through boycotting a business whose boss is thinking about firing them in an unfair way. Or a politician who supports a measure may receive tons of calls to their own office or letters to them, jailed people may get friendlier letters or financial support (which can also be mutual aid if the jailed repays them once they get out) and so on. All of these things have been done in the community of anarchists and it can continue to be done.


Now where and when should this solidarity be shown? Well the rallying cry for some may be, “Right here and now, and forevermore it should be everywhere!” and while I have some respect for this I must disagree in the end. This is because I believe when and where we show solidarity and to whom and why is chiefly a strategic matter. It is specifically one that requires thought and action in certain appropriate environments.

Therefore I think being solidaritarian is a very contextual matter that chiefly depends on the individuals own interests, current alliances, possible future ones and whatever other matters seem to affect them the most. For example, I would not recommend any ibertarians to try join some sort of free speech defense for Nazis and fascists, etc. because even if free speech is a good idea. It’s certainly arguable and perhaps true that free speech shouldn’t be advocated for excuses of hate and violence, etc. Free speech itself should of course be touted as a good thing but when groups like white supremacists of any sort or what have you are looking for support in the name of free speech I think it’s safe to say that the libertarians should stay out of it.

On the other hand if a worker is having his or her wages unfairly depreciated (they’ve for example, been working hard and amicably with the boss, etc. and there’s no real reason to decrease them such as taxes, etc.) then perhaps you would get in contact with the worker and ask if they’d like to join an organization you’re trying to start. And to build upon that you could also tell them to spread the word to their fellow workers who feel wrongs. It seems to me that helping the people who are already feeling the heavy hand of the corporate economy we live in is a good move in particular.

Another, final example. Perhaps someone is exiting the courts and is thoroughly displeased with the system at that time. Now would be a good time by probably any libertarian’s standards to talk to them about why the legal system isn’t accountable and why something like agorism is a viable alternative. Or, instead start smaller and discuss why the current system is inherently corrupt, etc.


So with all of that taken care of what are the barriers towards the anarchist community being more solidaritarian?


Property Rights


Of course this, I think, will be the biggest substantial difference across the anarcho-party-lines, but how do we get past something like this? Well through the methods I’ve discussed above of direct action, building mutual aid and a general building of a solidaritiarian spirit in the anarchist community I still do not see property disputes going away. This is because anarchism is not utopian and says that all problems will be solved if people are able to be autonomous and subsequently respect that same right for other people. It only says that it’ll be much better because there is an extreme lack of such a thing in the present society due to intervention through the idea of the state, sexism, racism, patriacy, labor exploitation, etc. etc. So I don’t think property rights will become completely objective, undisputable and so on.  Instead, I suggest that people will come to their own individual conceptions (as well as collective ones within communities, neighborhoods, etc.) of what property is, whether use and occupancy is enough, whether property is theft or property is liberty and so on.
I do tend to think that property has many meaning (and as PJC has said at the very least dual meanings) but I also think people will tend towards universals. Universal ideas, universal preferences, etc. I don’t think it’s constant because I believe in the Proudhonian notion of change  where change is something that is inevitable and much needed. I think there may be constant tendencies ideas in some things that just make sense and perhaps shouldn’t be changed for a time. But of course that doesn’t change the fact that the phenomena of change will stop just for that. I do think one of these tendencies will be an opposition to propertarian absolutism  and a denial of other absolutes such as no property for anyone or a universal gift economy or whatever. I also believe that anarchism is both communistic and individualist in its approach and much more and so will be pretty accommodating to different ideas of property.

But how will people get past these differences? Well I don’t have all the answers but I do think those who simply could not agree on property rights either would not associate or might try to badmouth them or the like. Any violence that may happen would be the extreme but since there’s no state to externalize the costs of pointless warfare I don’t see that as likely. To expand upon that briefly warfare is heavily subsidized by taxation, the benign consent of the people , the cultural perception of what a “legitimate authority” is, and the other cultural perceptions of race, gender and hierarchy that perpetuate statism and wars. Abolishing or at least severely limiting the existence of these things is one of the key parts in my mind towards having a plurality of property rights.

Finally, I think that abolishing the four monopolies (particularly the land one) will allow for much more freedom in people’s own lives and what they can do with it. This amount of personal autonomy and  external liberty (negative and positive liberty in other words) will hopefully tend people’s lives towards more voluntary cooperation and general association as well as much more land for them to be able to hold, use, occupy, etc. For me the abolishment of the land monopoly in particular means anarchists wouldn’t have to worry much about large sprawling property conflicts.


There’s one more obstacle I see…


Awkward Penguin

Self-Fulfilling Prophecies 


Here’s another problem I saw on the reddit thread for the response to my last article  where an-caps were widely chiding anarcho-socialists and the like for being “religious fanatics”. This goes back to some insights that have recently come from George Donnelly about the way we treat other people  which is an important lessons and something that shouldn’t be forgotten. Are you treating your comrades as just obstacles on to the way of freedom? How beneficial of an outlook is this? In fact, I’d argue that treating people like they are just obstacles or what have you effectively insures that they will be obstacles to whatever you are trying to do. Now this isn’t so much a problem when they are in fact problems you are trying to deal with. But to do this when the differences between you are most likely not as large on most things as most people it seems like a bad strategy to empathize such an approach so much on those people.

Moreover it just makes you seem dogmatic in of itself that you’d say that these people must be religious fanatics just because they believe in an idea strongly and you just so happen to not agree with it.

The idea of dogmatism brings me to my second to last topic…


Paul Feyerabend

Against Method and Epistemological Anarchism


A form of anarchism some might not be familiar with is Paul Feyerabend’s “epistemoloigical anarchism” and ideas on method that science often uses. Now how is that particularly useful in this discussion? Well I think that analyzing some quotes from “Against Method”  and “On Epistemological Anarchism” I can then further elaborate there my own “method” of why I think anarchism without adjectives (from hereon AWA because I’m lazy) is one of the best solutions.


In his book “Against Method” (of which I’ve only read large quotes of admittedly)  Feyerabend lays out some ideas about how and why any universal method is doomed to fail quite convincingly for myself:

My intention is not to replace one set of general rules by another such set: my intention is, rather, to convince the reader that allmethodologies, even the most obvious ones, have their limits. The best way to show this is to demonstrate the limits and even the irrationality of some rules which she, or he, is likely to regard as basic. In the case that induction (including induction by falsification) this means demonstrating how well the counterinductive procedure can be supported by argument.” (p. 32, bold in original)


Freyerabend here does what should be first explained, the intentions behind his writing in his book “Against Method”. He does not seek to bring an overarching conclusion to the business of science or the process of discovery. Indeed, he most likely thinks that the mere fact that science seems to have a monopoly on the process of science is something that is illogical and unnecessary. So too, is the dogmatic ideas and self-fulfilling prophecies that I briefly sketched out in the last section have speakers who wish to monopolize what is “rational” and what is “good” in an anarchist society. Even though the battle of good vs. evil has been seen as by some as a battle of semantics. Even so, the chef principle of this quote is to show that all methods have limits and that to not recognize this is to at once fall into the pits of dogmatisim. This is something I think anarchists are completely susceptible to.

Now, the process Feyerabend is saying instead is this: anything goes. Here, I don’t think Feyerabend is conflating anarchism (or any theoretical/philosophical subset of it for that matter) as chaos. I think he’s only recognizing that in the world as it stands and most likely shall forevermore stand is that any method that is seen as valuable will be used and should be used. This doesn’t mean it should be allowed per se’ or that it can’t be changed (as I’ve said the notion of change for me is that it’s inevitable) but instead that this shouldn’t be necessarily looked down upon.


Some of the best things have been caused by change as Feyerabend points out:


“Progress was often achieved by a “criticism from the past”… After Aristotle and Ptolemy, the idea that the earth moves – that strange, ancient, and “entirely ridiculous”, Pythagorean view was thrown on the rubbish heap of history, only to be revived by Copernicus and to be forged by him into a weapon for the defeat of its defeaters. The Hermetic writings played an important part in this revival, which is still not sufficiently understood, and they were studied with care by the great Newton himself. Such developments are not surprising. No idea is ever examined in all its ramifications and no view is ever given all the chances it deserves. Theories are abandoned and superseded by more fashionable accounts long before they have had an opportunity to show their virtues. Besides, ancient doctrines and “primitive” myths appear strange and nonsensical only because their scientific content is either not known, or is distorted by philologists or anthropologists unfamiliar with the simplest physical, medical or astronomical knowledge.” (p. 48)


“The ideas survived and they can now be said to be in agreement with reason. They survived because prejudice, passion, conceit, errors, sheer pigheadedness, in short because all the elements that characterize the context of discovery, opposed the dictates of reason and because these irrational elements were permitted to have their way. To express it differently: Copernicanism and other “rational” views exist today only because reason was overruled at some time in their past. (The opposite is also true: witchcraft and other “irrational” views had ceased to be influential only because reason was overruled at some time in their past.)” (p. 155)


And again we return to Feyrabend explaining how the current method of science, discovery, methodology, etc. is so flawed. The complete number of problems both internal and external with one’s perception of reality is almost infinite or at least hard to tell or nearly impossible to from moment to moment. Thus it’s hard to see (or worse) what use the process has to us until we test it. But what if we just do the same test again and again, with the same tools, same ideas, same actions, etc. and get the same results? Is this nothing but a failure of experimentation? That science can only see through one lens of repeat, repeat, repeat reveals a fundamental problem of how it stands today. And why does it stand today? Well as Feyrabrand points out, the separation of science and state should be following the same separation of the church and state, why? Because science has an unfair advantage over other ideas due to state backed privily that they don’t get. The lack of funds for other kinds of research, experimentation and the like results, once again, in science being victorious. But this is once again a monopolizing a theory of discovery and Feyerabrand’s whole point is that science is a largely anarchic (read: pluralistic) affair not a monopolistic one. And not only this but this “victory” is largely an artificial one. from an anarchist’s point of view. This is in much the same way as corporations are artificially bigger than they would be on the truly freed market.

I am mainly making these points to get across my own point: that the dogma shown against other anarchists by anarchists is largely illogical,  unnecessary and potentially destructive of efforts and alliances that could prove lucrative for all.


To further this point epistomological anarchism is defined as such:


“Epistemological anarchism differs both from scepticism and from political (religious) anarchism. While the sceptic either regards every view as equally good, or as equally bad, or desists from making such judgements altogether, the epistemological anarchist has no compunction to defend the most trite, or the most outrageous statement. While the political or the religious anarchist wants to remove a certain form of life, the epistemological anarchist may want to defend it, for he has no everlasting loyalty to, and no everlasting aversion against, any institution or any ideology”


And likewise AWA holds no everlasting aversion against or for any particular system of self-governance aka system of anarchic-legal, property (or non-property), etc. systems. It make way a stance at some point and propose to keep it but chances are it holds it in no firm place and so long as the basic tenants of anarchism are met (voluntarism, mutual benefit, non-aggression and non-oppressive) then the AWA has not much to say outside of preferential or practical statements about the program in which someone favors.


Karl Hess

Anarchism Without Adjectives as a Solution


And so finally we come to the conclusion. By combining Feyerabend’s epistomological anarchism with the already great tradition of AWA thinkers such as Karl Hess and Voltairine de Cleyre, a lack of ideological dogmatism in science discovery and progress, must necessarily transform into an AWA’s sort of philosophy and constantly moving ideology. Notice the title of this section “a solution” it is not THE solution. Instead, it is only ONE method that I think should be tried and have no idea of forcing other people to use them. At the same time those who would oppress others, demean them, reduce their notion of themselves,  subjugate, exploit, displace for no logical reason, etc. I shall oppose, advocate against and if necessary use defensive force to see that they do not harm others.

Does this ruin my voluntarism? No, simply because these notions ruin the idea and environment for any sort of anarchism to exist and thus I must oppose this. In a way it is defense of anarchism that I would eventually oppose these things through force like anything else. Furthermore I am culturally thick and mostly have some so called “left” values. For example: I favor unions in a truly freed society as a way of balancing the power between bosses and workers. I am quasi-feminist in a lot of my stances towards women in that they should be treated as equals and that patriarchy is a real threat to a free society. I see racism and sexism as things that exist in today’s society and that interlock with things like statism and so on to form mulit-leveled oppressive systems. I oppose corporations, corporate welfare, subsidies to business, patents, copyrights, intellectual property all! Instead I favor things like worker-cooperatives, collectives, independent contractors and the like. So I certainly have my stances and preferences but I also recognize others do too and that they should be able to see them through so long as they allow me the same.
But is all of this going to be enforced by me? Hardly. I expect in a truly freed society (as opposed to a somehow singular and monopolistic market place)  to have experimentation and for the best to win out.  I and others like me will work towards our goal through voluntary cooperation and through this cooperation shall come more free and open competition that shall forever benefit the world. I therefore think AWA is one of the best methods of establishing a truly freed society, culture, environment and so forth. But will progress stop there? No, the Philosophy of Progress dictates that it will not be so! But of course epistomological anarchism on the other hand wags it’s finger and says, “only time will tell!”

Voltairine de Cleyre

Granulocyte macrophage colony stimulating factor augmented hepatitis B vaccine protocol for rapid seroprotection in voluntary kidney donors

Indian Journal of Medical Research April 1, 2004 | Krishnamurthy, K; John, George T; Abraham, Priya; Jacob, Chakko K Background & objectives: Conventional hepatitis B vaccine protocols do not provide rapid seroprotection against hepatitis B. This randomized controlled trial was carried out to investigate the efficacy of granulocyte macrophage-colony stimulating factor (GM-CSF) augmented double-dose vaccine protocol in voluntary kidney donors prior to donor nephrectomy.

Methods; A total of 54 kidney donors, who had no history of hepatitis B infection, hepatitis B vaccination and tested negative for anti-HBs and anti-HBc antibodies were randomly allocated to the control or test groups. GM-CSF (300 ?µg) was administered subcutaneously on day 0, followed by 40 ?µg of rccombinant hepatitis B vaccine intramuscularly on the same deltoid on day 1. The control group received only 40 ?µg of intramuscular hepatitis B vaccine. Anti-HBs titres were measured at the end of 4 wk.

Results: Of the 54 donors studied, there was a significant (P<0.003) seroconversion in the GM-CSF group (82%) compared to the control group (37%), after a single immunization with double-dose recombinant hepatitis B vaccine by 4 wk. Minor side effects such as fever in four patients and myalgia in three were noticed.

Interpretation & conclusion: GM-CSF augmented double-dose hepatitis B vaccine could be used in unvaccinated patients when a rapid response is desired.

Key words GM-CSF – hepatitis B – vaccine augmentation Voluntary kidney donors get about (bur weeks when essential tests prior to donor nephrectomy are conducted. Conventional hepatitis B vaccination does not result in protective antibody titres in kidney donors within such a short period. In endemic regions for hepatitis B virus particularly, in addition to universal precautions, it is important to protect these patients with an efficient vaccine protocol within the short interval prior to surgery. Recombinant human granulocyte macrophage colony stimulating factor (GM-CSF) has been shown as an adjuvant to improve the kinetics and magnitude of the immune response after vaccination1. GM-CSF is a haematopoetic growth factor, which affects the growth and function of granulocytes, macrophages, eosinophils and dendritic cells. It enhances neutrophil chemotaxis and phagocytic action of macrophages23. hepatitis b vaccine

Though the efficacy of GM-CSF in augmenting hepatitis B vaccine has been studied in normal subjects, patients with chronic renal failure and geriatric population, information is not available in voluntary kidney donors going for elective surgical procedure. This prospective randomized controlled study was undertaken to test the efficacy and safety of GM-CSF augmented double-dose hepatitis B vaccination in inducing protective antobody titres as compared to non-augmented double-dose vaccine in voluntary kidney donors.

Material & Methods The study was conducted at the Christian Medical College and Hospital, Vellore in southern India during October 2001 to june 2002. Consecutive prospective voluntary kidney donors who were found fit to donate kidneys were included after obtaining the informed consent. They were included in the control ortest group based on a list of computer-generated random numbers. The study protocol was approved by the hospital ethics committee.

The inclusion criteria were as follows: (i) all consenting donors who were fit to donate a kidney after period of 4 wk; (ii) no history of hepatitis B infection or hepatitis B vaccination; and (iii) anti-HBs antibody and hepatitis B core antibody (anti-HBc) negative status.

Exclusion criteria were (i) donors likely to have less than a 4-wk vaccination-donor nephrectomy interval; (ii) current or past hepatitis B infection; (iii) history of sideeffects with GM-CSF; and (iv) anti HBs and/or anti-HBc positivity.

The test group received 300 ?µg of GM-CSF (Leucomax, Novartis, Basle, Switzerland) subcutaneously on day O followed by 40 ?µg of recombinant hepatitis B vaccine intramuscularly on the ipsilateral deltoid on day 1. The control group received 40 ?µg of intramuscular hepatitis B vaccine only. Anti-HBs titre was measured at the end of 4 wk using AUSAB kit (Axsym, Abbot Labs, IL, USA). HBsAg was tested using a third generation ELISA kit (Hepanostika Uniform II – Organon Technika Netherlands, or MEIA-Axsym, Abbott Lab, USA) and anti-HBc was tested with CORL kit (Axsym, Abbott Labs, IL, USA). Donors were advised to continue the vaccination at one and six months after the first dose to ensure persistence of protective antibody levels.

Chi square test and Student t-test were used to determine difference in the two groups. Mann Whitney U test was done to study difference in titres between the two groups. P<0.05 was considered significant.

Results & Discussion The study population consisted of 54 donors; 25 were males. The mean age was 37.9?±9.3 yr. There was no significant difference in age between subjects in the test and the control groups, mean age in GM-CSF group being 37.3?± 10.7 and in control group 37.55?±10.08 yr (Table). There were 27 donors in each group.

Thirty four voluntary kidney donors scroconverted with an anti-HBs titre of more than 10mlU/ml,23 in the GM-CSF group seroconverted compared to the 11 from the control group, the difference was statistically significant (p<0.001). The median anti-HBs titres were 32 mlU/ml and 8 mlU/ml in the study group and controls respectively. The mean titre achieved in the GM-CSF group (42.12?±36mIU/ml) was significantly (P<0.003) higher compared to 20.33?±38.5 mlU/ml in the control group (Table). Minor side effects v/z., fever in four patients and myalgia in three patients were noticed in the GM-CSF group.

Voluntary kidney donors need protective antibody levels against hepatitis B prior to donor nephrectomy to avoid possible infection with the virus. Conventional vaccine protocols do not provide protective antibody levels in 4 wk\ GM-CSF produces improvement in the kinetics and antibody response in human studies^. The ability of GM-CSF to stimulate hepatitis B vaccine in haemodialysis patients^ with a defect in antigen presenting cells and in nonresponders have been shown in earlier studies.

In the present study the efficacy of GM-CSF augmented double-dose vaccine protocol was evaluated. A 300 ?µg dose of GM-CSF was given subcutaneously 24 h prior to administering hepatitis B vaccine (40 ?µg) intramuscularly at the same site as GM-CSF, since GM-CSF is known to produce local inflammation at the site of injection and enhances dendritic cell maturation and migration10,11. Confounding factors like previous hepatitis 13 infection, vaccination, and the remote possibility of subclinical hepatitis B infection were removed by excluding subjects having antibody to HBV core antigen.

The findings showed a significant seroconversion (82%) in the GM-CSF group as compared to the control group (37%) after a single immunization with double-dose recombinant hepatitis B vaccine. Some of the earlier studies however, have failed to demonstrate the adjuvant effect of GM-CSF12,13 or has shown only a marginal adjuvant effect14. The effect of GM-CSF shown in this study may be due to the use of higher doses of GM-CSF and hepatitis B vaccine and the same site for vaccination. site hepatitis b vaccine

The GM-CSF group had significantly higher titres of anti-HBs compared to the control group and it was well tolerated except for mild fever and myalgia, making the protocol applicable to similar situations elsewhere.

In conclusion, GM-CSF was found to be a safe and effective hepatitis B vaccine adjuvant. The potential of GM-CSF to augment double-dose hepatitis B vaccine could be used in unvaccinated patients when a rapid response is desired prior to elective surgical procedures and in situations where protective antibody levels are required for health care workers.

Acknowledgment The authors acknowledge the financial support from Novartis. India.

[Reference] References 1. Jones T, Stern A, Lin R. Potential role of granulocyte-macrophage colony-stimulating factor as vaccine adjuvant. Eur J CIm Microbiol Infect Dis 1994; 13 (Suppl) : S 47-53.

2. Morrissey PJ, Bressler L, Park LS, Alpert A, Gillis S. Granulocyle-macrophagc colony-stimulating factor augments the primary antibody response by enhancing the function of antigen-presenting cell. Jlmmunol 1987; 139 : 1113-9.

3. Aman MJ, Stockdreher K, Thews A, Kienast K, Aulitzky WR, Farber L, et al. Regulation of immunomodulalory functions by granulocytc-inacrophagc colony-stimulating factor and granulocytc colony-stimulating factor in vivo. Ann Hemalol 1996; 73:231-8.

4. Young MO, Rosenthal MIi, Dickson B, DuVV. Maddrcy WC. A multi-center controlled study of rapid hepatitis B vaccination using a novel triple antigen recombinant vaccine, Vaccine 2001 ; 19:3437-43.

5. Sudhagar K, Chandrasekar S, Rao MS, Ravichandran R. Effect of granulocytc macrophage colony stimulating factor on hepatitisB vaccination in haemodialysis patients. J Assoc Physicians India 1999; 47: 602-4.

6. Jha R, Lakhtakia S, Jalecl MA, Narayan G, Heinlathe K. (iranulocyte macrophage colony stimulating factor (CiM-CSF) induced seroprotection in end stage renal failure patients to hepatitis B in vaccine non-respondcrs. Ren Fail 2001 ; 23 : 629-36.

7. Kapoor D, Aggarwal SR, Singh Nl5, Thakur V, Sarin SK. Granulocyte macrophage-colony stimulating factor enhances the efficacy of hepatitis B virus vaccine in previously unvaccinated hemodialysis patients. J Viral IIepal 1999; 6 : 405-9.

8. Hess G, Kreiter F, Kosters W, Deusch K. The effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) on hepatitis B vaccination in haemodialysis patients. J Viral Hepal 1996; 3 : 149-53.

9. Anandh U, Bastani B, Ballal S. Granulocyte-macrophage colony-stimulating factor as an adjuvant to hepatitis B vaccination in maintenance hemodialysis patients. Am J Nephrol 2000; 20 : 53-6.

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[Author Affiliation] K. Krishnamurthy, George T. John, Priya Abraham* & Chakko K. Jacob Departments of Nephrology & * Clinical Virology, Christian Medical College, Vellore, India Received September 9, 2003 [Author Affiliation] Reprint requests : Dr George T. .lohn, Professor, Department of Ncphrology, Christian Medical College, Vellore 632004, India Krishnamurthy, K; John, George T; Abraham, Priya; Jacob, Chakko K

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