NDT Advance Access originally published online on May 18, 2004
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Nephrol Dial Transplant (2004) 19: 1862-1865
Nephrol Dial Transplant Vol. 19 No. 7 © ERA-EDTA 2004; all rights reserved
Original Article
Serum levels of macrophage-colony stimulating factor (M-CSF): a marker of kidney allograft rejection
1 Service de Néphrologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France, 2 Laboratoire de Physiologie, Faculté de Médecine, Limoges, France, 3 Renal Laboratory, Monash Medical Centre, Melbourne, Australia, 4 Service de Néphrologie et Immunologie Clinique, Centre Hospitalier Universitaire, Nantes, France and 5 Laboratoire Universitaire d’Hématologie, Université Victor Segalen, Bordeaux, France
Correspondence and offprint requests to: Yannick Le Meur, Service de Néphrologie, Centre Hospitalier Universitaire Dupuytren, 2, rue Martin Luther King, F-87042 Limoges Cedex, France. Email: yann.lemeur{at}chu-limoges.fr
Background. Macrophage-colony stimulating factor (M-CSF) is the principal factor for survival of monocytes and macrophages that play an important role in allograft rejection. We studied M-CSF serum levels during successful renal transplantation and acute graft rejection.
Methods. A total of 114 kidney allograft recipients were assessed for M-CSF levels by enzyme-linked immunosorbent assay (ELISA).
Results. M-CSF serum levels were elevated in pre-transplant haemodialysis patients (611±355 IU/ml vs 168±61 in normal controls, P<0.01). Following successful renal transplantation, M-CSF decreased in the first month, stabilizing at 257±222 IU/ml (not significantly different from normal controls) in 52 post-transplant stable patients. There was no correlation between M-CSF level and creatinine clearance. M-CSF levels increased significantly (2–5 times) during biopsy-proven acute rejection episodes in 20 of 25 patients. All rejection episodes were successfully treated and serum M-CSF decreased rapidly to pre-rejection levels in 17/20 patients. In contrast, in five patients with cyclosporin toxicity and four patients with other causes of allograft dysfunction, M-CSF serum levels did not change.
Conclusions. M-CSF serum level might be a specific marker of acute rejection. The source of increased production during rejection warrants further investigation, with infiltrating T cells and resident kidney cells being likely candidates.
Keywords: acute rejection; kidney graft; macrophage; macrophage-colony stimulating factor