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NDT Advance Access published online on May 18, 2004
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfh257
© 2004 by European Renal Association - European Dialysis and Transplant Association
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Received July 1, 2003
Accepted March 10, 2004

Original Papers

Serum levels of macrophage-colony stimulating factor (M-CSF): a marker of kidney allograft rejection

Yannick Le Meur 1*, Valérie Leprivey-Lorgeot 2, Sandrine Mons 1, Mattew José 3, Jacques Dantal 4, Brigitte Lemauff 4, Jean-Claude Aldigier 1, Claude Leroux-Robert 1, Vincent Praloran 5

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
5 Laboratoire Universitaire d’Hématologie, Université Victor Segalen, Bordeaux, France

* To whom correspondence should be addressed. E-mail: yann.lemeur{at}chu-limoges.fr.



  Abstract

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


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