title: Macrophage colony stimulating factor involvement in uremic patients.
abstract: The immunodeficiency of patients with chronic renal failure (CRF) is related to multiple and complex alterations of the cytokine network and of its target cells such as T or B lymphocytes, monocytes, fibroblasts or endothelial cells. Chronic activation of monocytic functions is recognized as a key factor in these immunological disorders. Since macrophage colony stimulating factor (M-CSF) is essential for the activation of several functions of monocytes and macrophages and their production of cytokines such as interleukin-1, interleukin-6, and tumor necrosis factor alpha, we investigated its involvement in patients with CRF. When measured by ELISA, M-CSF serum levels were significantly higher in patients with progressive CRF and those on hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) than in controls. M-CSF serum levels did not correlate with the degree of renal insufficiency and were probably related to complex alterations in its production and/or degradation by the specific M-CSF receptors of macrophages. In HD patients the M-CSF serum concentrations inversely correlated with the number of circulating lymphocytes and were significantly higher in anemic patients requiring treatment with erythropoietin. Our results suggest that M-CSF may play a role in altering the immune system in uremic patients by maintaining in the circulation and tissues permanently primed monocytes and/or macrophages that can then be triggered to an activated state by secondary stimuli such as endotoxins, complement components, other cytokines or contact with foreign surfaces.
authors.affiliation: Service de Néphrologie et d'Hémodialyse, Hôpital Universitaire Dupuytren, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Le Meur
authors.forename: P
authors.initials: P
authors.lastname: Fixe
authors.forename: J C
authors.initials: JC
authors.lastname: Aldigier
authors.forename: C
authors.initials: C
authors.lastname: Leroux-Robert
authors.forename: V
authors.initials: V
authors.lastname: Praloran
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001708:Biopterins / Q000031:analogs & derivatives / Q000097:blood / Q000494:pharmacology / Q000652:urine; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes / Q000166:cytology; D016173:Macrophage Colony-Stimulating Factor / Q000096:biosynthesis / Q000097:blood* / Q000652:urine; D008297:Male; D008875:Middle Aged; D019798:Neopterin; D006435:Renal Dialysis; D014511:Uremia / Q000097:blood* / Q000276:immunology / Q000628:therapy
chemical_list: D001708:Biopterins; D019798:Neopterin; D016173:Macrophage Colony-Stimulating Factor