Serum levels of macrophage-colony stimulating factor (M-CSF): a marker of kidney allograft rejection.
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.
Le Meur
Yannick
Y
Service de Nephrologie, Centre Hospitalier Universitaire Dupuytren, Limoges, France. yann.lemeur@chu-limoges.fr
Leprivey-Lorgeot
Valérie
V
Mons
Sandrine
S
José
Mattew
M
Dantal
Jacques
J
Lemauff
Brigitte
B
Aldigier
Jean-Claude
JC
Leroux-Robert
Claude
C
Praloran
Vincent
V
D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D006084:Graft Rejection / Q000097:blood*; D006801:Humans; D016030:Kidney Transplantation; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood*; D012189:Retrospective Studies
D015415:Biomarkers; D016173:Macrophage Colony-Stimulating Factor