title: Colony-stimulating factor-1: a potential biomarker for lupus nephritis.
abstract: A noninvasive means to predict the onset and recurrence of lupus nephritis (LN) before overt renal injury is needed to optimize and individualize treatment. Colony-stimulating factor-1 (CSF-1) is expressed by kidney tubules at the onset of LN, increases with disease progression, and spills into the circulation in lupus-prone mice. We tested the hypothesis that amplified expression of CSF-1 detected in the serum or urine correlates with intrarenal CSF-1 expression and histopathology (increased macrophage accumulation, activity indices) and clinical kidney disease activity and predicts the onset and recurrence of nephritis in patients with systemic lupus erythematosus (SLE). We found increased serum or urine CSF-1 levels in patients with cutaneous, serositis, and musculoskeletal disease; however, the increase in CSF-1 levels was far greater in LN. Moreover, an elevation in serum or urine CSF-1 levels correlated with increasing intrarenal CSF-1 expression and histopathology. By longitudinally tracking patients, we found that elevated serum CSF-1 heralded the initial onset of disease, and a rise in serum or urine CSF-1 predicted recurrences of LN before clinical evidence of glomerular dysfunction and conventional serologic measures, even in patients with other manifestations of SLE. These findings indicate that serial monitoring for a rise in serum or urine CSF-1 levels in patients with SLE reflects kidney histopathology and may predict renal disease activity and the onset and recurrence of LN more accurately than conventional laboratory measures.
authors.affiliation: Department of Nephrology and Rheumatology and.
authors.forename: Julia
authors.initials: J
authors.lastname: Menke
authors.affiliation: Department of Pathology, Friedrich-Alexander University Erlangen-Nuernberg, Erlangen, Germany;
authors.forename: Kerstin
authors.initials: K
authors.lastname: Amann
authors.affiliation: Division of Rheumatology University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy; and.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cavagna
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, Johannes-Gutenberg University Mainz, Mainz, Germany;
authors.forename: Maria
authors.initials: M
authors.lastname: Blettner
authors.affiliation: Department of Nephrology and Rheumatology and.
authors.forename: Arndt
authors.initials: A
authors.lastname: Weinmann
authors.affiliation: Department of Nephrology and Rheumatology and.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schwarting
authors.affiliation: Laboratory of Molecular Autoimmune Disease, Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts vkelley@rics.bwh.harvard.edu.
authors.forename: Vicki R
authors.initials: VR
authors.lastname: Kelley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001706:Biopsy; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007678:Kidney Glomerulus / Q000503:physiopathology; D007684:Kidney Tubules / Q000378:metabolism / Q000473:pathology; D008137:Longitudinal Studies; D008181:Lupus Nephritis / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood* / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016173:Macrophage Colony-Stimulating Factor
keywords: glomerulonephritis; kidney disease; lupus nephritis; macrophages; renal tubular epithelial cells; rheumatology