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Urine macrophage migration inhibitory factor concentrations as a diagnostic tool in human renal allograft rejection


Brown, FG and Nikolic-Paterson, DJ and Chadban, SJ and Dowling, J and Jose, MD and Metz, CN and Bucala, R and Atkins, RC, Urine macrophage migration inhibitory factor concentrations as a diagnostic tool in human renal allograft rejection, Transplantation, 71, (12) pp. 1777-83. ISSN 0041-1337 (2001) [Refereed Article]

Copyright Statement

Copyright 2001 Lippincott Williams & Wilkins

DOI: doi:10.1097/00007890-200106270-00013


BACKGROUND: Macrophage migration inhibitory factor (MIF) is a pro-inflammatory cytokine that is a potent activator of macrophages and T cells. Previous studies have shown that local MIF production is increased in acute renal allograft rejection, suggesting that it may play an important role in the rejection process.

AIMS: To determine if urine and serum MIF concentrations: (1) are increased in acute rejection, and (2) can be used as noninvasive tools to discriminate between acute rejection (AR) and cyclosporine nephrotoxicity (CyA toxicity).

METHODS: In a prospective study of nine renal allograft patients (five acute rejection and four stable), serial urine MIF concentrations were measured by ELISA in the first 14 days after transplantation. In a retrospective study, MIF concentrations in urine and serum were measured in 24 patients who were biopsied for acute renal transplant dysfunction (11 AR, 13 CyA toxicity). Urine and serum MIF were also measured in 23 stable renal transplant patients and 10 normals.

RESULTS: MIF was readily detected in the urine of normal healthy controls (106+/-61 pg/micromol creatinine). In the prospective study, the urinary MIF concentration was increased substantially on day 1 posttransplantation and subsequently fell in parallel with the serum creatinine. However, urine MIF increased before episodes of biopsy proven acute rejection. The retrospective study showed that urine MIF concentrations in patients with AR were increased 5-fold compared to normal controls (439+/-313 pg/micromol Cr; P<0.01). In contrast, urine MIF concentrations in CyA toxicity were not significantly different to normal controls (145+/-119 pg/micromol Cr; P=NS). A marked increase in MIF immunostaining was seen in biopsies of AR, but not in CyA toxicity. No significant differences were evident in serum MIF levels between normals and any transplant patient group.

CONCLUSIONS: These results suggest that measurement of urine MIF concentration may be useful in monitoring renal transplant patients for acute rejection and as a discriminator from cyclosporine nephrotoxicity.

Item Details

Item Type:Refereed Article
Keywords:allograft rejection
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Nephrology and urology
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Jose, MD (Professor Matthew Jose)
ID Code:90568
Year Published:2001
Web of Science® Times Cited:40
Deposited By:Medicine
Deposited On:2014-04-10
Last Modified:2016-11-17

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