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      Increased Urinary Excretion of Macrophage-Colony-Stimulating Factor (M-CSF) in Patients with IgA Nephropathy: Tonsil Stimulation Enhances Urinary M-CSF Excretion

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          Upper respiratory tract infection including chronic tonsillitis is considered to be involved in the onset and/or the progression of IgA nephropathy. It is well known that deterioration of urinary findings occurs after episodes of upper respiratory tract infection in patients with IgA nephropathy. We previously showed that the expression of macrophage-colony-stimulating factor (M-CSF) is increased in the glomeruli of patients with IgA nephropathy and correlated with glomerular mesangial proliferation, suggesting that M-CSF plays an important role in the progression of IgA nephropathy. In the present study, we measured the serum and urinary concentrations of M-CSF in patients with IgA nephropathy associated with chronic tonsillitis. Furthermore, we evaluated the effects of the local provocation test of tonsils (mechanical tonsil stimulation) on the serum and urinary concentrations of M-CSF in the following three groups: (1) IgA nephropathy with severe mesangial proliferation, (2) IgA nephropathy with mild mesangial proliferation, and (3) patients with chronic tonsillitis without renal disease. The serum and urinary levels of M-CSF in the groups with severe and mild IgA nephropathy were significantly higher than those in the chronic tonsillitis group. The urinary M-CSF level but not the serum M-CSF level was positively correlated with the degrees of mesangial proliferation and glomerular M-CSF expression in the renal biopsy specimens. The urinary M-CSF concentration was significantly increased after tonsillitis stimulation in both mild and severe IgA nephropathy groups. Enhanced urinary excretion of M-CSF prolonged for 7 days after tonsil stimulation in the severe IgA nephropathy group; in contrast, the urinay M-CSF level was increased for only 2 days after tonsil stimulation in the mild IgA nephropathy group. The urinary M-CSF level was not changed in the chronic tonsillitis group after tonsil stimulation. The serum concentrations of M-CSF were not changed after tonsil stimulation in these three groups. Our present results suggest that tonsil stimulation contributes to the progression of IgA nephropathy via enhancement of glomerular production of M-CSF. The urinary excretion of M-CSF may be a useful predictor to evaluate the relevance of chronic tonsillitis to the disease and the indication of tonsillectomy in patients with IgA nephropathy.

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          Haemophilus parainfluenzae antigen and antibody in renal biopsy samples and serum of patients with IgA nephropathy

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            Eight Years of Follow-up - Uvulopalatopharyngoplasty Combined with Midline Glossectomy as a Treatment for Obstructive Sleep Apnoea Syndrome

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              Vestibular Schwannoma Surgery and Headache


                Author and article information

                S. Karger AG
                March 1999
                26 February 1999
                : 81
                : 3
                : 264-270
                aDepartment of Medicine III and bDepartment of Otolaryngology, Okayama University Medical School, Okayama, cCellular Technology Institute, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan
                45291 Nephron 1999;81:264–270
                © 1999 S. Karger AG, Basel

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                Figures: 5, Tables: 1, References: 29, Pages: 7
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