Tubular damage following ischemic renal injury is often reversible, and tubular epithelial cell (TEC) proliferation is a hallmark of tubular repair. Macrophages have been implicated in tissue repair, and
CSF-1, the principal macrophage
growth factor, is expressed by TECs. We therefore tested the hypothesis that
CSF-1 is central to tubular repair using an
acute renal injury and repair model,
ischemia/reperfusion (I/R). Mice injected with
CSF-1 following I/R exhibited hastened healing, as evidenced by decreased tubular pathology, reduced
fibrosis, and improved renal function. Notably,
CSF-1 treatment increased TEC proliferation and reduced TEC apoptosis. Moreover, administration of a
CSF-1 receptor-specific (CSF-1R-specific) antibody after I/R increased tubular pathology and
fibrosis, suppressed TEC proliferation, and heightened TEC apoptosis. To determine the contribution of macrophages to CSF-1-dependent renal repair, we assessed the effect of
CSF-1 on I/R in mice in which CD11b+ cells were genetically ablated and determined that macrophages only partially accounted for CSF-1-dependent tubular repair. We found that TECs expressed the CSF-1R and that this receptor was upregulated and coexpressed with
CSF-1 in TECs following renal injury in mice and humans. Furthermore, signaling via the CSF-1R stimulated proliferation and reduced apoptosis in human and mouse TECs. Taken together, these data suggest that
CSF-1 mediates renal repair by both a macrophage-dependent mechanism and direct autocrine/paracrine action on TECs.