The early diagnostic value of perforin and granzyme B mRNAs of peripheral blood lymphocytes in detection of renal allograft acute rejection

To investigate the early diagnostic value of perforin and granzyme B mRNA of peripheral blood lymphocytes(PBL) in detection of renal allograft acute rejection(AR),perforin and granzyme B mRNAs expression of PBL in 67 patients with renal allograft AR were dynamically measured by quantitative reverse transcription PCR(RT-PCR).At the same time,the creatinine(Cr) was examined in all patients.The levels of mRNA of perforin and granzyme B as well of Cr value at different time points were compared,and the relationship of perforin,granzyme B and AR was analyzed.When the levels of the 3 indeces on day 1 after transplantation was compared with those on day 1 after transplantation,mRNA of perforin and granzyme B remained unchanged(P0.05) whereas the value of Cr decreased significantly(P0.05).Three days prior to AR took place,mRNA levels of perforin and granzyme B were increased significantly(P0.05) compared with those of all previous time points,and while the level of Cr was decreased significantly(P0.05).The levels of mRNA of PBL perforin and granzyme B reached the peak 1d after AR,then decreased gradually(P0.05),but the level of Cr reached the peak 5 days after AR,then decreased gradually(P0.05).Therefore the increase of perforin and granzyme B mRNA appeared 4 days earlier than Cr.The levels of perforin and granzyme B mRNA decreased to the original basic levels by MP/OKT3 pulse therapy.These results showed that the levels of perforin and granzyme B mRNA of PBL may be a noninvasive,sensitive indices for early diagnosis of AR and for assessing clinic effect of anti-rejection therapy,and It may be worthy of clinical application.