title: Gene expression of perforin by peripheral blood lymphocytes as a marker of acute rejection.
abstract: BACKGROUND
  Previous findings have demonstrated that the expression of cytotoxic effector molecules is increased in acute rejection of renal allografts. In the present study, we serially examined the gene expression of perforin, granzyme B and Fas ligand (FasL) in peripheral blood lymphocytes (PBLs) of renal allograft recipients to assess the potential of their expression as a marker of acute rejection.
  
  
  METHODS
  PBLs were isolated from blood samples taken on days 2, 4, 6, 8, 10 and 12 after transplantation. Competitive PCR was performed to evaluate the abundance of mRNA of perforin, granzyme B and FasL. The mean value + 2 SD of each molecule in the control group was set as a discriminatory level for that particular molecule.
  
  
  RESULTS
  When all measured samples were compared, perforin expression was significantly higher in patients with acute rejection than in the control group (1.84 +/- 3.01 vs. 0.71 +/- 0.48, p = 0.01). The percentage of perforin expression exceeding the discriminatory level was also significantly higher in patients with acute rejection (p = 0.0003). Five patients in the rejection group (5/7, 71.4%) showed perforin expression exceeding the discriminatory level, while only 1 patient in the control group did so (1/8, 12.5%) (p = 0.02). Perforin expressions of days 0 and 1 of rejection crisis were the highest over the study period. No consistent pattern of granzyme B and FasL expression was identified in relation to rejection crisis.
  
  
  CONCLUSIONS
  Gene expression of perforin by PBLs was upregulated in accordance with acute rejection, thus offering the possibility that it may be utilized as a marker of acute rejection.
authors.affiliation: Department of Nephrology, Ajou University School of Medicine, Suwon, Korea. gtshin@ajou.ac.kr
authors.forename: Gyu-Tae
authors.initials: GT
authors.lastname: Shin
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Kim
authors.forename: Tae-Seung
authors.initials: TS
authors.lastname: Lee
authors.forename: Chang-Kwon
authors.initials: CK
authors.lastname: Oh
authors.forename: Heungsoo
authors.initials: H
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D015415:Biomarkers; D053222:Fas Ligand Protein; D006084:Graft Rejection / Q000175:diagnosis*; D053804:Granzymes; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008214:Lymphocytes / Q000378:metabolism*; D008562:Membrane Glycoproteins / Q000235:genetics*; D054353:Perforin; D052899:Pore Forming Cytotoxic Proteins; D012189:Retrospective Studies; D012697:Serine Endopeptidases / Q000235:genetics; D014184:Transplantation, Homologous; D048069:Tumor Necrosis Factors / Q000235:genetics
chemical_list: D015415:Biomarkers; C505661:FASLG protein, human; D053222:Fas Ligand Protein; D008562:Membrane Glycoproteins; D052899:Pore Forming Cytotoxic Proteins; D048069:Tumor Necrosis Factors; D054353:Perforin; C509213:GZMB protein, human; D053804:Granzymes; D012697:Serine Endopeptidases