【摘要】 目的:探讨大鼠同种异体肾移植外周血淋巴细胞(peripheralbloodlymphocyte,PBL)穿孔素、颗粒酶B的表达与急性排斥反应(acuterejection,AR)的关系。方法:实验组:异基因移植组(SD→Wister),对照组:同基因移植组(Wister→Wister)。采用逆转录聚合酶链反应(RT-PCR)检测移植肾和PBL穿孔素、颗粒酶B的表达,并以同基因肾移植为对照。结果:病理学检查结果显示实验组大鼠在术后第5、7、9、11天分别发生轻、中、重度排斥,对照组无明显排斥现象。RT-PCR结果显示急性排斥反应发生在肾移植术后3天,即急性排斥早期均表达穿孔素、颗粒酶B基因mRNA,4天后表达明显增强,并贯穿整个排斥反应全过程,而同基因对照组术后11天内均不表达两基因。外周血和肾组织中穿孔素、颗粒酶BmRNA的表达水平平均在急性排斥反应发生前3￣5天开始明显上升,其变化趋势早于血清肌酐。结论:穿孔素、颗粒酶B是一种有价值的AR标志物。定量RT-PCR测定外周血淋巴细胞中穿孔素、颗粒酶BmRNA表达可以较敏感预测肾移植急性排斥反应的发生,这一非侵入性检查方法可以为急性排斥反应的监测和诊断提供客观依据。更多还原

【Abstract】 Objective: To explore the relationship between the expression of perforin and granzyme B in peripheral blood lymphocytes and acute rejection after renal transplantation. Methods: The study concluded two groups, experimental group(SD→Wister) and control group(Wister→Wister). The level of blood serum carnine and the level of perforin and granzyme B were detected by using RT-PCR in the renal allografts and peripheral blood lymphocyte(PBL). Results:The pathological results showed that mild, moderate and severe acute rejection occurred on the fifth, seventh, and ninth to eleventh day after operation in the experimental group respectively. But none of control group had the histological evidence of acute rejection. The RT-PCR showed that the expression of perforin and granzyme B mRNA in kindy tissues and PBL began to be up-regulated on the third day after transplantation, when no histologic evidence of rejection was found. Granzyme B expression was significantly increased after 5 days later and remained in high level during the whole course of rejection. In contrast, perforin and granzyme B mRNA were undetectable in the control group. The expression of Perforin and granzyme B was earlier than the change of blood serum creatinine. Conclusion: Perforin and granzyme B mRNA may be useful markers for acute rejection. The level of perforin and granzyme B expression in PBL is sensitive predictors for early diagnosis of acute rejection. The noninvasive method can provide reference for clinical mornioring and diagnosis of allograft rejection.更多还原