Document Detail


Blood monitoring of granzyme B and perforin expression after intestinal transplantation: considerations on clinical relevance.
MedLine Citation:
PMID:  18580471     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The use of biomarkers for rejection monitoring represents a major goal in intestinal transplantation. We analyzed the blood expression of Granzyme B (GB) and Perforin (PF) in the following pathological conditions after intestinal transplantation: acute rejection (AR), Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infection, and posttransplant lymphoproliferative disease (PTLD). The diagnostic accuracy and the clinical utility of these tests are finally discussed. METHODS: GB and PF levels were measured by real time polymerase chain reaction on peripheral blood samples from 32 intestinal recipients. Blood samples (n=494) after comparison of clinical, histological, and microbiological data were assigned to the following groups: normal (n=307), AR (n=30), EBV infection (n=107), CMV infection (n=25), and PTLD (n=25). RESULTS: Mean levels of GB and PF in the AR (GB=279.7; PF=256.7), PTLD (GB=199; PF=185.9), EBV (GB=133.2; PF=143.7), and CMV (GB=151.3; PF=144) groups were significantly higher than in the normal group (GB=100.1; PF=101.1) (all P<0.05, except for PF in CMV infection). The best accuracy was obtained for the diagnosis of AR with sensitivity and specificity of 80% and 79% for GB and 70% and 79% for PF, respectively. The area under the receiver-operator characteristics curve was 0.87 for GB and 0.82 for PF. CONCLUSIONS: GB and PF are diagnostic molecular markers of AR. GB and PF blood levels are also increased in case of viral infections or PTLD. Serial blood testing for GB and PF might be predictive of early intestinal graft dysfunction and should be interpreted in the context of the histological and virological analyses.
Authors:
Annalisa Altimari; Elisa Gruppioni; Elisa Capizzi; Alberto Bagni; Barbara Corti; Michelangelo Fiorentino; Tiziana Lazzarotto; Augusto Lauro; Antonio Daniele Pinna; Lorenza Ridolfi; Walter Franco Grigioni; Antonia D'errico-Grigioni
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Transplantation     Volume:  85     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-26     Completed Date:  2008-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1778-83     Citation Subset:  IM    
Affiliation:
Pathology Unit, Istituto Oncologico "F. Addarii," S. Orsola-Malpighi Hospital, Bologna University Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Biological Markers / blood
Cytomegalovirus Infections / blood,  diagnosis*
Epstein-Barr Virus Infections / blood,  diagnosis*
Follow-Up Studies
Graft Rejection / blood,  diagnosis*
Granzymes / blood*,  metabolism
Humans
Intestines / transplantation*
Leukemia, Large Granular Lymphocytic
Middle Aged
Organ Transplantation
Perforin / blood*,  metabolism
Postoperative Complications / blood,  diagnosis,  virology
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Biological Markers; 126465-35-8/Perforin; EC 3.4.21.-/Granzymes

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