Clément M V, Haddad P, Soulié A, Benvenuti C, Lichtenheld M G, Podack E R, Sigaux N, Sasportes M
INSERM U 93, Hôpital St Louis, Paris, France.
Int Immunol. 1991 Nov;3(11):1175-81. doi: 10.1093/intimm/3.11.1175.
Histological analysis of endomyocardial biopsies (EMB) is regarded as the most satisfactory technique for monitoring crisis of rejection in heart transplanted patients. In this study, 42 biopsies from 14 patients who underwent heart transplantation were examined. Three patients did not present any rejection crisis at the date of the biopsy analysis, six were examined during an early rejection crisis (day 7-70 post-graft), and five were examined during a late rejection crisis (day 74-960 post-graft). Since granzyme B and perforin are proteins associated with cell lysis histological grading and cell phenotype analysis, in situ hybridization using granzyme B and perforin [35S]RNA probes was performed on 30 EMB to characterize the cytolytic activation of heart infiltrating cells. Our data suggest that granzyme B and perforin could be used as predictive markers for acute rejection in patients with early rejection crisis. Their detection might be an indication to administrate corticoids to resolve an acute rejection crisis. In contrast, their absence in patients with late rejection crisis appears as a good prognostic factor for the outcome of rejection and raises the question of the necessity to treat such patients with additional corticoid treatment.
心内膜心肌活检（EMB）的组织学分析被认为是监测心脏移植患者排斥反应危象最令人满意的技术。在本研究中，对14例接受心脏移植患者的42份活检样本进行了检查。3例患者在活检分析时未出现任何排斥反应危象，6例在早期排斥反应危象期间（移植后7 - 70天）接受检查，5例在晚期排斥反应危象期间（移植后74 - 960天）接受检查。由于颗粒酶B和穿孔素是与细胞溶解组织学分级和细胞表型分析相关的蛋白质，因此使用颗粒酶B和穿孔素[35S]RNA探针进行原位杂交，对30份EMB进行检测，以表征心脏浸润细胞的溶细胞激活情况。我们的数据表明，颗粒酶B和穿孔素可作为早期排斥反应危象患者急性排斥反应的预测标志物。它们的检测可能提示应给予皮质类固醇以解决急性排斥反应危象。相比之下，晚期排斥反应危象患者中未检测到它们似乎是排斥反应预后良好的一个因素，并引发了是否有必要对这类患者进行额外皮质类固醇治疗的问题。
