Zhang Gang, Han Fang-hai, Zhang Zhao-da, Hu Wei-ming, Ke Neng-wen, Zhou Xiang, Lu Hui-min
Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2008 Nov;39(6):957-61.
To assess the value of perforin mRNA and granzyme B mRNA in lymphocytes as an early diagnostic indicator for acute rejection of pancreatic transplantation.
Twenty-four hybrid landraces were divided into three groups (control group, transplantation group, transplantation plus immunosuppressant group) randomly. The landraces in the transplantation group were treated with pancreatoduodenal allotranplantation. The landraces in the transplantation plus immunosuppressant group underwent the same surgery and were intervened simultaneously with CsA, MMF, and Metrisone. Peripheral venous bloods were sampled via subclavic veins one day before the operations and on the 1st, 3rd, 5th and 7th day after the operations. The RNA was extracted from the blood samples. The mRNA of perforin and granzyme B expressed in the lymphocytes were detected by RT-PCR. The serum glucose, insulin and glucagons were also measured with routine methods. The pancreatic graft tissues were collected for pathologic examinations at the 1st, 3rd, 5th and 7th day after the operations.
No differences in serum glucose, insulin and glucagons had been detected among the three groups (P>0.05). The landraces in the transplantation plus immunosuppressant group had significantly lower expression of the mRNA of perforin and granzyme B in the lymphocytes and the local transplanted pancreas than those in the transplantation group (P<0.05). The change of mRNA expression of perforin and granzyme B in the lymphocytes occurred 2-4 days earlier than the pathological changes when the acute rejection started.
Monitoring the change of mRNA expression of perforin and granzyme B in the lymphocytes from the peripheral blood can help the early diagnosis of acute rejection of pancreatic transplantation.
评估淋巴细胞中穿孔素mRNA和颗粒酶B mRNA作为胰腺移植急性排斥反应早期诊断指标的价值。
将24只杂种猪随机分为三组（对照组、移植组、移植加免疫抑制剂组）。移植组的猪接受胰十二指肠同种异体移植。移植加免疫抑制剂组的猪接受相同手术，并同时用环孢素A、霉酚酸酯和甲泼尼龙进行干预。术前1天及术后第1、3、5、7天经锁骨下静脉采集外周静脉血。从血样中提取RNA。采用逆转录聚合酶链反应（RT-PCR）检测淋巴细胞中穿孔素和颗粒酶B的mRNA表达。同时采用常规方法检测血清葡萄糖、胰岛素和胰高血糖素水平。术后第1、3、5、7天收集胰腺移植组织进行病理检查。
三组间血清葡萄糖、胰岛素和胰高血糖素水平差异无统计学意义（P>0.05）。移植加免疫抑制剂组淋巴细胞及局部移植胰腺中穿孔素和颗粒酶B的mRNA表达明显低于移植组（P<0.05）。淋巴细胞中穿孔素和颗粒酶B的mRNA表达变化比急性排斥反应开始时的病理变化早2 - 4天。
监测外周血淋巴细胞中穿孔素和颗粒酶B的mRNA表达变化有助于胰腺移植急性排斥反应的早期诊断。
