Pașatu-Cornea Ana-Maria, Ciciu Elena, Tuță Liliana-Ana
Department of Nephrology, Constanta County Emergency Hospital, 900591 Constanta, Romania.
Department of Clinical Medical Sciences, Faculty of General Medicine, 'Ovidius' University of Constanta, 900527 Constanta, Romania.
Exp Ther Med. 2022 Jun 15;24(2):519. doi: 10.3892/etm.2022.11446. eCollection 2022 Aug.
Chronic kidney disease (CKD) is a worldwide public health problem. The constantly increasing prevalence of CKD requires further research into new additional strategies in its management. The preferred treatment of end-stage renal disease (ESRD) is renal transplantation. Kidney transplant patients benefit from substantial improvement in their quality and duration of life. For these to be feasible, the long-term graft and host survival optimization of the renal transplant recipient must be ensured and chronic allograft dysfunction (CAN) must be prevented. Once an equilibrium in the allograft tolerance is established, renal transplanted patients would benefit from the withdrawal or the reduction of immunosuppression therapy. Identification of early predictive biomarkers of CAN is essential. Recent publications have revealed that in long-term immune tolerance and graft survival several populations of immune cells are involved. Starting from the identification of perforin (PRF) in pathological renal glomeruli and following with the analysis of the molecular expression of PRF in renal biopsy samples, it appears that serum PRF is one of the potential biomarkers of graft dysfunction. Over the years, this protein has captured the attention of the medical world, conducting research that could potentially lead to the discovery of an innovative biomarker. Discovering and understanding the involvement of PRF in developing CAN may open up new therapeutic pathways that would ensure the survival of the kidney transplant. In this review the authors examined the structure, the role and the present understanding of the mechanisms by which serum PRF may be involved in chronic graft dysfunction as well as its role as an immune tolerance biomarker for chronic dysfunction of the renal graft.
慢性肾脏病（CKD）是一个全球性的公共卫生问题。CKD患病率的不断上升需要对其管理的新策略进行进一步研究。终末期肾病（ESRD）的首选治疗方法是肾移植。肾移植患者的生活质量和寿命得到显著改善。为了使这些可行，必须确保肾移植受者的长期移植物和宿主存活优化，并预防慢性移植物功能障碍（CAN）。一旦在移植物耐受性方面建立平衡，肾移植患者将从免疫抑制治疗的撤减或减少中获益。识别CAN的早期预测生物标志物至关重要。最近的出版物表明，在长期免疫耐受和移植物存活中涉及多个免疫细胞群体。从在病理性肾小球中鉴定穿孔素（PRF）开始，随后分析肾活检样本中PRF的分子表达，血清PRF似乎是移植物功能障碍的潜在生物标志物之一。多年来，这种蛋白质引起了医学界的关注，开展了可能导致发现创新生物标志物的研究。发现并了解PRF在CAN发生中的作用可能会开辟新的治疗途径，确保肾移植的存活。在这篇综述中，作者研究了血清PRF可能参与慢性移植物功能障碍的机制的结构、作用和目前的理解，以及其作为肾移植慢性功能障碍免疫耐受生物标志物的作用。
