RETOSPECTIVE ANALYSYS OF GRANZYME B AND PERFORIN EXPRESSION IN BORDERLINE LESIONS OF KIDNEY BIOPSIES.

 

Balbarrey Z.; Rial M.; Guardia O.; Hilhenbach G.; Casadei D.; Goldberg J.

Dept. of Pathology and Transplantation. Institute of Nephrology. Buenos Aires. Argentina.

 

Background: Acute rejection has shown to be the strongest predictive factor of subsequent chronic rejection and both lesions are the major causes of renal allograft loss. Perforin (PF)-Granzyme B (GZ) is one route by which cytotoxic T lymphocytes induce apoptosis in target cells, and intragraft expression of these markers has shown to be correlated with clinical rejection. The aim of this study was to see if the evaluation of GZ and PF antibodies improves the diagnostic accuracy of transplant biopsies compared to morphological analysis alone.

 

Methods: In these retrospective studies, we immunolabeled 16 needle-core biopsy samples from 16 renal transplant patients (p) (6 of them without extra treatment after biopsy) with histological diagnosis of Borderline Lesion using Banff 97 criteria. The patients where biopsied when renal dysfunction and/or increases of serum creatinine levels where found. Renal allograft biopsies obtained from paraffin blocks where labeled with monoclonal antibodies to GZ and PF with the immunoperoxidase method. They where examined by two pathologists, without knowing the clinical context, in a cualitative lesion scoring, graded as mild (Mi), moderate (Mo) and severe (S).

 

Results: Three of the six patients without extra treatment lost their allograft. GZ stain in these 6 patients were: GZ: Mo-S: 1p; Mo: 1p; Mi: 4p. PF stain was: Mo: 1p; Mi-Mo: 1p; Mi: 3p and in one case tissue sample was not available to perform PF stain. One out of ten extra treated patients lost their allograft. In these group the stains were: GZ: Mo: 3p; Mi: 7 p. PF: Mo-S: 1p; Mo: 4 p; Mi-Mo: 1p; Mi: 4p.

 

Conclusion: No significant correlation was found between the degree of GZ and PF staining and the renal allograft evolution, although 3 of 4 patients that lost their graft had moderate to severe levels of GZ-PF or both. As we have a small sample, no significant statistical conclusions are available.

 

 

 

 

RETOSPECTIVE ANALYSYS OF GRANZYME B AND PERFORIN EXPRESSION IN BORDERLINE LESIONS OF KIDNEY BIOPSIES.

Balbarrey Z. ; Rial M.; Guardia O.; Hilhenbach G.; Casadei D.; Goldberg J.

Dept. of Pathology and Transplantation. Institute of Nephrology. Buenos Aires. Argentina.

 

 

 

Dr. Julio Goldberg

Republica de la India 2779 1er P

1425 Buenos Aires. Argentina.

Fax: 541148242357

Email: jgoldberg@intramed.net.ar