PRF1 and systemic lupus erythematosus: In addition, the high expression of perforin and/or granzyme B in CD8+ T-cells has been associated with disease severity/activity in patients with herpesvirus reactivation after organ transplantation, and in patients with systemic lupus erythematosus [75,76]; in the autoimmune condition, this cytotoxic profile was driven by cell activation [76].