Persistence of high CD40 and CD40L expression after restorative proctocolectomy for ulcerative colit

• 作 者: Lino Polese Tmerio Angriman Giuseppe De Franchis Attilio Cecchetto Giacomo C. Sturniolo Renata D’Incà Marco Scarpa Cesare Ruffolo Lorenzo Norberto Mauro Frego Davide F D’Amico
• 机 构: Department of Gastroenterological and Surgical Sciences. Surgical Unit, University of Padova, Italy“
• 出 处: 世界胃肠病学杂志（英文版）
• 发表日期: 2005年34期
• 关键词: Ulcerative colitis Pouchitis Spondyloarthropathy CD40 CD40L Arthritis

AIM: To focus on the role of CD40 and CD40L in their pathogenesis.METHODS: We analyzed by immunohistochemistry the CD40 and CD40L expression in the pouch mucosa of 28 patients who had undergone RPC for UC, in the terminal ileum of 6 patients with UC and 11 healthy subjects. We also examined by flow cytometry the expression of CD40 by B lymphocytes and monocytes in the peripheral blood of 20 pouch patients, 15 UC patients and 11 healthy controls.RESULTS: Ileal pouch mucosa leukocytes presented a significantly higher expression of CD40 and CD40L as compared to controls. This alteration correlated with pouchitis, but was also present in the healthy pouch and in the terminal ileum of UC patients. CD40 expression of peripheral B lymphocytes was significantly higher in patients with UC and pouch, respect to controls. Increased CD40 levels in blood B cells of pouch patients correlatedwith the presence of spondyloarthropathy, but not with pouchitis, or inflammatory indices.CONCLUSION: High CD40 expression in the ileal pouch mucosa could be implied in the pathogenesis of pouchitis following proctocolectomy for UC, whereas its increased levels on peripheral blood B lymphocytes are associated with the presence of extraintestinal manifestations.