Polese Lino, Angriman Imerio, Cecchetto Attilio, Norberto Lorenzo, Scarpa Marco, Ruffolo Cesare, Barollo Michela, Sommariva Antonio, D'Amico Davide F
Dipartimento di Scienze Chirurgiche e Gastroenterologiche "P.G. Cévese", Clinica Chirurgica I, Università di Padova, Italy.
Eur J Gastroenterol Hepatol. 2002 Mar;14(3):237-41. doi: 10.1097/00042737-200203000-00006.
CD40 co-stimulator seems to be implicated in the loss of tolerance against self-antigens in many autoimmune diseases. The evidence suggests that in the pathogenesis of ulcerative colitis there is an activity state against self-antigens of the gut wall and flora. The aim of this study was to analyse the expression of CD40 in ulcerative colitis, comparing it with Crohn's disease and nonspecific inflammation of the colon and to determine whether there is a relationship between its expression and the activity stage of the disease.
The expression of CD40 in the colonic samples of 51 patients (30 ulcerative colitis, 9 Crohn's disease and 12 nonspecific inflammation) was analysed by immunohistochemistry. Twenty-four patients with ulcerative colitis were scored according to clinical, endoscopic and histological classification.
The mean percentage of CD40+ cells per field in the colonic mucosa was: ulcerative colitis 21 +/- 11%, Crohn's disease 24 +/- 9%, nonspecific inflammation 7 +/- 7%. The ulcerative colitis patients were statistically significantly different compared to the patients with nonspecific inflammation (P < 0.005), even when comparing the patients in remission (P < 0.05). The expression in Crohn's disease was similar to that in ulcerative colitis. The expression of CD40 in ulcerative colitis was directly proportional to the state of activity of the disease according to the clinical (P < 0.02), endoscopic (P < 0.01) and histological (P < 0.02) criteria.
The expression of CD40 in the colonic mucosae of patients with ulcerative colitis is significantly increased and is proportional to the state of activity. The results seem to confirm the hypothesis that a loss of tolerance could be involved in the pathogenesis of this disease.
CD40共刺激分子似乎在多种自身免疫性疾病中与针对自身抗原的免疫耐受丧失有关。有证据表明，在溃疡性结肠炎的发病机制中，存在针对肠壁和肠道菌群自身抗原的激活状态。本研究的目的是分析溃疡性结肠炎中CD40的表达情况，并与克罗恩病和结肠非特异性炎症进行比较，以确定其表达与疾病活动期之间是否存在关联。
采用免疫组织化学方法分析51例患者（30例溃疡性结肠炎、9例克罗恩病和12例非特异性炎症）结肠样本中CD40的表达。根据临床、内镜和组织学分类对24例溃疡性结肠炎患者进行评分。
结肠黏膜中每视野CD40+细胞的平均百分比分别为：溃疡性结肠炎21±11%，克罗恩病24±9%，非特异性炎症7±7%。与非特异性炎症患者相比，溃疡性结肠炎患者在统计学上有显著差异（P<0.005），即使是在缓解期患者之间比较也是如此（P<0.05）。克罗恩病中的表达与溃疡性结肠炎相似。根据临床（P<0.02）、内镜（P<0.01）和组织学（P<0.02）标准，溃疡性结肠炎中CD40的表达与疾病活动状态呈正比。
溃疡性结肠炎患者结肠黏膜中CD40的表达显著增加，且与活动状态成正比。结果似乎证实了免疫耐受丧失可能参与该疾病发病机制的假说。
