Polese Lino, Angriman Imerio, Giuseppe De Franchis, Cecchetto Attilio, Sturniolo Giacomo-C, Renata D'Inca, Scarpa Marco, Ruffolo Cesare, Norberto Lorenzo, Frego Mauro, D'Amico Davide-F
Clinica Chirurgica I, Policlinico Universitario, via Giustiniani 2, Padova 35128, Italy.
World J Gastroenterol. 2005 Sep 14;11(34):5303-8. doi: 10.3748/wjg.v11.i34.5303.
To focus on the role of CD40 and CD40L in their pathogenesis.
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.
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 correlated with the presence of spondyloarthropathy, but not with pouchitis, or inflammatory indices.
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.
关注CD40和CD40L在其发病机制中的作用。
我们采用免疫组织化学方法分析了28例因溃疡性结肠炎（UC）接受直肠结肠切除术后回肠储袋肛管吻合术（RPC）患者的储袋黏膜、6例UC患者的回肠末端以及11例健康受试者的回肠末端中CD40和CD40L的表达情况。我们还通过流式细胞术检测了20例储袋患者、15例UC患者和11例健康对照者外周血中B淋巴细胞和单核细胞上CD40的表达。
与对照组相比，回肠储袋黏膜白细胞中CD40和CD40L的表达显著更高。这种改变与储袋炎相关，但在健康储袋以及UC患者的回肠末端也存在。与对照组相比，UC患者和储袋患者外周B淋巴细胞上CD40的表达显著更高。储袋患者血液B细胞中CD40水平升高与脊柱关节病的存在相关，但与储袋炎或炎症指标无关。
回肠储袋黏膜中CD40的高表达可能与UC直肠结肠切除术后储袋炎的发病机制有关，而外周血B淋巴细胞上其水平升高与肠外表现的存在有关。
