Myśliwiec J, Waligórski D, Nikołajuk A, Górska M
Department of Endocrinology, Diabetology and Internal Diseases, Medical University of Białystok, ul. M. Sklodowskiej-Curie 24 A, 15-276 Białystok, Poland.
Adv Med Sci. 2007;52:104-8.
To assess the role of CD40/CD154 interaction in GO pathogenesis and to estimate usefulness of soluble CD40 (sCD40) and CD154 (sCDI54) measurements as markers of GO activity.
61 individuals in 4 groups: (1) 15 euthyroid patients with clinical symptoms of ophthalmopathy (GO) who underwent corticosteroid therapy consisting of intravenous infusions of methylprednisolone (MP) and subsequent treatment with oral prednisone (P) and teleradiotherapy (TR); (2) 14 patients with hyperthyroid GD (GDtox); (3) 22 patients with GD in euthyreosis treated with methimazol (GDeu); (4) 10 healthy volunteers age and sex-matched to group 1-3. The serum samples were collected 24 hours before MP, 24 hours after MP, after TR and at the end of therapy. Serum CD40, CD154 and TPOab were determined by ELISA and TSHRab by RIA.
Serum concentrations of CD40 (in pg/ml) and CD154 (in ng/ml) were increased in GO patients: 84.9 (74.7-93.9) and 4.0 (2.5-7.3) respectively in comparison to controls (p < 0.001 and p < 0.05 respectively). Serum CD154 in GO group was elevated as compared to both hyperthyroid and euthyroid GD without clinical ophthalmopathy (p < 0.001 both). The sCD40/sCD154 quotient was significantly elevated during GO therapy with CS and TR in nonresponders after MP (p < 0.05) and at the end of the study (p < 0.01).
Our data suggest an important role of CD40/ CD154 interaction in the pathogenesis of autoimmune process leading to inflammatory infiltration in Graves' ophthalmopathy, however usefulness of sCD40 and sCD154 measurements in prediction of effects of GO treatment and its monitoring needs further investigations.
评估CD40/CD154相互作用在Graves眼病（GO）发病机制中的作用，并评估可溶性CD40（sCD40）和CD154（sCD154）检测作为GO活动标志物的实用性。
61名个体分为4组：（1）15例患有眼病临床症状（GO）的甲状腺功能正常患者，接受了由静脉输注甲泼尼龙（MP）以及随后口服泼尼松（P）和远距离放射治疗（TR）组成的皮质类固醇治疗；（2）14例甲状腺功能亢进的Graves病（GD甲亢）患者；（3）22例接受甲巯咪唑治疗的甲状腺功能正常的GD患者（GD甲功正常）；（4）10名年龄和性别与1-3组匹配的健康志愿者。在MP治疗前24小时、MP治疗后24小时、TR治疗后以及治疗结束时采集血清样本。通过酶联免疫吸附测定（ELISA）测定血清CD40、CD154和甲状腺过氧化物酶抗体（TPOab），通过放射免疫分析（RIA）测定促甲状腺素受体抗体（TSHRab）。
GO患者血清中CD40（单位：pg/ml）和CD154（单位：ng/ml）浓度升高：与对照组相比，分别为84.9（74.7 - 93.9）和4.0（2.5 - 7.3）（分别p < 0.001和p < 0.05）。与无临床眼病的甲亢和甲功正常的GD患者相比，GO组血清CD154均升高（均p < 0.001）。在MP治疗后无反应者中，GO患者接受皮质类固醇（CS）和TR治疗期间以及研究结束时，sCD40/sCD154比值显著升高（p < 0.05和p < 0.01）。
我们的数据表明CD40/CD154相互作用在导致Graves眼病炎症浸润的自身免疫过程发病机制中起重要作用，然而sCD40和sCD154检测在预测GO治疗效果及其监测方面的实用性需要进一步研究。
