Du Li, Chang Haoxiao, Wei Yuzhen, Zhang Xinghu, Yin Linlin
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Neurol Res. 2020 May;42(5):372-378. doi: 10.1080/01616412.2020.1716469. Epub 2020 Mar 16.
: Soluble CD40 ligand (sCD40L) plays an important role in inflammation and autoimmune disorders. There is still a controversy regarding sCD40L in neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS). Herein the aims of this study were to evaluate the levels of sCD40L in patients with NMOSD, MS, and other noninflammatory neurological diseases; to investigate its potential relationship with laboratory parameters, glial fibrillary acidic protein (GFAP), thrombopoietin (TPO) and IL-6; and to address whether serum sCD40L levels in acute attacks of NMOSD patients were decreased after treatment with immunoglobulins, plasma exchange, or methylprednisolone.: We enrolled 13 patients with NMOSD, 9 patients with MS, and 9 patients with other noninflammatory neurological diseases. The levels of sCD40L, IL-6 were measured by cytokine multiplex assay. GFAP levels were measured by ELISA. Both serum and cerebrospinal fluid (CSF) sCD40L levels were increased in NMOSD and MS. No differences were found in serum and CSF sCD40L levels between NMOSD and MS. The CSF sCD40L levels were positively correlated with the CSF cell counts in NMOSD, whereas serum sCD40L levels were positively correlated with the albumin index in MS. Furthermore, the levels of CSF sCD40L were positively correlated with CSF GFAP levels in NMOSD. Serum sCD40L levels were correlated with serum TPO levels in MS. No correlation was found between levels of sCD40L and IL-6 in NMOSD and MS. No statistically meaningful difference between NMOSD patients with or without immunotherapy. : Our study suggests that sCD40L can contribute to the destruction of the blood-brain barrier in MS, whereas it may contribute to CNS inflammation in NMOSD. The serum sCD40L concentrations were not changed after treatment with immunoglobulins, plasma exchange, or methylprednisolone in acute attacks of NMOSD.
可溶性CD40配体（sCD40L）在炎症和自身免疫性疾病中起重要作用。关于sCD40L在视神经脊髓炎谱系障碍（NMOSD）和多发性硬化症（MS）中的作用仍存在争议。本研究的目的是评估NMOSD、MS和其他非炎性神经系统疾病患者的sCD40L水平；研究其与实验室参数、胶质纤维酸性蛋白（GFAP）、血小板生成素（TPO）和白细胞介素-6（IL-6）的潜在关系；并探讨NMOSD患者急性发作期经免疫球蛋白、血浆置换或甲基强的松龙治疗后血清sCD40L水平是否降低。我们纳入了13例NMOSD患者、9例MS患者和9例其他非炎性神经系统疾病患者。通过细胞因子多重检测法测定sCD40L、IL-6水平。通过酶联免疫吸附测定法测定GFAP水平。NMOSD和MS患者的血清和脑脊液（CSF）sCD40L水平均升高。NMOSD和MS患者的血清和CSF sCD40L水平无差异。NMOSD患者的CSF sCD40L水平与CSF细胞计数呈正相关，而MS患者的血清sCD40L水平与白蛋白指数呈正相关。此外，NMOSD患者的CSF sCD40L水平与CSF GFAP水平呈正相关。MS患者的血清sCD40L水平与血清TPO水平相关。NMOSD和MS患者的sCD40L水平与IL-6水平之间无相关性。接受或未接受免疫治疗的NMOSD患者之间无统计学意义上的差异。我们的研究表明，sCD40L可能导致MS患者血脑屏障的破坏，而在NMOSD中可能导致中枢神经系统炎症。NMOSD急性发作期经免疫球蛋白、血浆置换或甲基强的松龙治疗后，血清sCD40L浓度未发生变化。
