title: Potential role of soluble CD40 in the humoral immune response impairment of uraemic patients.
abstract: CD40/CD154 interaction is essential for both humoral and cellular immune response. We investigated whether this interaction could be altered in patients with kidney failure who are known to present an impaired immune response. To that aim, we measured the levels of the soluble form of CD40 (sCD40), which is known to interfere with CD40/CD154 interaction, in 43 chronic renal failure patients, 162 hemodialysed patients, and 83 healthy donors. Uraemic and haemodialysed patients presented a three- and fivefold increase, respectively, of the antagonist soluble form of CD40 in their serum, when compared to healthy subjects. Serum sCD40 levels correlated with those of creatinine in uraemic non-haemodialysed patients. While sCD40 is widely excreted in urine of healthy individuals, it is not eliminated by dialysis sessions on classic membranes. The return to a normal kidney function in nine haemodialysed patients who received renal transplantation, leads to a rapid decrease of serum sCD40 levels. This natural sCD40 exhibited multimeric forms and was able to inhibit immunoglobulin production by CD154-activated B lymphocytes in vitro. Furthermore, the positive correlation we observed between the serum levels of sCD40 and the deficient response to hepatitis B vaccination in uraemic patients suggests that sCD40 also compromises the humoral response in vivo.
authors.affiliation: UMR-CNRS 5540, Université Bordeaux 2, Bordeaux, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Contin
authors.forename: Vincent
authors.initials: V
authors.lastname: Pitard
authors.forename: Yahsou
authors.initials: Y
authors.lastname: Delmas
authors.forename: Nadège
authors.initials: N
authors.lastname: Pelletier
authors.forename: Thierry
authors.initials: T
authors.lastname: Defrance
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Moreau
authors.forename: Pierre
authors.initials: P
authors.lastname: Merville
authors.forename: Julie
authors.initials: J
authors.lastname: Déchanet-Merville
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001667:Binding, Competitive; D019013:CD40 Antigens / Q000097:blood / Q000276:immunology*; D023201:CD40 Ligand / Q000378:metabolism; D002478:Cells, Cultured; D005260:Female; D006510:Hepatitis B Antibodies / Q000096:biosynthesis; D017325:Hepatitis B Vaccines / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D007676:Kidney Failure, Chronic / Q000276:immunology* / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D012995:Solubility; D014511:Uremia / Q000276:immunology*
chemical_list: D019013:CD40 Antigens; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D023201:CD40 Ligand