Persistence of high CD40 and CD40L expression after restorative proctocolectomy for ulcerative colitis.
OBJECTIVE
To focus on the role of CD40 and CD40L in their pathogenesis.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Polese
Lino
L
Clinica Chirurgica I, Policlinico Universitario, via Giustiniani 2, Padova 35128, Italy. linopolese@hotmail.com
Angriman
Imerio
I
Giuseppe
De Franchis
DF
Cecchetto
Attilio
A
Sturniolo
Giacomo-C
GC
Renata
D'Inca
D
Scarpa
Marco
M
Ruffolo
Cesare
C
Norberto
Lorenzo
L
Frego
Mauro
M
D'Amico
Davide-F
DF
D000328:Adult; D019013:CD40 Antigens / Q000378:metabolism*; D023201:CD40 Ligand / Q000378:metabolism*; D003093:Colitis, Ulcerative / Q000378:metabolism* / Q000601:surgery*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000378:metabolism; D019449:Pouchitis / Q000378:metabolism; D016737:Proctocolectomy, Restorative
D019013:CD40 Antigens; D023201:CD40 Ligand