Clinical Research
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2005; 11(34): 5303-5308
Published online Sep 14, 2005. doi: 10.3748/wjg.v11.i34.5303
Persistence of high CD40 and CD40L expression after restorative proctocolectomy for ulcerative colitis
Lino Polese, Imerio Angriman, Giuseppe De Franchis, Attilio Cecchetto, Giacomo C. Sturniolo, Renata D’Incà, Marco Scarpa, Cesare Ruffolo, Lorenzo Norberto, Mauro Frego, Davide F D’Amico
Lino Polese, Imerio Angriman, Marco Scarpa, Cesare Ruffolo, Lorenzo Norberto, Mauro Frego, Davide F D’Amico, Department of Gastroenterological and Surgical Sciences. Surgical Unit, University of Padova, Italy
Giacomo C. Sturniolo, Renata D’Incà, Department of Gastroenterological and Surgical Sciences, Gastroenterological Unit, University of Padova, Italy
Giuseppe De Franchis, Department of Laboratory Medicine, University of Padova, Italy
Attilio Cecchetto, Department of Pathology, University of Padova, Italy
Author contributions: All authors contributed equally to the work.
Correspondence to: Lino Polese, Clinica Chirurgica I, Policlinico Universitario, via Giustiniani 2, Padova 35128, Italy. linopolese@hotmail.com
Telephone: +39-3490587897 Fax: +39-049656145
Received: February 17, 2005
Revised: March 3, 2005
Accepted: March 9, 2005
Published online: September 14, 2005
Abstract

AIM: 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.

CONCLUSION: 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.

Keywords: Ulcerative colitis; Pouchitis; Spondyloarthropathy; CD40; CD40L; Arthritis