CD40/CD40配体结合产生共刺激信号对干细胞及B细胞增殖分化的影响

目的:探讨CD40/CD40配体结合产生的共刺激信号对干细胞、B细胞增殖分化的影响及CD40配体抗白血病的作用。资料来源:检索Pubmed和Springer数据库1995-01/2005-12与CD40/CD40配体、白血病干细胞及白血病相关文献,检索词为“CD40,CD40L,Leukemia,Leukemicstemcell”,限定文献语种为英语。资料选择:对资料进行初审,选取实验包括实验组和对照组的文献,排除明显不随机实验和临床研究及重复性研究。资料提炼:共收集到30篇关于CD40/CD40配体结合产生的共刺激信号对干细胞、B细胞增殖分化的影响及CD40配体抗白血病作用的实验文章,23篇符合纳入标准,排除的7篇均为同一研究。资料综合:综合23个实验包括CD40/CD40配体对白细胞干细胞、B细胞增殖分化的影响,对白血病患者预后的影响及CD40配体对白血病患者的治疗作用,并对CD40/CD40配体对白细胞干细胞、B细胞及白血病患者的影响、作用进行分析。结论:CD40/CD40L结合所产生的共刺激信号可促进白血病干细胞和B细胞的增殖分化,与白血病的发生、发展和预后有密切关系。CD40/CD40L在免疫应答中起关键作用,广泛应用于白血病的免疫治疗。     

CD40—CD40L在血液病中的作用

CD40－CD40L作为一种重要的共刺激信号，在信号传导通路中的异常变化直接或简接地参与了许多疾病的发生和发展。本文就其在白血病、淋巴瘤、再障及骨髓移植中的作用作一综述。     

Daudi细胞CD40和CD40配体的共表达及其生物学意义

CD40抗原是属于TNFR超家族的细胞表面分子，广泛表达于B淋巴细胞的所有发育和分化阶段和一些其它特定细胞类型上。B细胞表达的CD40分子主要通过与表达在活化CD4T细胞上的CD40配体（CD40L）相互作用传递信号，从而调控B细胞的分化，特别是免疫球蛋白（Ig）的同型转换和生发中心（GC）的形成。我们首先检测CD40抗原和CD40L在细胞表面的表达和分布情况，然后分别用CD40和CD40L的阻断性抗体阻断这对信号，观察对细胞生长、增殖和凋亡的影响。     

辛伐他汀对人脐静脉内细胞CD40／CD40L表达的影响

目的：探讨辛伐他汀对氧化低密度脂蛋白刺激下的人脐静脉内皮细胞CD40／CD40L表达的影响。方法：实验于2004—03／06在中南大学湘雅二医院实验室完成。实验所用脐带于无菌条件下取自本院产房健康新生儿，产妇知情同意，实验符合赫尔辛基宣言中的伦理学标准。辛伐他汀原粉由杭州默沙东制药公司提供。原代培养人脐静脉内皮细胞，实验在第4代有70％细胞汇合的情况下进行。低密度脂蛋白快速分离后加入含10μmol／L硫酸铜的磷酸盐缓冲液氧化修饰24h，在准备后15d内用于实验。采用流式细胞技术检测CD40／CD40L在细胞上的表达，采用逆转录多聚酶链式反应检测NF-κBP65 mRNA，同时行细胞免疫化学染色检测细胞NF-κBP65的表达。观察辛伐他汀对氧化低密度脂蛋白刺激人脐静脉内皮细胞表达CD40／CD40L分子和NF-κB P65 mRNA的影响实验中，共分5组：①空白对照组，给予磷酸盐缓冲液。②氧化低密度脂蛋白刺激组，80mg／L氧化低密度脂蛋白与人脐静脉内皮细胞共同培养24h。③低浓度辛伐他汀组，先予1μmol／L辛伐他汀干预1h，再予80mg／L氧化低密度脂蛋白与人脐静脉内皮细胞共同培养24h。④高浓度辛伐他汀组，先予10μmol／L辛伐他汀干预1h，再予80mg／L氧化低密度脂蛋白与人脐静脉内皮细胞共同培养24h。⑤单纯辛伐他汀组，10μmol／L辛伐他汀干预25h。免疫化学检测人脐静脉内皮细胞NF-κBP65分子表达的实验中，共分3组：①空白对照组，给予磷酸盐缓冲液。②氧化低密度脂蛋白刺激组，80mg／L氧化低密度脂蛋白与人脐静脉内皮细胞共同培养24h。③辛伐他汀组，10μmol／L辛伐他汀干预1h，再予80mg／L氧化低密度脂蛋白与人脐静脉内皮细胞共同培养24h。结果：①氧化低密度脂蛋白刺激人脐静脉内皮细胞后CD40／CD40L的表达情况：20-80mg／L氧化低密度脂蛋白与人脐静脉内皮细胞共同培养24h后，CD40／CD40L的表达以浓度依赖和时间依赖的方式增加。②辛伐他汀对氧化低密度脂蛋白刺激的人脐静脉内皮细胞CD40／CD40L表达的影响：预先给予辛伐他汀（1μmol／L和10μmol／L）干预1h明显降低氧化低密度脂蛋白所致的CD40／CD40L表达，与单纯氧化低密度脂蛋白刺激组比较，差异显著（P均〈0．05）；10μmol／L的高浓度辛伐他汀较1μmol／L的低浓度辛伐他汀作用更明显（P〈0．05）；而单纯给予10μLmol／L的辛伐他汀干预不影响人脐静脉内皮细胞CD40／CD40L的表达。③辛伐他汀对NF-v：BP65 mRNA在人脐静脉内皮细胞表达的影响：人脐静脉内皮细胞中加入80mg／L氧化低密度脂蛋白培养24h后NF-κB mRNA的表达明显高于空白对照组（0．53&;#177;0．06，0．08&;#177;0．01，P〈0．01）。而预先给予1μmol／L辛伐他汀孵育lh显著降低氧化低密度脂蛋白刺激升高的NF-κB P65 mRNA，明显低于单纯氧化低密度脂蛋白刺激组（0．31&;#177;0．04，0．53&;#177;0．06，P〈0．01）。高浓度组（10μmol／L）作用更显著，显著低于单纯氧化低密度脂蛋白刺激组（0．14&;#177;0．04，0．53&;#177;0．06，P〈0．01），而单纯给予辛伐他汀（10μmol／L）不影响人脐静脉内皮细胞NF-κB P65 mRNA的表达。结论：氧化低密度脂蛋白以浓度和时间依赖的方式刺激人脐静脉内皮细胞表达CD40/CD40L，而辛伐他汀以剂量依赖的方式减轻氧化低密度脂蛋白刺激下人脐静脉内皮细胞CD40/CD40L的表达，可能与其抑制人脐静脉内皮细胞的NF—κBP65的表达有关。提示辛伐他汀可通过抑制高脂血症患者炎症信号通路而到达抗动脉硬化的作用。     

自身反应性T细胞及共刺激分子CD28／CTLA-4／B7、CD40／CD40L和ITP

血小板抗原特异性自身反应性T细胞的活化在特发性血小板减少性紫癜（ITP）的发病机制中起着关键性作用，T细胞的活化除需要抗原递呈细胞表面MHCⅡ抗原复合物外还需要共刺激分子（第二信号），主要包括CD28／CTLA-4／B7和CD40／CD40L。本文就自身反应性T细胞和共刺激分子CD28／CTLA-4／B7、CD40／CD40L在ITP中的作用机制及潜在的治疗价值作一综述。     

CD40不同形式的活化对CD40突变的RPMI8226细胞增殖和表型的影响

目的 分析CD40抗体或配体不同形式刺激对RPMI8226细胞增殖及表面共刺激分子和黏附分子表达的影响,探讨RPMI8226细胞CD40基因突变在其生物学行为中的作用.方法 用RT-PCR方法和DNA序列测定检测RPMI8226细胞CD40基因突变体,分析RPMI8226细胞经CD40抗体或配体四种不同方式(CD40单抗、CD40单抗包板、rhsCD40L和CD40L转基因细胞)刺激后,其体外生长曲线、细胞表型及细胞周期的变化,并利用激光共聚焦显微镜对RPMI8226细胞表面CD40信号转导体的形成进行初步分析.结果 RPMI8226细胞表达CD40突变体(TCA→TTA,Ser→Leu),但是该点突变并未影响hmuCD40的抗原表位.三种激发CD40活化的分子(CD40单抗、rhsCD40L和CD40L转基因细胞)并不影响RPMI8226细胞的体外增殖,但是CD40单抗包板能明显抑制RPMI8226细胞的增殖[(2.5±0.6)×105 vs (7.8±1.2)×105,P＜0.05],并产生明显的G1期阻滞[(58.0±3.6)% vs (42.0±2.3)%,P＜0.05].RPMI8226细胞上黏附分子和共刺激分子的表达无明显变化.激光共聚焦显微镜分析结果显示,在CD40被激活后能形成CD40信号传导的复合体.结论 RPMI8226细胞高表达一种CD40基因突变体,该突变体能在被激活后形成相应的信号传导复合体.     

海马神经干细胞在抑郁症治疗中的可能作用

目的：从国外神经干细胞和抑郁症的相关研究出发，探讨海马神经干细胞在抑郁症治疗中的可能作用。资料来源：应用计算机检索Medline 1995—01／2005—04与神经干细胞和抑郁症相关文献，检索词分别为“neuralstemcell，hippocampus，rat”和“depression，hippoeampus，rat”，并限定语种为英文；并手工检索2003—01／2005—02《中国临床康复》相关文献，检索词为“海马，神经干细胞，大鼠”并限定语种为中文。资料选择：从资料中选取有关神经干细胞、抑郁症实验研究的相关文章，纳入标准：①实验中涉及激素、神经递质和各种营养因子诱导海马神经干细胞增殖的研究。②实验中涉及抑郁症时海马损伤的研究，如糖皮质激素、谷氨酸、一氧化氮等。③实验涉及中神经营养因子对抑郁症的治疗作用。排除综述类文献，对剩余文献查阅全文。资料提炼：共收集到相关文献106篇，42篇纳入标准。排除相似或重复文献27篇，共15篇文献选定为参考文献。15篇文献涉及诱导海马神经干细胞的内容有10篇，探讨抑郁症海马损伤的研究有5篇。资料综合：海马损伤是抑郁症的中枢神经系统的主要病理表现，这与下丘脑-腺垂体-肾上腺轴-谷氨酸-N-甲基-D-天冬氨酸受体-一氧化氮途径亢进有关；由于该途径还能够抑制海马神经干细胞的增殖分化，导致海马的自身修复能力下降，引起海马萎缩。因此抑制其亢进是预防和控制抑郁症的重要手段，促进海马神经干细胞增殖分化是抑郁症治疗的关键措施。目前，利用原位诱导神经干细胞的方法治疗抑郁症更有实际意义。结论：原位诱导神经干细胞，促进海马神经干细胞增殖分化将可能成为治疗抑郁症的关键措施。     

自身反应性T细胞及共刺激分子CD28/CTLA-4/B7、CD40/CD40L和ITP

血小板抗原特异性自身反应性T细胞的活化在特发性血小板减少性紫癜(ITP)的发病机制中起着关键性作用,T细胞的活化除需要抗原递呈细胞表面MHCⅡ抗原复合物外还需要共刺激分子(第二信号),主要包括CD28／CTLA-4／B7和CD40／CD40L。本文就自身反应性T细胞和共刺激分子CD28／ CTLA-4／B7、CD40／CD40L在ITP中的作用机制及潜在的治疗价值作一综述。     

CD40-CD40L在血液病中的作用

CD40-CD40L作为一种重要的共刺激信号,在信号传导通路中的异常变化直接或简接地参与了许多疾病的发生和发展。本文就其在白血病、淋巴瘤、再障及骨髓移植中的作用作一综述。     

D40—CD40L在移植免疫中的研究进展

CD40－CD40L交联在体液免疫和细胞免疫中是一条重要的细胞信号传导途径，参与了体液免疫和细胞免疫的调节。近年在骨髓移植和器官移植中应用anti-CD40/CD40L单克隆抗体或基因敲除等手段来干预CD40－CD40L的异常表达，发现阻断CD40－CD40L共刺激信号可诱导免疫耐受和抑制移植物抗宿主反应等。因此阻断CD40－CD40L共刺激途径将成为临床移植领域中防治排斥反应的新途径。本文就CD40／CD40L及其交联作用在移植免疫中的研究进展作一综述。     

CD40-deficient, influenza-specific CD8 memory T cells develop and function normally in a CD40-sufficient environment

Two models have been proposed to explain the requirement for CD40 signaling in CD8 T cell responses. The first model suggests that CD4 T cells activate antigen-presenting cells (APCs) through CD40 signaling (APC licensing). In turn, licensed APCs are able to prime naive CD8 T cells. The second model suggests that CD154-expressing CD4 T cells activate CD40-bearing CD8 T cells directly. Although the requirement for CD40 in APC licensing can be bypassed by inflammatory responses to pathogens that activate APCs directly, the second model predicts that CD8 responses to all antigens will be dependent on CD40 signaling. Here we determined which model applies to CD8 responses to influenza. We demonstrate that optimal CD8 T cell responses to influenza are dependent on CD40 signaling, however both primary and secondary responses to influenza require CD40 expression on non-T cells. Furthermore, CD40-/- CD8 T cells proliferate and differentiate to the same extent as CD40+/+ CD8 T cells in response to influenza, as long as they have equal access to CD40+/+ APCs. Thus, CD4 T cells do not activate influenza-specific CD8 cells directly through CD40 signaling. Instead, these data support the classical model, in which CD4 T cells provide help to CD8 T cells indirectly by activating APCs through CD40.     

Generation of human CD8 T regulatory cells by CD40 ligand-activated plasmacytoid dendritic cells

Although CD8 T cell-mediated immunosuppression has been a well-known phenomenon during the last three decades, the nature of primary CD8 T suppressor cells and the mechanism underlying their generation remain enigmatic. We demonstrated that naive CD8 T cells primed with allogeneic CD40 ligand-activated plasmacytoid dendritic cells (DC)2 differentiated into CD8 T cells that displayed poor secondary proliferative and cytolytic responses. By contrast, naive CD8 T cells primed with allogeneic CD40 ligand-activated monocyte-derived DCs (DC1) differentiated into CD8 T cells, which proliferated to secondary stimulation and killed allogeneic target cells. Unlike DC1-primed CD8 T cells that produced large amounts of interferon (IFN)-gamma upon restimulation, DC2-primed CD8 T cells produced significant amounts of interleukin (IL)-10, low IFN-gamma, and no IL-4, IL-5, nor transforming growth factor (TGF)-beta. The addition of anti-IL-10-neutralizing monoclonal antibodies during DC2 and CD8 T cell coculture, completely blocked the generation of IL-10-producing anergic CD8 T cells. IL-10-producing CD8 T cells strongly inhibit the allospecific proliferation of naive CD8 T cells to monocytes, and mature and immature DCs. This inhibition was mediated by IL-10, but not by TGF-beta. IL-10-producing CD8 T cells could inhibit the bystander proliferation of naive CD8 T cells, provided that they were restimulated nearby to produce IL-10. IL-10-producing CD8 T cells could not inhibit the proliferation of DC1-preactivated effector T cells. This study demonstrates that IL-10-producing CD8 T cells are regulatory T cells, which provides a cellular basis for the phenomenon of CD8 T cell-mediated immunosuppression and suggests a role for plasmacytoid DC2 in immunological tolerance.     

Expression of functional CD40 by vascular endothelial cells

The interaction between activated vascular endothelium and T cells has been shown to play an important role in the recruitment and activation of T cells at sites of inflammation. Here we report the expression of CD40 by vascular endothelial cells and its regulation by inflammatory agents. Using the soluble recombinant CD40 ligand, sgp39, we show that the interaction of CD40 with its ligand can lead to endothelial cell activation, which in turn leads to leukocyte adhesion. This adhesion is partly mediated by the expression of E-selectin. In addition to E- selectin expression, sgp39 induces the expression of intercellular adhesion molecule 1 and augments the tumor necrosis factor alpha- induced expression of vascular cell adhesion molecule 1. The effects of sgp39 on endothelial cells can be blocked with anti-gp39 monoclonal antibody (mAb), anti-CD40 mAb, or soluble CD40. Staining of tissues from healthy human skin using anti-CD40 mAb showed very weak expression of CD40 by the endothelium, while skin involved in inflammatory disease showed marked upregulation of CD40 expression. These studies suggest that interactions between cell surface proteins expressed by activated T cells with their receptors on vascular endothelium can stimulate the vasculature at sites of inflammation and may be involved in normal inflammatory responses and in inflammatory disease.     

Microvascular thrombosis and CD40/CD40L signaling

Summary. Background: Although inflammation and thrombosis are now recognized to be interdependent processes that activate and perpetuate each other, the signaling molecules that link these two processes remain poorly understood. Objectives: The objective of this study was to assess the contribution of the CD40/CD40L signaling system to the enhanced microvascular thrombosis that accompanies two distinct experimental models of inflammation, that is, endotoxemia (lipopolysaccharide [LPS]) and dextran sodium sulfate (DSS)‐induced colitis. Methods: Thrombosis was induced in cerebral (LPS model) and cremaster muscle (DSS model) arterioles and venules of wild‐type (WT) mice and mice deficient in either CD40 (CD40^?/?) or CD40L (CD40L^?/?), using the light/dye (photoactivation) method. Results and conclusions: A comparison of thrombus formation between WT and mutant mice revealed a role for CD40 and/or CD40L in the inflammation‐enhanced thrombosis responses in both of the cerebral and muscle vasculatures. However, the relative contributions of CD40 and its ligand to thrombus formation differed between vascular beds (brain vs. muscle) and vessel types (arterioles vs. venules). The protective effect of CD40L deficiency in cerebral arterioles exposed to LPS was significantly blunted by administration of soluble CD40L. These findings implicate CD40 and its ligand in the enhanced thrombus formation that is associated with acute and chronic inflammation.     

CD8(+) T cells mediate CD40-independent maturation of dendritic cells in vivo.

Induction of cytotoxic T lymphocyte (CTL) responses against minor histocompatibility antigens is dependent upon the presence of T cell help and requires the interaction of CD40 on dendritic cells (DCs) with CD40 ligand on activated T helper cells (Th). This study demonstrates that CD40 is neither involved in Th-dependent nor Th-independent antiviral CTL responses. Moreover, the data show that DC maturation occurs in vivo after viral infection in the absence of CD40 and Th. This maturation did not require viral infection of DCs but was mediated by peptide-specific CD8(+) T cells. Surprisingly, naive CD8(+) T cells were able to trigger DC maturation within 24 h after activation in vivo and in vitro. Moreover, peptide-activated CD8(+) T cells were able to induce maturation in trans, as DCs that failed to present the relevant antigen in vivo also underwent maturation. Upon isolation, the in vivo-stimulated DCs were able to convert a classically Th-dependent CTL response (anti-HY) into a Th-independent response in vitro. Thus, antiviral CD8(+) T cells are sufficient for the maturation of DCs in the absence of CD40.     

辛伐他汀对人脐静脉内细胞CD40/CD40L表达的影响

目的:探讨辛伐他汀对氧化低密度脂蛋白刺激下的人脐静脉内皮细胞CD40/CD40L表达的影响。方法:实验于2004-03/06在中南大学湘雅二医院实验室完成。实验所用脐带于无菌条件下取自本院产房健康新生儿,产妇知情同意,实验符合赫尔辛基宣言中的伦理学标准。辛伐他汀原粉由杭州默沙东制药公司提供。原代培养人脐静脉内皮细胞,实验在第4代有70%细胞汇合的情况下进行。低密度脂蛋白快速分离后加入含10μmol/L硫酸铜的磷酸盐缓冲液氧化修饰24h,在准备后15d内用于实验。采用流式细胞技术检测CD40/CD40L在细胞上的表达,采用逆转录多聚酶链式反应检测NF-κBP65mRNA,同时行细胞免疫化学染色检测细胞NF-κBP65的表达。观察辛伐他汀对氧化低密度脂蛋白刺激人脐静脉内皮细胞表达CD40/CD40L分子和NF-κBP65mRNA的影响实验中,共分5组:①空白对照组,给予磷酸盐缓冲液。②氧化低密度脂蛋白刺激组,80mg/L氧化低密度脂蛋白与人脐静脉内皮细胞共同培养24h。③低浓度辛伐他汀组,先予1μmol/L辛伐他汀干预1h,再予80mg/L氧化低密度脂蛋白与人脐静脉内皮细胞共同培养24h。④高浓度辛伐他汀组,先予10μmol/L辛伐他汀干预1h,再予80mg/L氧化低密度脂蛋白与人脐静脉内皮细胞共同培养24h。⑤单纯辛伐他汀组,10μmol/L辛伐他汀干预25h。免疫化学检测人脐静脉内皮细胞NF-κBP65分子表达的实验中,共分3组:①空白对照组,给予磷酸盐缓冲液。②氧化低密度脂蛋白刺激组,80mg/L氧化低密度脂蛋白与人脐静脉内皮细胞共同培养24h。③辛伐他汀组,10μmol/L辛伐他汀干预1h,再予80mg/L氧化低密度脂蛋白与人脐静脉内皮细胞共同培养24h。结果:①氧化低密度脂蛋白刺激人脐静脉内皮细胞后CD40/CD40L的表达情况:20～80mg/L氧化低密度脂蛋白与人脐静脉内皮细胞共同培养24h后,CD40/CD40L的表达以浓度依赖和时间依赖的方式增加。②辛伐他汀对氧化低密度脂蛋白刺激的人脐静脉内皮细胞CD40/CD40L表达的影响:预先给予辛伐他汀(1μmol/L和10μmol/L)干预1h明显降低氧化低密度脂蛋白所致的CD40/CD40L表达,与单纯氧化低密度脂蛋白刺激组比较,差异显著(P均<0.05);10μmol/L的高浓度辛伐他汀较1μmol/L的低浓度辛伐他汀作用更明显(P<0.05);而单纯给予10μmol/L的辛伐他汀干预不影响人脐静脉内皮细胞CD40/CD40L的表达。③辛伐他汀对NF-κBP65mRNA在人脐静脉内皮细胞表达的影响:人脐静脉内皮细胞中加入80mg/L氧化低密度脂蛋白培养24h后NF-κBmRNA的表达明显高于空白对照组(0.53±0.06,0.08±0.01,P<0.01)。而预先给予1μmol/L辛伐他汀孵育1h显著降低氧化低密度脂蛋白刺激升高的NF-κBP65mRNA,明显低于单纯氧化低密度脂蛋白刺激组(0.31±0.04,0.53±0.06,P<0.01)。高浓度组(10μmol/L)作用更显著,显著低于单纯氧化低密度脂蛋白刺激组(0.14±0.04,0.53±0.06,P<0.01),而单纯给予辛伐他汀(10μmol/L)不影响人脐静脉内皮细胞NF-κBP65mRNA的表达。结论:氧化低密度脂蛋白以浓度和时间依赖的方式刺激人脐静脉内皮细胞表达CD40/CD40L,而辛伐他汀以剂量依赖的方式减轻氧化低密度脂蛋白刺激下人脐静脉内皮细胞CD40/CD40L的表达,可能与其抑制人脐静脉内皮细胞的NF-κBP65的表达有关。提示辛伐他汀可通过抑制高脂血症患者炎症信号通路而到达抗动脉硬化的作用。     

共信号分子CD40/CD40L质粒标准品的构建

背景:目前,对CD40/D40L的研究主要集中在可溶性和蛋白方面,对其在转录水平上的研究文献不多,可能与其无商品化质粒标准品有关.目的:构建检测CD40/CD40L mRNA表达水平差异的标准品.设计、时间及地点:单一样本实验,于2009-04在苏州大学附属第一医院检验科实验室完成.材料:取手术切除的子宫肌瘤组织,经患者知情同意.方法:以手术切除的子宫肌瘤组织细胞的总RNA为模板、Random 6mers为引物反转录合成cDNA,用该cDNA为模板PCR扩增人CD40/CD40L基因相应的cDNA片断,构建PMD-18-CD40/CD40L重组质粒,鉴定测序后,用荧光定量PCR制作标准曲线.主要观察指标:①RNA质量检测结果.②扩增的目的片段电泳结果.③CD40/CD40L基因测序结果.④标准品的扩增情况.结果:组织提取的总RNA完整性良好,构建的CD40/CD40L质粒经PCR扩增后分别得到136 bp,200 bp的清晰条带,测序结果与目的片段完全一致,且质粒的原始浓度为2.66×10~(13)、2.45×10~(13) copies/mL,倍比稀释至2.0×10~6 copies/mL均能得到良好的标准曲线(R~2=1).结论:实验成功构建了CD40/CD40L基因荧光定量PCR标准质粒.     

血液透析患者血浆中可溶性CD40及CD4+T细胞上CD154水平的变化

目的 探讨CD40-CD40配体(CD154)相互作用在血液透析患者免疫异常及肾脏损伤中的可能作用。方法 慢性肾功能衰竭进行血液透析患者22名,透析前采静脉血,正常对照10名,非空腹采静脉血;sCD40的测定采用ELISA法,CD4+T细胞上CD154的测定采用双色流式细胞仪。结果 sCD40在正常对照血浆中水平为(30.28±11.09)pg/ml,而血液透析患者为(781.22±203.03)pg/ml,显著高于正常对照(P<0.01)。外周血CD4+T细胞上CD154在正常对照的水平为(29.24±3.99)％,而血液透析患者为(41.41±5.54)％,也明显高于正常对照(P<0.05);说明在血液透析患者,其CD40-CD154相互作用处于过度活跃状态。结论 CD40-CD154可能通过影响免疫功能及加速肾脏损伤参与了尿毒症的发生发展,阻断CD40-CD154相互作用可能有助于延缓疾病进程。