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Abnormal high-expression of CD154 on T lymphocytes of ankylosing spondylitis patients is down-regulated by etanercept treatment

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Abstract

The pathogenesis of ankylosing spondylitis (AS) still remains an enigma. Although some studies have indicated the importance of T-cells and proinflammatory cytokines in the pathogenesis of the AS, it is still unknown whether co-stimulatory molecule CD154 participates in the pathogenesis of AS and how its level changes during the anti-TNF-α treatment of AS. This study is performed to evaluate the expression of CD154 in peripheral blood T-lymphocytes of patients with AS and observe the change of CD154 in etanercept-treated AS patient. We collected the peripheral blood and clinical data from 66 AS, 30 rheumatoid arthritis (RA) patients, and 30 healthy controls. Thirty-nine active AS patients were enrolled in a randomized double-blind placebo-controlled trial. We followed up 37 cases that fulfilled the ASAS20 response criteria after they finished etanercept treatment till week 48. The percentage of CD3+CD154+ in peripheral blood lymphocytes was evaluated by flow cytometry. We found that CD154 expression in AS patients was significantly higher than that in healthy volunteers and RA patients (both P < 0.001). The expressions of CD154 in AS patients at active stage or with peripheral joint involvement were significantly higher than those at stable stage or with axial involvement alone (P = 0.005 and 0.044, respectively). The expression of CD154 decreased in AS patients treated with etanercept compared with patients treated with placebo at week 6 (P < 0.001). Compared with healthy volunteers, the expression of CD154 in 16 AS patients who relapsed after finishing etanercept treatment was elevated again (P = 0.012). These findings show that co-stimulatory molecule CD154 is overexpressed on T-lymphocytes in peripheral blood of AS patients and can be down-regulated by etanercept treatment, which suggest that CD154 might be involved in the inflammatory evolvement of AS and might be a potential biomarker to monitor AS disease activity and the effect of etanercept treatment.

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Acknowledgments

We thank the patients who volunteered to take part in this study. We acknowledge the help of Dr. Haixia Xu and Jijun Zhao for collecting the materials of this study. This study was supported by National Natural Sciences Foundations of China (No. 30325019, 30571735, and 30471611), Ministry of health key clinical project and Science foundation of Guangdong province of China (No. 2002Z3-E4021 and 2005A30801005).

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Authors and Affiliations

  1. Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, 510630, Guangzhou, China

    Qu Lin, Zhiming Lin, Jieruo Gu, Feng Huang, Tianwang Li, Qiujing Wei, Zetao Liao, Shuangyan Cao, Yingjuan Jiang & Jinxian Huang

  2. Department of Rheumatology, China PLA Hospital, 100853, Beijing, China

    Feng Huang

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  1. Qu Lin
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  2. Zhiming Lin
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  3. Jieruo Gu
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Correspondence to Jieruo Gu.

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Q. Lin and Z. Lin equally contributed to this study.

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Lin, Q., Lin, Z., Gu, J. et al. Abnormal high-expression of CD154 on T lymphocytes of ankylosing spondylitis patients is down-regulated by etanercept treatment. Rheumatol Int 30, 317–323 (2010). https://doi.org/10.1007/s00296-009-0958-8

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  • DOI: https://doi.org/10.1007/s00296-009-0958-8

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