Increased CD40 ligand in patients with acute anterior uveitis

Purpose: The inflammatory response in acute anterior uveitis (AU) is believed to be primarily mediated by autoreactive T-cells. We wanted to evaluate whether the T-cell activation marker CD40 ligand is involved in the AU immunopathogenesis. Methods: We evaluated the expression of the CD40 ligand on CD4+ T-cells, CD8+ T-cells and CD19+ B-cells on peripheral blood mononuclear cells using flow cytometry in six patients with unilateral AU, six patients with monosymptomatic optic neuritis (ON) as inflammatory controls, and in six healthy controls. The ex vivo induction of the CD40 ligand on T-cells in patients and controls was also studied. Results: A significantly higher expression of the CD40 ligand on both CD4+ (p < 0.05) and CD8+ (p < 0.05) T-cells in patients with AU compared to ON patients and healthy controls was found. There was a significantly higher induction of the CD40 ligand on CD8+ T-cells in AU patients compared to ON patients and healthy controls (p < 0.01). No differences in the B-cell population were observed between the three groups. Conclusion: Patients with AU had increased expression of the CD40 ligand on T-cells in the blood and expressed higher levels of the CD40 ligand when stimulated, compared to ophthalmological inflammatory controls and healthy controls. The data suggest that the CD40 ligand is involved in the development of AU.