Abstract
Experimental evidence suggests that interference with gp39—CD40 interactions may have therapeutic potential in prevention of certain autoimmune disorders (i.e., collagen-induced rheumatoid arthritis). The binding between CD40 expressed on mature B cells and CD40 ligand (CD40L, gp39) transiently expressed on activated T helper cells (Th) further stabilizes the interactions (between Th and B cells) and coordinates the responses of the interacting cells during antigen presentation, and is essential for thymus-dependent humoral immunity. Graves' disease is the most common form of hyperthyroidism, in which hyperactivity of the thyroid gland is due to an autoantibody directed against the thyrotropin receptor (TSHR). The main objective of our study was to determine the role of interactions between gp39 and CD40 in "an established" human Graves' disease (GD). Severe combined immunodeficient (SCID) mouse served as a vehicle for human Graves' thyroid tissue. This experimental setting allows us to study, observe, and immunomodulate human autoimmune tissue in so called in vivo condition. We studied the effects of ip administration of anti-gp39 mAb on humoral response, thyroid function tests, expression of adhesion molecules, and HLA-DR on human thyrocytes and histopathological changes from human GD thyroid tissue xenografts. GD thyroid tissue from 4 patients was xenografted into 20 SCID mice (0.8 g/mouse). Human immunoglobulin G (IgG) levels became detectable in SCID mice 1 week after xenograftment. Ten SCID mice were sequentially administered anti-gp39 mAb (250 μg/mouse/dose) ip every 4 days until the end of the experiment. Ten control animals were injected with vehicle (PBS) in similar fashion. Blood samples were taken every 2 weeks from the tail veins for measurement of the humoral response [human IgG, thyroid-stimulating antibody (TSAb), antithyroperoxidase (anti-TPO), and antithyroglobulin (anti-Tg) Abs], and thyroid function tests. After 8 weeks, animals were sacrificed and thyroid tissue was examined histologically. The humoral response from the intrathyroidal lymphocytes was measured and the tissue morphology of GD was preserved during the 8-week period in phosphate-buffered saline (PBS)-treated SCID mice xenografted with GD xenografts. However, administration of anti-gp39 mAb completely blocked or significantly decreased the humoral response in all treated animals. On the other hand, no significant histological changes were associated with the administration of anti-gp39 mAb. The degree of lymphocytic infiltration in thyroid tissue xenografts was comparable in both groups. Serum thyroxine values were normal in both groups. In spite of a profound immunosuppressive effect on the humoral response by directly blocking CD40-gp39 interactions in vivo, this did not result in complete deletion of the responding Th in the thyroid specimens.
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