ABSTRACT:The interactions between CD40 and CD40L (CD154) are critical for effective humoral immune response. CD40 signaling facilitates T lymphocyte dependent B cell proliferation and immunoglobulin isotype switch. The objective of our study was to investigate the CD40 and CD40L expression on peripheral blood mononuclear cells (PBMC) of children with symptomatic transient hypogammaglobulinemia (THI), common variable immunodeficiency (CVID) and selective IgA deficiency (SIgAD). Additionally we studied the production of IL-12 and IL-18 by PBMC stimulated with soluble CD40L. CD40 expression was analyzed on B cells and monocytes, CD40L on activated T lymphocytes, using flow cytometry following staining of the cells with appropriate MAb. We found that CD40 expression on B cells and CD40L on activated T cells were essentially similar in the control and patient groups, while the decreased CD40 expression on monocytes was observed in THI and SIgAD patients compared with normal subjects. The most significant decrease of CD40 expression was observed in THI (37% of positive cells) in comparison with control (81% of positive cells). IL-12, but not IL-18, release by PBMC was increased in THI and CVID, but not in SIgAD. In conclusion we suggest that the decreased expression of CD40 on monocytes of children with THI and SIgAD, but not CVID, may be involved in the pathomechanism of these immunodeficiencies. THI is characterized by delay in IgG, and often IgA, synthesis for as long as 40 mo of age, which spontaneously return to normal values at the age of 2-4 y (1). Affected children often suffer from recurrent otitis, upper respiratory tract infections, food intolerance and atopy. According to Walker et al. (2), THI appears to have a similar prevalence to symptomatic SIgAD, the reasons for delayed immunoglobulin synthesis in THI remain unknown (2).SIgAD is the most common primary immunodeficiency. Approximately 60% of subjects with IgA deficiency are asymptomatic. Those with symptoms suffer from recurrent infections of respiratory tract, gastrointestinal disorders, allergy and autoimmune diseases (3). The term CVID is used to describe an incompletely defined syndrome characterized by defective antibody formation, usually accompanied by decreased serum IgG and IgA levels and generally, but not invariably, decreased serum IgM level (1). First symptoms may occur at any time of life, but the most common disease onset is between 1-5 and 16 -25 y of life (4).Many studies attempting to identify the immunologic defects in CVID have been published. Recently identified monogenic defects (ICOS, TACI, BAFF-R and CD19 defects) account for about 10% of cases, but the immunopathogenesis of the majority of CVID cases still remains unexplored (5,6). The variable clinical features and variety of affected immunologic functions suggest involvement of multiple pathogenetic factors.The production of antibodies is regulated by a complex array of cellular and molecular interactions that take place between antigens and cells of the innate and adaptive ...