Dynamics of CD40 ligand levels in newly diagnosed and treated tuberculosis patients: An evaluation of sCD40L concentration and CD4<sup>+</sup> T cell surface expression

Sara Samar; Romeeza Tahir; Victoria Samar; Faheem Shahzad; Muhammad Kashif; Abdul Razzaq; Nadeem Afzal; Sara Samar; Romeeza Tahir; Victoria Samar; Faheem Shahzad; Muhammad Kashif; Abdul Razzaq; Nadeem Afzal

doi:10.3934/Allergy.2026003

AIMS Allergy and Immunology

2026, Volume 10, Issue 1: 21-30. doi: 10.3934/Allergy.2026003

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Research article

Dynamics of CD40 ligand levels in newly diagnosed and treated tuberculosis patients: An evaluation of sCD40L concentration and CD4⁺ T cell surface expression

1.
Department of Immunology, University of Health Sciences, Lahore 54000, Pakistan
2.
People's Nursing School, Liaquat University of Medical and Health Sciences, Jamshoro76060, Pakistan
3.
Bakhtawar Amin Medical and Dental College, Northern Bypass Road, 60000, Multan, Pakistan
4.
Focal person TB-DOTS program, Services Hospital, Lahore 54000, Pakistan
5.
Department of Pathology, Akhtar Saeed Medical and Dental College Lahore Pakistan

Received: 09 September 2025 Revised: 02 January 2026 Accepted: 06 January 2026 Published: 15 January 2026

Background/objective
CD40 ligand (CD40L/CD154), a member of the TNF superfamily, plays a critical role in immune regulation. Primarily expressed on CD4⁺ T cells, the CD40-CD40L interaction is essential for B-cell activation, antibody production, and isotype class switching. CD40L expression on T cells has been linked to Mycobacterium tuberculosis (MTB)-stimulated IFN-γ production by peripheral blood mononuclear cells. This study aimed to determine the serum concentration of soluble CD40L (sCD40L) and its surface expression on CD4⁺ T cells in newly diagnosed tuberculosis (TB) patients and in TB patients undergoing anti-tuberculosis treatment (ATT) for 2–3 months.
Materials and methods
Ninety-two subjects infected with MTB were recruited and divided into two groups; Group I consisted of 46 newly diagnosed TB patients without prior treatment, and Group II included 46 TB patients receiving ATT for the last 2–3 months. Serum sCD40L concentration of each participant was measured using ELISA, while its surface expression on CD4⁺ T cells was analyzed via flow cytometry.
Results
Serum sCD40L levels were significantly lower in (Group I) newly diagnosed TB patients (median = 11.1 ng/mL, IQR = 1.19–20.8) compared to (Group II) patients undergoing ATT (median = 17.4 ng/mL, IQR = 8.9–27.8), with a statistically significant difference between the groups (p = 0.000). The surface expression of CD40L on CD4⁺ T cells was also lower in Group I (median = 2.9, IQR = 0.16–13.99) compared to Group II (median = 3.22, IQR = 0.01–12), though the difference was not statistically significant (p = 0.893).
Conclusion
Newly diagnosed TB patients exhibited reduced levels of sCD40L, which increased following 2–3 months of anti-tuberculosis treatment. These findings suggest that CD40L may play a role in the immune response to tuberculosis and that its levels are modulated by treatment.
- tuberculosis,
- mycobacterium,
- MTB,
- CD40,
- CD40L,
- CD154
Citation: Sara Samar, Romeeza Tahir, Victoria Samar, Faheem Shahzad, Muhammad Kashif, Abdul Razzaq, Nadeem Afzal. Dynamics of CD40 ligand levels in newly diagnosed and treated tuberculosis patients: An evaluation of sCD40L concentration and CD4⁺ T cell surface expression[J]. AIMS Allergy and Immunology, 2026, 10(1): 21-30. doi: 10.3934/Allergy.2026003

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Abstract

Background/objective

CD40 ligand (CD40L/CD154), a member of the TNF superfamily, plays a critical role in immune regulation. Primarily expressed on CD4⁺ T cells, the CD40-CD40L interaction is essential for B-cell activation, antibody production, and isotype class switching. CD40L expression on T cells has been linked to Mycobacterium tuberculosis (MTB)-stimulated IFN-γ production by peripheral blood mononuclear cells. This study aimed to determine the serum concentration of soluble CD40L (sCD40L) and its surface expression on CD4⁺ T cells in newly diagnosed tuberculosis (TB) patients and in TB patients undergoing anti-tuberculosis treatment (ATT) for 2–3 months.

Materials and methods

Ninety-two subjects infected with MTB were recruited and divided into two groups; Group I consisted of 46 newly diagnosed TB patients without prior treatment, and Group II included 46 TB patients receiving ATT for the last 2–3 months. Serum sCD40L concentration of each participant was measured using ELISA, while its surface expression on CD4⁺ T cells was analyzed via flow cytometry.

Results

Serum sCD40L levels were significantly lower in (Group I) newly diagnosed TB patients (median = 11.1 ng/mL, IQR = 1.19–20.8) compared to (Group II) patients undergoing ATT (median = 17.4 ng/mL, IQR = 8.9–27.8), with a statistically significant difference between the groups (p = 0.000). The surface expression of CD40L on CD4⁺ T cells was also lower in Group I (median = 2.9, IQR = 0.16–13.99) compared to Group II (median = 3.22, IQR = 0.01–12), though the difference was not statistically significant (p = 0.893).

Conclusion

Newly diagnosed TB patients exhibited reduced levels of sCD40L, which increased following 2–3 months of anti-tuberculosis treatment. These findings suggest that CD40L may play a role in the immune response to tuberculosis and that its levels are modulated by treatment.

Acknowledgments

The researcher acknowledges and expresses sincere appreciation to UHS Lahore, Pakistan for their invaluable financial support, which made this research possible. Furthermore, heartfelt gratitude is extended to the patients who graciously volunteered to participate in this study.

Conflicts of interest

The authors declare that there is no conflict of interest regarding the publication of this paper.

Author contributions

(I) Conception and design: SS, RT, NA, MK, FS; (II) Administrative & supervision support: NA, RT, FS, VS, AR; (III) Provision of study materials or patients: MK, AS, NA, SS, VS, AR; (IV) Collection and assembly of data: SS, AR, MK, AR; (V) Data analysis and interpretation: SS, VS, MK, FS; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

Data availability

Data supporting the findings of this research article can be provided on demand by contacting the corresponding author.

Funding statement

UHS Lahore provided necessary funds and logistics to conduct this research.

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