Serum Interleukin-40 and Soluble CD40 Ligand as Complementary Biomarkers for Disease Activity in Multiple Sclerosis Patients

Sep 28, 2026

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Multiple sclerosis (MS) remains a complex autoimmune CNS disease with an unmet need for reliable indicators of disease activity. This study evaluated serum interleukin-40 (IL-40) and soluble CD40 ligand (sCD40L) as biomarkers, comparing MS patients with healthy controls and contrasting active versus inactive disease status. IL-40 and sCD40L were significantly higher in both patient groups, showed positive correlation, and demonstrated strong diagnostic accuracy, supporting complementary monitoring and clinical decision-making.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

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Abstract

Objectives

Methods

Results

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Introduction

DOI: 10.4274/MMJ.galenos.2025.48830 Medeni Med J 2025;40:226-234 Original Article Serum Interleukin-40 and Soluble CD40 Ligand as Complementary Biomarkers for Disease Activity in Multiple Sclerosis Patients Multipl Skleroz Hastalarında Hastalık Aktivitesinin Tamamlayıcı Biyobelirteçleri Olarak Serum Mustafa Ziyad NEAMAH1, Inas K SHARQUIE1, Gheyath AL GAWWAM2 1University of Baghdad College of Medicine Department of Microbiology and Immunology, Baghdad, Iraq 2University of Baghdad College of Medicine, Department of Medicine, Baghdad, Iraq ABSTRACT Objectives: Multiple sclerosis (MS) is a complex autoimmune disease of the central nervous system for which reliable biomarkers of disease activity remain an unmet need. Interleukin-40 (IL-40) and soluble CD40 ligand (sCD40L) have been proposed to play roles in the pathogenesis of autoimmune diseases. This study aimed to evaluate serum levels of IL-40 and sCD40L as biomarkers of disease activity in MS patients, and to compare their diagnostic and monitoring performance between MS patients and healthy controls. Methods: One hundred twenty MS patients were recruited from the Department of MS at the Baghdad Teaching Hospital and divided into two groups based on disease status: active (n=60) and inactive (n=60) . Additionally, 57 matched healthy individuals were included as controls. A sandwich enzyme-linked immunosorbent assay was used to measure theserum levels of IL-40 and sCD40L in blood samples from each participant. Results: Both active and inactive patient cohorts showed significantly higher serum levels of IL-40 (44 .25±8 .57 ng/mL and 38. 98±11 .31 ng/ mL, respectively) compared with their control group (20 . 82±14 .27 ng/ mL) (p=0 . 005) . Likewise, sCD40L concentrations were elevated in both active (2155 . 59±587 .02 pg/mL) and inactive (1885 .23±851 .32 pg/mL) patients compared with controls (849 .79±341 .87 pg/mL; p=0 . 0006) . IL- 40 correlated positively with sCD40L (r=0 . 399, p=0 . 005) . The receiver operating characteristic analysis showed high diagnostic performance for IL-40 (area under the curve =0 . 873; sensitivity 87 . 5%; specificity 76 .7%) and sCD40L (area under the curve =0 . 901; sensitivity 92 . 5%; specificity 81 .7%) . Conclusions: Both IL-40 and sCD40L are significantly elevated in MSand exhibit promising diagnostic validity. These biomarkers may serve as complementary tools for monitoring MS disease activity and progression, offering potential value in clinical practice and therapeutic decisionmaking. Keywords: Multiple sclerosis, interleukin-40, soluble CD40 ligand, biomarker, disease activity ÖZ Amaç: Multipl skleroz (MS), merkezi sinir sisteminin karmaşık birotoimmün hastalığıdır ve hastalık aktivitesinin güvenilir biyobelirteçleri hala karşılanmamış bir ihtiyaçtır. Interlökin-40 (IL-40) ve çözünür CD40 ligandının (sCD40L) otoimmün hastalıkların patogenezinderol oynadığı öne sürülmüştür. Bu çalışma, MS hastalarında hastalıkaktivitesinin biyobelirteçleri olarak IL-40 ve sCD40L serum düzeylerinideğerlendirmek ve MS hastaları ile sağlıklı kontrol grubu arasında bu belirteçlerin tanı ve izleme performansını karşılaştırmak amacıylayapılmıştır. Yöntemler: Bağdat Eğitim Hastanesi MS Bölümünden 120 MS hastası seçildi ve hastalık durumuna göre aktif (n=60) ve inaktif (n=60) olmak üzere iki gruba ayrıldı. Ayrıca, 57 eşleştirilmiş sağlıklı birey kontrol grubu olarak dahil edildi. Her katılımcının kan örneklerinde IL-40 ve sCD40L serum düzeylerini ölçmek için sandviç enzim bağlı immünosorbent testi kullanıldı. Bulgular: Hem aktif hem de inaktif hasta kohortları, kontrol grubuna (20,82±14,27 ng/mL) kıyasla (p=0,005) anlamlı olarak daha yüksek IL-40 serum düzeyleri (sırasıyla 44,25±8,57 ng/mL ve 38,98±11,31 ng/mL) gösterdi. Benzer şekilde, sCD40L konsantrasyonları, aktif (2155,59±587,02 pg/mL) ve inaktif (1885,23±851,32 pg/mL) hastalardakontrol grubuna (849,79±341,87 pg/mL; p=0,0006) kıyaslayükselmiştir. IL-40, sCD40L ile pozitif korel

FAQs

What was the main objective of the study?

To evaluate serum IL-40 and sCD40L levels as biomarkers of disease activity in MS patients and compare their diagnostic and monitoring performance versus healthy controls.

How were IL-40 and sCD40L measured?

Serum levels of IL-40 and sCD40L were measured using a sandwich enzyme-linked immunosorbent assay (ELISA) from blood samples.

What did the results show about IL-40 and sCD40L levels?

Both IL-40 and sCD40L were significantly elevated in active and inactive MS cohorts compared with controls, and IL-40 correlated positively with sCD40L.

Sep 28, 2026

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