title: Upregulation of CD40 and CD40 ligand (CD154) in patients with moderate hypercholesterolemia.
abstract: BACKGROUND
  Hypercholesterolemia, a risk factor for cardiovascular disease, is associated with inflammation and hypercoagulability. Both can be mediated by the CD40 system. This study investigated whether the CD40 system is upregulated in patients with moderate hypercholesterolemia and whether it is influenced by therapy with a hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitor.
  
  
  RESULTS
  Fifteen patients with moderate hypercholesterolemia and 15 healthy control subjects were investigated. CD154 and P-selectin were analyzed on platelets and CD40 was analyzed on monocytes before and under therapy with the statin cerivastatin by double-label flow cytometry. Blood concentrations of soluble CD154 and monocyte chemoattractant protein-1 (MCP-1) were evaluated. Our main findings were as follows. Patients with moderate hypercholesterolemia showed a significant increase of CD154 and P-selectin on platelets and CD40 on monocytes compared with healthy subjects. Soluble CD154 showed a nonsignificant trend for higher plasma levels in patients. A positive correlation was found for total or LDL cholesterol and CD154, but not for CD40 on monocytes. The latter was upregulated in vitro by C-reactive protein, which was found to be significantly elevated in patients with moderate hypercholesterolemia. CD154 on platelets proved to be biologically active because it enhanced the release of MCP-1, which was markedly elevated in an in vitro platelet-endothelial cell coculture model and in the serum of patients. Short-term therapy with a HMG-CoA reductase inhibitor significantly downregulated CD40 on monocytes and serum levels of MCP-1.
  
  
  CONCLUSIONS
  Patients with moderate hypercholesterolemia show upregulation of the CD40 system, which may contribute to the known proinflammatory, proatherogenic, and prothrombotic milieu found in these patients.
authors.affiliation: Medical Clinic II and Medical Clinic IV, Friedrich Alexander University, Erlangen-Nürnberg, Germany. Christoph.Garlichs@rzmail.uni-erlangen.de
authors.forename: C D
authors.initials: CD
authors.lastname: Garlichs
authors.forename: S
authors.initials: S
authors.lastname: John
authors.forename: A
authors.initials: A
authors.lastname: Schmeisser
authors.forename: S
authors.initials: S
authors.lastname: Eskafi
authors.forename: C
authors.initials: C
authors.lastname: Stumpf
authors.forename: M
authors.initials: M
authors.lastname: Karl
authors.forename: M
authors.initials: M
authors.lastname: Goppelt-Struebe
authors.forename: R
authors.initials: R
authors.lastname: Schmieder
authors.forename: W G
authors.initials: WG
authors.lastname: Daniel
mesh_terms: D000328:Adult; D001161:Arteriosclerosis / Q000209:etiology; D001792:Blood Platelets / Q000378:metabolism; D019013:CD40 Antigens / Q000096:biosynthesis*; D023201:CD40 Ligand / Q000096:biosynthesis*; D002478:Cells, Cultured; D018932:Chemokine CCL2 / Q000096:biosynthesis; D004730:Endothelium, Vascular / Q000378:metabolism; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D007249:Inflammation / Q000209:etiology; D008297:Male; D009000:Monocytes / Q000378:metabolism; D019007:P-Selectin / Q000378:metabolism; D011725:Pyridines / Q000494:pharmacology; D013927:Thrombosis / Q000209:etiology; D015854:Up-Regulation
chemical_list: D019013:CD40 Antigens; D018932:Chemokine CCL2; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019007:P-Selectin; D011725:Pyridines; D023201:CD40 Ligand; C086276:cerivastatin