Increased soluble CD40L levels are reduced by long-term simvastatin treatment in peritoneally dialyzed patients.
BACKGROUND
Dyslipidemia and increased mortality due to cardiovascular events are common in peritoneally dialyzed patients [continuous ambulatory peritoneal dialysis (CAPD)]. Statins show beneficial effects on serum lipids and reduce cardiovascular mortality. The CD40-CD40 ligand (CD40L) system has proved critical for the activation of tissue structural cells that include endothelial cells, epithelial cells and fibroblasts. It has been reported that enhanced CD40L-CD40 interaction in familial hypercholesterolemia may be downregulated by statins, but prospective studies on CAPD patients are lacking.


OBJECTIVE
To determine the effects of 6 months treatment with simvastatin on platelet aggregation, markers of endothelial cell injury, and sCD40L in 15 hyperlipidemic CAPD patients.


METHODS
Simvastatin (Zocor, Merck Sharp & Dohme) was given in a dose of 10 mg at bedtime.


RESULTS
CD40L decreased significantly after 6 months of the therapy. Thrombomodulin decreased significantly after 3 months of the therapy, whereas von Willebrand factor, E-selectin and P-selectin did not change significantly during the study.


CONCLUSIONS
Simvastatin reduced enhanced sCD40L levels together with amelioration of endothelial dysfunction. Treatment with simvastatin might downregulate enhanced CD40L-CD40 interactions in CAPD patients.
Nephrology and Transplantology Department, Medical University, 15-540 Bialystok, Zurawia 14, Poland. jolmal@poczta.onet.pl
Jolanta
J
Malyszko
Jacek S
JS
Malyszko
Tomasz
T
Hryszko
Michal
M
Mysliwiec
D001161:Arteriosclerosis / Q000150:complications / Q000188:drug therapy; D002097:C-Reactive Protein / Q000032:analysis; D023201:CD40 Ligand / Q000097:blood*; D019040:E-Selectin / Q000097:blood; D004730:Endothelium, Vascular / Q000187:drug effects; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D006973:Hypertension / Q000150:complications; D007249:Inflammation / Q000097:blood / Q000188:drug therapy; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010974:Platelet Aggregation / Q000187:drug effects; D019821:Simvastatin / Q000494:pharmacology* / Q000627:therapeutic use; D012995:Solubility; D014841:von Willebrand Factor / Q000032:analysis
D019040:E-Selectin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019007:P-Selectin; D014841:von Willebrand Factor; D023201:CD40 Ligand; D002097:C-Reactive Protein; D019821:Simvastatin