Association between enhanced soluble CD40 ligand and prothrombotic state in inflammatory bowel disease.
BACKGROUND
Inflammatory bowel disease is associated with an increased incidence of thromboembolic complications. The aim of this study was to investigate the role of the soluble CD40 ligand (sCD40L), which displays prothrombotic properties, in patients with ulcerative colitis (UC) and Crohn's disease (CD) in comparison with inflammatory and healthy controls.


METHODS
Plasma levels of sCD40L, prothrombin fragment 1+2 (F1+2), thrombin-antithrombin (TAT) complex and soluble P-selectin were measured in 104 inflammatory bowel disease patients (54 ulcerative colitis and 50 Crohn's disease), in 18 cases with other causes of intestinal inflammation and in 80 healthy controls using commercially available enzyme-linked immunosorbent assays. Plasma levels of sCD40L were correlated with disease activity, type, localization and treatment as well as with the measured thrombophilic parameters.


RESULTS
CD patients had significantly higher sCD40L levels than both groups of controls (CD vs HC P < 0.001; CD vs non-IBD P < 0.05). UC patients had higher but not significantly different sCD40L levels compared with the controls. Both UC and CD patients with active disease had significantly higher sCD40L levels in comparison with patients with inactive disease. Plasma levels of sCD40L were correlated with platelet count (r = 0.27, P = 0.001). They also showed a correlation with prothrombin F1+2 (r = 0.16, r = 0.03) and TAT (r = 0.15, r = 0.04) as well as with P-selectin (r = 0.19, P = 0.01).


CONCLUSIONS
The increased sCD40L plasma levels may represent, at least in some degree, a molecular link between inflammatory bowel disease and the procoagualant state.
Department of Gastroenterology University Hospital Heraklion; and Regional Blood Bank Center Venizelion Hospital Heraklion, Crete, Greece.
Ioannis E
IE
Koutroubakis
Angeliki
A
Theodoropoulou
Costas
C
Xidakis
Aekaterini
A
Sfiridaki
George
G
Notas
George
G
Kolios
Elias A
EA
Kouroumalis
D000328:Adult; D000990:Antithrombin III; D015415:Biomarkers / Q000097:blood; D023201:CD40 Ligand / Q000097:blood*; D003093:Colitis, Ulcerative / Q000097:blood / Q000150:complications; D003424:Crohn Disease / Q000097:blood / Q000150:complications; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood* / Q000150:complications; D008297:Male; D019007:P-Selectin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010447:Peptide Hydrolases / Q000097:blood; D010976:Platelet Count; D011516:Prothrombin; D012995:Solubility; D013923:Thromboembolism / Q000097:blood* / Q000150:complications
D015415:Biomarkers; D019007:P-Selectin; D010446:Peptide Fragments; C046193:antithrombin III-protease complex; C045879:prothrombin fragment 1.2; D023201:CD40 Ligand; D000990:Antithrombin III; D011516:Prothrombin; D010447:Peptide Hydrolases