title: Association of low-grade inflammation and platelet activation in patients with hypertension with microalbuminuria.
abstract: Increased levels of sCD40L (soluble CD40 ligand) have been associated with enhanced in vivo platelet activation, and may represent a molecular link between inflammation and a prothrombotic state. The aim of the present study was to analyse the relationship between platelet activation, endothelial dysfunction, low-grade inflammation and sCD40L in patients with hypertension with or without MA (microalbuminuria). A cross-sectional comparison of sCD40L levels was performed in 25 patients with MH (essential hypertension with MA) pair-matched for gender and age with 25 patients with EH (essential hypertension) and 25 HS (healthy subjects with normotension). Circulating levels of CRP (C-reactive protein), a marker of inflammation, sP-selectin (soluble P-selectin), a marker of in vivo platelet activation, and ADMA (asymmetric dimethylarginine) and vWF (von Willebrand factor), markers of endothelial dysfunction, were analysed in each subject. sCD40L levels were increased in patients with MH compared with either patients with EH (P<0.001) or HS (P<0.0001). A highly significant correlation between plasma sCD40L and sP-selectin (P<0.0001), vWF (P<0.001) or CRP levels (P<0.05) was observed in patients with MH. Multivariate regression analysis showed that sP-selectin was the strongest independent predictor of sCD40L levels (P<0.0001) in patients with MH. Patients with hypertension with both vWF and CRP levels above the median had the highest sCD40L levels (P<0.0001). Factorial ANOVA of all of the patients with hypertension confirmed that only patients with MH with low-grade inflammation had elevated levels of sCD40L. In conclusion, sCD40L levels appear to discriminate a subset of patients characterized by MA and low-grade inflammation, suggesting that inhibition of the CD40/CD40L system may represent a potential therapeutic target in subjects with hypertension at a high risk of cardiovascular events.
authors.affiliation: Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS San Raffaele Pisana, Rome, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ferroni
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Guagnano
authors.forename: Angela
authors.initials: A
authors.lastname: Falco
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Paoletti
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Manigrasso
authors.forename: Noemi
authors.initials: N
authors.lastname: Michetti
authors.forename: Francesca
authors.initials: F
authors.lastname: Santilli
authors.forename: Fiorella
authors.initials: F
authors.lastname: Guadagni
authors.forename: Stefania
authors.initials: S
authors.lastname: Basili
authors.forename: Giovanni
authors.initials: G
authors.lastname: Davì
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis; D023201:CD40 Ligand / Q000097:blood; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D007249:Inflammation / Q000097:blood / Q000150:complications*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D015539:Platelet Activation; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D008055:Lipids; D019007:P-Selectin; D014841:von Willebrand Factor; D023201:CD40 Ligand; D002097:C-Reactive Protein