Elevated circulating levels of soluble CD-40 ligand in haemodialysis patients with symptomatic coronary heart disease.
OBJECTIVE
The CD40-CD40L system has been implicated in the pathogenesis of atherothrombotic complications in cardiovascular disease. The aim of this study was to determine the relationship between plasma soluble CD40 ligand (sCD40L) and symptomatic coronary heart disease (CHD) in end-stage renal disease (ESRD) patients on maintenance haemodialysis (HD).


METHODS
This cross-sectional study included 57 HD patients, 31 of whom had symptomatic CHD. Lipid profile, markers of endothelial activation such as sCD40L, and both inflammatory and oxidative stress markers were measured and analyzed.


RESULTS
The sCD40L concentration was significantly higher in HD patients than in controls (1.34 +/- 0.53 vs 0.86 +/- 0.12 ng/mL, P < 0.01). Plasma concentration of sCD40L (P < 0.01), soluble vascular adhesion molecule-1 (sVCAM-1; P < 0.01) and high-sensitivity CRP (hsCRP; P < 0.01) were higher in HD patients with symptomatic CHD than in those without CHD. In addition, we also found that oxidative stress biomarkers such as nitrotyrosine (NT), malonaldehyde (MDA) and protein carbonyl (PC) were significantly elevated in patients with symptomatic CHD compared to those without. There was a strong overall positive relationship between sCD40L concentration and sVCAM-1 (r = 0.54, P < 0.001), MDA (r = 0.365, P < 0.01), NT (r = 0.293, r < 0.05) and log-transformed triglycerides (r = 0.275, P < 0.05).


CONCLUSIONS
Circulating concentrations of sCD40L were elevated in HD patients with symptomatic CHD. This study suggests that CD40-CD40L may play a potentially important role in the atherosclerotic complications of HD patients.
Lim
Paik-Seong
PS
Division of Renal Medicine, Tungs' Taichung Metroharbour Hospital, Taichung, Taiwan. ps.lim@msa.hinet.net
Wu
Ming-Ying
MY
Chien
Shiaw-Wen
SW
Wu
Tsai-Kun
TK
Liu
Chia-Shan
CS
Hu
Chuen-Yuh
CY
Chang
Hui-Chen
HC
Pai
Mei-An Tsai
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D023201:CD40 Ligand / Q000097:blood*; D016022:Case-Control Studies; D003327:Coronary Disease / Q000097:blood / Q000150:complications / Q000276:immunology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000276:immunology / Q000628:therapy*; D008055:Lipids / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D018384:Oxidative Stress; D010865:Pilot Projects; D050050:Protein Carbonylation; D006435:Renal Dialysis; D014443:Tyrosine / Q000031:analogs & derivatives / Q000097:blood; D015854:Up-Regulation; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D015415:Biomarkers; D018836:Inflammation Mediators; D008055:Lipids; D019010:Vascular Cell Adhesion Molecule-1; D023201:CD40 Ligand; C002744:3-nitrotyrosine; D014443:Tyrosine; D008315:Malondialdehyde; D002097:C-Reactive Protein