title: Elevated circulating levels of soluble CD-40 ligand in haemodialysis patients with symptomatic coronary heart disease.
abstract: 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.
authors.affiliation: Division of Renal Medicine, Tungs' Taichung Metroharbour Hospital, Taichung, Taiwan. ps.lim@msa.hinet.net
authors.forename: Paik-Seong
authors.initials: PS
authors.lastname: Lim
authors.forename: Ming-Ying
authors.initials: MY
authors.lastname: Wu
authors.forename: Shiaw-Wen
authors.initials: SW
authors.lastname: Chien
authors.forename: Tsai-Kun
authors.initials: TK
authors.lastname: Wu
authors.forename: Chia-Shan
authors.initials: CS
authors.lastname: Liu
authors.forename: Chuen-Yuh
authors.initials: CY
authors.lastname: Hu
authors.forename: Hui-Chen
authors.initials: HC
authors.lastname: Chang
authors.forename: Mei-An Tsai
authors.initials: MA
authors.lastname: Pai
mesh_terms: 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
chemical_list: 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