The CD40/CD40 ligand system: linking inflammation with atherothrombosis.
The role of CD40/CD40 ligand (CD40L) in atherothrombosis is now widely accepted. However, the exact mechanisms linking the CD40/CD40L system and the soluble form of CD40 ligand (sCD40L) with atherothrombosis are currently a topic of intensive research. CD40L and sCD40L belong to the tumor necrosis factor superfamily, and they are molecules with a dual prothrombotic and proinflammatory role. They are expressed in a variety of tissues such as the immune system (in both B and T cells), the vascular wall, and activated platelets. Soluble CD40L has multiple autocrine, paracrine, and endocrine actions, and it may trigger key mechanisms participating in atherothrombosis. CD40/CD40L may participate in the development of coronary atherosclerosis and the triggering of acute coronary syndromes, while sCD40L seems to have a prognostic role not only in subjects with advanced atherosclerosis but also in the general population. Although conventional cardiovascular medication such as antiplatelet therapy, statins, angiotensin-converting enzyme inhibitors, and many others have been shown to reduce both sCD40L and cardiovascular risk, it is still unclear whether specific treatments targeting the CD40/CD40L system will prove to be beneficial against atherothrombosis in the near future.
Antoniades
Charalambos
C
1st Department of Cardiology, University of Athens Medical School, Athens, Greece. antoniades@vodafone.net.gr
Bakogiannis
Constantinos
C
Tousoulis
Dimitris
D
Antonopoulos
Alexios S
AS
Stefanadis
Christodoulos
C
D054058:Acute Coronary Syndrome / Q000235:genetics / Q000276:immunology / Q000503:physiopathology*; D000818:Animals; D050197:Atherosclerosis / Q000276:immunology / Q000503:physiopathology*; D019013:CD40 Antigens / Q000502:physiology*; D023201:CD40 Ligand / Q000235:genetics / Q000502:physiology*; D003324:Coronary Artery Disease / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D015539:Platelet Activation / Q000502:physiology; D011110:Polymorphism, Genetic; D011379:Prognosis; D012995:Solubility; D013927:Thrombosis / Q000276:immunology / Q000503:physiopathology*
D019013:CD40 Antigens; D023201:CD40 Ligand