title: CD40 ligand as a potential biomarker for atherosclerotic instability.
abstract: OBJECTIVE
  The signaling protein CD40 and its ligand, CD40L, are thought to contribute to atherosclerotic plaque formation and rupture. We sought to determine their utility as markers of cerebral atherosclerosis and neurological dysfunction.
  
  
  METHODS
  We recruited 82 patients with acute cerebral infarction (ACI) and classified each as having large-artery atherosclerosis (LAA, 30), small-artery occlusion (36), or cardioaortic embolism (16). We also recruited 17 patients who had carotid artery stenosis (CAS) without stroke and 20 healthy individuals as controls. CD40L expression on peripheral blood monocytes (PBMCs) was detected by direct immunofluorescence with flow cytometry, and serum soluble CD40L (sCD40L) was measured by ELISA.
  
  
  RESULTS
  CD40L expression on PBMCs was highest in the LAA group, followed by that in the CAS group (both P < 0·01 versus control). It was also higher in patients with atherosclerotic infarction than in those without atherosclerosis (P < 0·05). PBMC CD40L expression was sensitive and specific for detecting atherosclerosis and LAA cerebral infarction and was superior to serum C-reactive protein for predicting cerebral atherosclerosis (P < 0·01). Serum sCD40L was higher in patients with ACI than in healthy controls (P < 0·01) or patients with CAS (P < 0·01) and correlated with increased disability on three scales (all P < 0·01).
  
  
  CONCLUSIONS
  We conclude that patients with ACI have an upregulated CD40-CD40L system, which could be used as a clinical biomarker for assessing atherosclerotic instability and severity of neurological dysfunction.
authors.affiliation: 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Jing-Hua
authors.initials: JH
authors.lastname: Wang
authors.forename: Yong-Wei
authors.initials: YW
authors.lastname: Zhang
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
authors.forename: Ben-Qiang
authors.initials: BQ
authors.lastname: Deng
authors.forename: Suju
authors.initials: S
authors.lastname: Ding
authors.forename: Zhong-Kui
authors.initials: ZK
authors.lastname: Wang
authors.forename: Tao
authors.initials: T
authors.lastname: Wu
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D023201:CD40 Ligand / Q000097:blood*; D002544:Cerebral Infarction / Q000175:diagnosis*; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D023201:CD40 Ligand
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