Enhanced Soluble Serum CD40L and Serum P-Selectin Levels in Primary Aldosteronism.
Primary aldosteronism (PA) is one of the most frequent forms of secondary hypertension, associated with atherosclerosis and higher risk of cardiovascular events. Platelets play a key role in the atherosclerotic process. The aim of the study was to evaluate the platelet activation by measuring serum levels of soluble CD40L (sCD40L) and P-selectin (sP-selectin) in consecutive PA patients [subgroup: aldosterone-secreting adrenal adenoma (APA) and bilateral adrenal hyperplasia (IHA)], matched with essential hypertensive (EH) patients. The subgroup of APA patients was revaluated 6-months after unilateral adrenalectomy. In all PA group, we measured higher serum levels of both sP-selectin (14.29±9.33 pg/ml) and sCD40L (9.53±4.2 ng/ml) compared to EH patients (9.39±5.3 pg/ml and 3.54±0.94 ng/ml, respectively; p<0.001). After removal of APA, PA patients showed significant reduction of blood pressure (BP) values, plasma aldosterone (PAC) levels and ARR-ratio, associated with a significant reduction of sP-selectin (16.74±8.9 pg/ml vs. 8.1±3.8 pg/ml; p<0.01) and sCD40L (8.6±1 ng/ml vs. 5.24±0.94 ng/ml; p<0.001). In PA patients, we found a significant correlation between sP-selectin and sCD40L with PAC (r=0.52, p<0.01; r=0.50, p<0.01, respectively); this correlation was stronger in APA patients (r=0.54; p<0.01 r=0.63; p<0.01, respectively). Our results showed that PA is related to platelet activation, expressed as higher plasma values of sCD40L and sP-selectin values. Surgical treatment and consequent normalization of aldosterone secretion was associated with significant reduction of sCD40L and sP-selectin values in APA patients.
Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Rome, Italy.
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Petramala
Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA.
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Iacobellis
Department of Internal Medicine and Medical Specialties, University of Rome "Sapienza", Rome, Italy.
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Carnevale
Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Rome, Italy.
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Marinelli
Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Rome, Italy.
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Zinnamosca
Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Rome, Italy.
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Concistrè
Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Rome, Italy.
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Galassi
Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Rome, Italy.
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Iannucci
Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Rome, Italy.
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Lucia
Department of Internal Medicine and Medical Specialties, University of Rome "Sapienza", Rome, Italy.
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Pignatelli
Department of Surgery "Pietro Valdoni", University of Rome "Sapienza", Rome, Italy.
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Ciardi
Department of Internal Medicine and Medical Specialties, University of Rome "Sapienza", Rome, Italy.
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Violi
Department of Surgery "Pietro Valdoni", University of Rome "Sapienza", Rome, Italy.
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De Toma
Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome "Sapienza", Rome, Italy.
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Letizia
D018246:Adrenocortical Adenoma / Q000097:blood / Q000652:urine; D000450:Aldosterone / Q000652:urine; D000886:Anthropometry; D023201:CD40 Ligand / Q000097:blood*; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood* / Q000652:urine; D006973:Hypertension / Q000097:blood / Q000652:urine; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood*; D012995:Solubility
D019007:P-Selectin; C546937:SELP protein, human; D023201:CD40 Ligand; D000450:Aldosterone