Schönbeck Uwe, Gerdes Norbert, Varo Nerea, Reynolds Rebecca S, Horton Daniel B, Bavendiek Udo, Robbie Linda, Ganz Peter, Kinlay Scott, Libby Peter
Leducq Center for Cardiovascular Research, Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02115, USA.
Circulation. 2002 Dec 3;106(23):2888-93. doi: 10.1161/01.cir.0000043029.52803.7b.
Although CD40 signaling participates in atherosclerosis, links between lipid risk factors and this inflammatory pathway remain obscure. Cardiovascular risk reduction by 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) may involve actions beyond lipid lowering, including reduced inflammation. Therefore, this study analyzed whether oxidized low-density lipoprotein (oxLDL) induces CD40/CD40L expression on cells implicated in atherogenesis and whether statins affect their expression in vitro as well as the expression of soluble CD40L (sCD40L) in vivo.
Treatment of human vascular endothelial and smooth muscle cells and mononuclear phagocytes with oxLDL augmented the basal expression of CD40 and CD40L mRNA and protein. In contrast, cerivastatin, atorvastatin, or simvastatin concentration-dependently diminished the constitutive as well as oxLDL- or cytokine-induced expression of the receptor/ligand dyad, an effect reversed by mevalonate. Patients treated with statins had diminished sCD40L plasma levels compared with untreated control patients (8.3+/-3.1 ng/mL [n=11] versus 13.1+/-2.5 ng/mL [n=16], P<0.05), supporting the clinical relevance of the in vitro observations. Platelet-enriched plasma of mice deficient in CD40L showed markedly delayed fibrin clot formation, suggesting a role for the ligand in blood coagulation and supporting the hypothesis that statin-mediated reduction in CD40/CD40L expression might limit thrombosis.
OxLDL may promote expression of CD40 and CD40L in human atheroma. Statins may limit the expression of the CD40 receptor/ligand dyad in two ways, directly as well as through diminished lipoprotein levels. Thus, reduced CD40 signaling may account for some of the statins' antiinflammatory action.
尽管CD40信号传导参与动脉粥样硬化,但脂质危险因素与这一炎症途径之间的联系仍不清楚。3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂(他汀类药物)降低心血管风险的作用可能不仅仅是降低血脂,还包括减轻炎症。因此,本研究分析了氧化型低密度脂蛋白(oxLDL)是否诱导参与动脉粥样硬化形成的细胞上CD40/CD40L的表达,以及他汀类药物在体外是否影响其表达以及在体内是否影响可溶性CD40L(sCD40L)的表达。
用oxLDL处理人血管内皮细胞、平滑肌细胞和单核吞噬细胞可增强CD40和CD40L mRNA及蛋白的基础表达。相反,西立伐他汀、阿托伐他汀或辛伐他汀可浓度依赖性地减少受体/配体二元体的组成性表达以及oxLDL或细胞因子诱导的表达,甲羟戊酸可逆转这一作用。与未治疗的对照患者相比,接受他汀类药物治疗的患者血浆sCD40L水平降低(8.3±3.1 ng/mL [n = 11] 对13.1±2.5 ng/mL [n = 16],P<0.05),支持了体外观察结果的临床相关性。缺乏CD40L的小鼠富含血小板的血浆显示纤维蛋白凝块形成明显延迟,提示该配体在血液凝固中起作用,并支持他汀类药物介导的CD40/CD40L表达降低可能限制血栓形成这一假说。
oxLDL可能促进人动脉粥样硬化斑块中CD40和CD40L的表达。他汀类药物可能通过两种方式限制CD40受体/配体二元体的表达,直接作用以及通过降低脂蛋白水平。因此,CD40信号传导减少可能是他汀类药物抗炎作用的部分原因。