Elevated circulating levels of soluble CD-40 ligand in haemodialysis patients with symptomatic coronary heart disease.

AIM

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).

CONCLUSION

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.