Document Detail

Association of low-grade inflammation and platelet activation in patients with hypertension with microalbuminuria.
MedLine Citation:
PMID:  17988217     Owner:  NLM     Status:  MEDLINE    
Increased levels of sCD40L (soluble CD40 ligand) have been associated with enhanced in vivo platelet activation, and may represent a molecular link between inflammation and a prothrombotic state. The aim of the present study was to analyse the relationship between platelet activation, endothelial dysfunction, low-grade inflammation and sCD40L in patients with hypertension with or without MA (microalbuminuria). A cross-sectional comparison of sCD40L levels was performed in 25 patients with MH (essential hypertension with MA) pair-matched for gender and age with 25 patients with EH (essential hypertension) and 25 HS (healthy subjects with normotension). Circulating levels of CRP (C-reactive protein), a marker of inflammation, sP-selectin (soluble P-selectin), a marker of in vivo platelet activation, and ADMA (asymmetric dimethylarginine) and vWF (von Willebrand factor), markers of endothelial dysfunction, were analysed in each subject. sCD40L levels were increased in patients with MH compared with either patients with EH (P<0.001) or HS (P<0.0001). A highly significant correlation between plasma sCD40L and sP-selectin (P<0.0001), vWF (P<0.001) or CRP levels (P<0.05) was observed in patients with MH. Multivariate regression analysis showed that sP-selectin was the strongest independent predictor of sCD40L levels (P<0.0001) in patients with MH. Patients with hypertension with both vWF and CRP levels above the median had the highest sCD40L levels (P<0.0001). Factorial ANOVA of all of the patients with hypertension confirmed that only patients with MH with low-grade inflammation had elevated levels of sCD40L. In conclusion, sCD40L levels appear to discriminate a subset of patients characterized by MA and low-grade inflammation, suggesting that inhibition of the CD40/CD40L system may represent a potential therapeutic target in subjects with hypertension at a high risk of cardiovascular events.
Patrizia Ferroni; Maria Teresa Guagnano; Angela Falco; Vincenzo Paoletti; Maria Rosaria Manigrasso; Noemi Michetti; Francesca Santilli; Fiorella Guadagni; Stefania Basili; Giovanni Davì
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical science (London, England : 1979)     Volume:  114     ISSN:  1470-8736     ISO Abbreviation:  Clin. Sci.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-11     Completed Date:  2008-03-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7905731     Medline TA:  Clin Sci (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  449-55     Citation Subset:  IM    
Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS San Raffaele Pisana, Rome, Italy.
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MeSH Terms
Aged, 80 and over
Albuminuria / blood,  etiology*,  physiopathology
C-Reactive Protein / analysis
CD40 Ligand / blood
Cross-Sectional Studies
Endothelium, Vascular / physiopathology
Hypertension / blood,  complications*,  physiopathology
Inflammation / blood,  complications*
Lipids / blood
Middle Aged
P-Selectin / blood
Platelet Activation*
von Willebrand Factor / analysis
Reg. No./Substance:
0/Lipids; 0/P-Selectin; 0/von Willebrand Factor; 147205-72-9/CD40 Ligand; 9007-41-4/C-Reactive Protein

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