Cardiopulmonary bypass induces release of soluble CD40 ligand

Cardiopulmonary bypass (CPB) is known to induce platelet activation, thrombosis, thrombocytopenia, and a systemic inflammatory response. It is known that CD40 ligand (CD40L) exists in platelets, that a soluble form of this protein (sCD40L) is released on platelet activation, that platelets are the p...

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Bibliographic Details
Published in:	Circulation (New York, N.Y.) Vol. 105; no. 24; pp. 2849 - 2854
Main Authors:	NANNIZZI-ALAIMO, Lisa, RUBENSTEIN, Mark H, ALVES, Veronica L, LEONG, Gil Y, PHILLIPS, David R, GOLD, Herman K
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins 18-06-2002 American Heart Association, Inc
Subjects:	Aged Anesthesia Anesthesia depending on type of surgery Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy beta-Thromboglobulin - analysis Biological and medical sciences Biomarkers - blood Blood Platelets - chemistry Cardiopulmonary Bypass - adverse effects CD40 Ligand - analysis CD40 Ligand - blood Female Humans Inflammation - etiology Interleukin-6 - blood Kinetics Male Medical sciences Platelet Activation Platelet Factor 4 - analysis Thoracic and cardiovascular surgery. Cardiopulmonary bypass Thrombosis - etiology Cardiopulmonary bypass Human Platelet Pathophysiology Ligand Coagulation Exploration Inflammation Release
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Summary:	Cardiopulmonary bypass (CPB) is known to induce platelet activation, thrombosis, thrombocytopenia, and a systemic inflammatory response. It is known that CD40 ligand (CD40L) exists in platelets, that a soluble form of this protein (sCD40L) is released on platelet activation, that platelets are the primary source of sCD40L in blood, and that sCD40L is involved in thrombosis and inflammation. The present study was designed to determine whether sCD40L is released during CPB. Methods and Results- Blood was obtained from patients undergoing CPB-requiring surgery and analyzed for sCD40L, interleukin-6, and platelet factor 4 and beta-thromboglobulin (markers of platelet activation). Platelets were also isolated and analyzed for their levels of CD40L. Plasma levels of sCD40L increased >1.7-fold (from 0.29 to 0.51 ng/mL, P=0.001) within 1 hour on CPB and increased further to 3.7-fold (to 1.08 ng/mL, P=0.03) 2 hours after the procedure. Half of the released sCD40L was cleared in 2 hours, which allowed the sCD40L to return to approximately baseline levels 8 hours after the procedure. The platelet content of CD40L was decreased by 40% (2.675 to 1.64 ng/10(8) platelets, P=0.001) 1 hour after initiation of CPB and was similar to that observed for platelet factor 4 and beta-thromboglobulin. Interleukin-6, a marker of inflammation, also increased during CPB. The present study demonstrates that CPB causes an increase in the concentration of plasma sCD40L. The corresponding decrease in platelet CD40L suggests that this prothrombotic and proinflammatory protein was derived primarily from platelets and may contribute to the thrombotic and inflammatory complications associated with CPB.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0009-7322 1524-4539
DOI:	10.1161/01.cir.0000019068.32280.b3