Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2011 Mar 15;15(2):R97.
doi: 10.1186/cc10104.

Association between serum soluble CD40 ligand levels and mortality in patients with severe sepsis

Leonardo Lorente  1 , María M Martín, Nerea Varo, Juan María Borreguero-León, Jordi Solé-Violán, José Blanquer, Lorenzo Labarta, César Díaz, Alejandro Jiménez, Eduardo Pastor, Felipe Belmonte, Josune Orbe, José A Rodríguez, Eduardo Gómez-Melini, José M Ferrer-Agüero, José Ferreres, María C Llimiñana, José A Páramo
Affiliations
Comparative Study

Association between serum soluble CD40 ligand levels and mortality in patients with severe sepsis

Leonardo Lorente et al. Crit Care. .

Abstract

Introduction: CD40 Ligand (CD40L) and its soluble counterpart (sCD40L) are proteins that exhibit prothrombotic and proinflammatory properties on binding to their cell surface receptor CD40. The results of small clinical studies suggest that sCD40L levels could play a role in sepsis; however, there are no data on the association between sCD40L levels and mortality of septic patients. Thus, the aim of this study was to determine whether circulating sCD40L levels could be a marker of adverse outcome in a large cohort of patients with severe sepsis.

Methods: This was a multicenter, observational and prospective study carried out in six Spanish intensive care units. Serum levels of sCD40L, tumour necrosis factor-alpha and interleukin-10, and plasma levels of tissue factor were measured in 186 patients with severe sepsis at the time of diagnosis. Serum sCD40L was also measured in 50 age- and sex-matched controls. Survival at 30 days was used as the endpoint.

Results: Circulating sCD40L levels were significantly higher in septic patients than in controls (P = 0.01), and in non-survivors (n = 62) compared to survivors (n = 124) (P = 0.04). However, the levels of CD40L were not different regarding sepsis severity. Logistic regression analysis showed that sCD40L levels >3.5 ng/mL were associated with higher mortality at 30 days (odds ratio = 2.89; 95% confidence interval = 1.37 to 6.07; P = 0.005). The area under the curve of sCD40L levels >3.5 ng/mL as predictor of mortality at 30 days was 0.58 (95% CI = 0.51 to 0.65; P = 0.03).

Conclusions: In conclusion, circulating sCD40L levels are increased in septic patients and are independently associated with mortality in these patients; thus, its modulation could represent an attractive therapeutic target.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Survival curves at 30 days using sCD40L levels higher or lower than 3.5 ng/mL.
Figure 2
Figure 2
Receiver operation characteristic analysis using sCD40L levels ≥ 3.5 ng/mL, APACHE-II and lactatemia as 30-days mortality predictors.
Figure 3
Figure 3
Relationship between sCD40L and tissue factor levels.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29:1303–1310. doi: 10.1097/00003246-200107000-00002. - DOI - PubMed
    1. Antoniades C, Bakogiannis C, Tousoulis D, Antonopoulos AS, Stefanadis C. The CD40/CD40 ligand system: linking inflammation with atherothrombosis. J Am Coll Cardiol. 2009;54:669–677. doi: 10.1016/j.jacc.2009.03.076. - DOI - PubMed
    1. Ferroni P, Santilli F, Guadagni F, Basili S, Davì G. Contribution of platelet-derived CD40 ligand to inflammation, thrombosis and neoangiogenesis. Curr Med Chem. 2007;14:2170–2180. doi: 10.2174/092986707781389664. - DOI - PubMed
    1. Aukrust P, Damås JK, Solum NO. Soluble CD40 ligand and platelets: self-perpetuating pathogenic loop in thrombosis and inflammation? J Am Coll Cardiol. 2004;43:2326–2328. doi: 10.1016/j.jacc.2004.03.023. - DOI - PubMed
    1. Anand SX, Viles-Gonzalez JF, Badimon JJ, Cavusoglu E, Marmur JD. Membrane-associated CD40L and sCD40L in atherothrombotic disease. Thromb Haemost. 2003;90:377–384. - PubMed

Publication types