A High Level of Soluble CD40L Is Associated with P. aeruginosa Infection in Patients with Cystic Fibrosis

Abstract

ObjectiveThe aim of this study was to evaluate whether the concentration of sCD40L, a product of platelet activation, correlates with the presence of Pseudomonas aeruginosa in the airway of patients with cystic fibrosis (CF) and to determine its possible clinical association.MethodsSixty patients with CF, ranging in age from 2 months to 36 years, were studied. The demographics, cystic fibrosis transmembrane conductance regulator (CFTR) genotype, spirometry measurements, radiographic and tomographic scans, platelet count in peripheral blood, sCD40L, IL-6, TNF-α and ICAM1 data were collected. Infection-colonization of the airway was evaluated using sputum and throat swab cultures; the levels of anti-Pseudomonas aeruginosa antibodies (Anti-PaAb) were evaluated.ResultsPatients with CF and chronic colonization had anti-PaAb values of 11.6 ± 2.1 ELISA units (EU) and sCD40L in plasma of 1530.9 ±1162.3 pg/mL; those with intermittent infection had 5.7 ± 2.7 EU and 2243.6 ± 1475.9 pg/mL; and those who were never infected had 3.46 ± 1.8 EU (p≤0.001) and 1008.1 ± 746.8 pg/mL (p≤0.01), respectively. The cutoff value of sCD40L of 1255 pg/mL was associated with an area under the ROC (receiver operating characteristic curve) of 0.84 (95% CI, 0.71 to 0.97), reflecting P. aeruginosa infection with a sensitivity of 73% and a specificity of 89%. Lung damage was determined using the Brasfield Score, the Bhalla Score, and spirometry (FVC%, FEV1%) and found to be significantly different among the groups (p≤0.001).ConclusionCirculating sCD40L levels are increased in patients with cystic fibrosis and P. aeruginosa infection. Soluble CD40L appears to reflect infection and provides a tool for monitoring the evolution of lung deterioration.

Serum CD40L, ST2, IL-6, and CRP serving as biomarkers for acute coronary syndrome

“…Previous studies showed that CD40L could bind to its receptors on macrophage surface and promote the secretion of inflammatory factors during infection, atherosclerosis, and myocardial infarction. 19–21 In this study, the sCD40L level was significantly higher in UA patients than that of healthy control. This may be caused by platelet activation.…”

Blood Platelets in Infection: The Multiple Roles of the Platelet Signalling Machinery

“…The normal range of sCD40L in the serum of healthy individuals is estimated to be 0.79 to 4.7 ng/mL [ 123 , 124 ]. Elevated levels of sCD40L have been found in several infectious diseases, including Pseudomonas aeruginosa infection in cystic fibrosis patients [ 125 ], visceral leishmaniasis caused by Leishmania infantum [ 126 ], meningococcal sepsis [ 127 ], DENV-2 [ 45 ], HIV [ 128 ], and periodontopathogens infections [ 129 ].…”