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Ann Rheum Dis 2005;64:481-483 doi:10.1136/ard.2003.020040
  • Concise report

Increased plasma soluble CD40 ligand concentrations in systemic sclerosis and association with pulmonary arterial hypertension and digital ulcers

  1. Y Allanore1,
  2. D Borderie2,
  3. C Meune3,
  4. H Lemaréchal2,
  5. S Weber3,
  6. O G Ekindjian2,
  7. A Kahan1
  1. 1Rheumatology A, Paris V University, Assistance Publique Hôpitaux de Paris, Cochin Hospital, Paris, France
  2. 2Biochemistry A, Paris V University, Cochin Hospital
  3. 3Cardiology, Paris V University, Cochin Hospital
  1. Correspondence to:
    Dr Yannick Allanore
    Hôpital Cochin, service de Rhumatologie A, 27 rue du faubourg Saint-Jacques 75014 Paris, France; yannick.allanorecch.ap-hop-paris.fr
  • Accepted 6 July 2004

Abstract

Background: Increased expression of CD40L has been reported on activated CD4+ T lymphocytes in systemic sclerosis. CD40L can be expressed in soluble form (sCD40L).

Objective: To compare sCD40L concentrations in patients with systemic sclerosis and healthy controls.

Methods: Quantitative sandwich ELISA was used to measure plasma sCD40L in systemic sclerosis (n = 50) and matched healthy controls (n = 20). Patients with systemic sclerosis had limited cutaneous disease (29), digital ulcers (14), pulmonary arterial hypertension (PAH) (10), pulmonary fibrosis on CT (23), positive anti-Scl70 (14), and anti-centromere antibodies (10). Calcium channel blockers were discontinued 72 hours before measurements.

Results: Median (range) sCD40L concentration (pg/ml) was higher in systemic sclerosis than in controls (495 (10 to 7720) v 79 (50 to 118); p = 0.003), in limited cutaneous disease v diffuse disease (620 (20 to 7720) v 250 (10 to 2690); p = 0.005), in patients with digital ulcers v those without (1430 (36 to 7720) v 370 (10 to 2320); p = 0.002), and in those with PAH v those without (995 (15 to 3850) v 400 (10 to 7720); p = 0.048). sCD40L correlated with pulmonary arterial pressure estimated by Doppler echocardiography (r = 0.41; p = 0.005).

Conclusions: The soluble form of CD40L is increased in plasma in systemic sclerosis and may be associated with vascular complications of the disease.

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