STATE-OF-THE-ART PAPER
The CD40/CD40 Ligand SystemLinking Inflammation With Atherothrombosis
Charalambos Antoniades, MD*,
Constantinos Bakogiannis, MD,
Dimitris Tousoulis, MD, PhD,
Alexios S. Antonopoulos, MD and
Christodoulos Stefanadis, MD
1st Department of Cardiology, University of Athens Medical School, Athens, Greece
Manuscript received December 30, 2008;
revised manuscript received March 5, 2009,
accepted March 10, 2009.
* Reprint requests and correspondence: Dr. Charalambos Antoniades, 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Ilias 8, Gerakas Attikis, 153 44, Athens, Greece (Email: antoniades{at}vodafone.net.gr).
The role of CD40/CD40 ligand (CD40L) in atherothrombosis is now widely accepted. However, the exact mechanisms linking the CD40/CD40L system and the soluble form of CD40 ligand (sCD40L) with atherothrombosis are currently a topic of intensive research. CD40L and sCD40L belong to the tumor necrosis factor superfamily, and they are molecules with a dual prothrombotic and proinflammatory role. They are expressed in a variety of tissues such as the immune system (in both B and T cells), the vascular wall, and activated platelets. Soluble CD40L has multiple autocrine, paracrine, and endocrine actions, and it may trigger key mechanisms participating in atherothrombosis. CD40/CD40L may participate in the development of coronary atherosclerosis and the triggering of acute coronary syndromes, while sCD40L seems to have a prognostic role not only in subjects with advanced atherosclerosis but also in the general population. Although conventional cardiovascular medication such as antiplatelet therapy, statins, angiotensin-converting enzyme inhibitors, and many others have been shown to reduce both sCD40L and cardiovascular risk, it is still unclear whether specific treatments targeting the CD40/CD40L system will prove to be beneficial against atherothrombosis in the near future.
Key Words: CD40 CD40L atherothrombosis atherogenesis inflammation endothelium
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Abbreviations and Acronyms
| | ACS = acute coronary syndrome | | AMI = acute myocardial infarction | | CAD = coronary artery disease | | CD40L = CD40 ligand | | EC = endothelial cell | | GP = glycoprotein | | IL = interleukin | | sCD40L = soluble CD40 ligand | | SMC = smooth muscle cell |
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Inside This Issue
J. Am. Coll. Cardiol. 2009 54: A24.
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