Publicaciones científicas

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

Lorente L, Martín MM, Varo N, Borreguero-León JM, Solé-Violán J, Blanquer J, Labarta L, Díaz C, Jiménez A, Pastor E, Belmonte F, Orbe J, Rodríguez JA, Gómez-Melini E, Ferrer-Agüero JM, Ferreres J, Llimiñana MC, Páramo JA.
Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n, La Laguna - 38320, Santa Cruz de Tenerife, Spain

Revista: Critical Care

Fecha: 15/05/2011

Hematología y Hemoterapia Bioquímica Clínica

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.

CITA DEL ARTÍCULO  Crit Care. 2011 Mar 15;15(2):R97

tal vezLE INTERESE

¿QUÉ TECNOLOGÍA UTILIZAMOS?

La Clínica es el hospital privado con mayor dotación tecnológica de España, todo en un único centro.

Imagen de un PET, tecnología de vanguardia en la Clínica Universidad de Navarra

NUESTROS
PROFESIONALES

Los profesionales de la Clínica realizan una labor continuada de investigación y formación, siempre en beneficio del paciente.

Imagen profesionales de la Clínica Universidad de Navarra

POR QUÉ VENIR
A LA CLÍNICA

Conozca por qué somos diferentes a otros centros sanitarios. Calidad, rapidez, comodidad y resultados.

Imagen del edificio de la Clínica Universidad de Navarra