The Relationship Between Serum Soluble CD40 Ligand And The Plasma Soluble ICAM-1 And E-selectin Concentration In Patients With Acute Coronary Syndrome

Objective 1. o determine the serum concentration of soluble CD40 ligand (sCD40L), plasma soluble Intercellular Adhesion Molecule -1 (sICAM-1) and plasma soluble E-selectin(sE-selectin) in patients with acute coronary syndrome(ACS),and explore the pathogenesis of coronary heart disease . 2. To determine the change of serum sCD40L concentration in different subtype of coronary heart disease(CHD) and the relationship between sCD40L and sICAM-1 and sE-selectin.Methods The study group was consisted of 52 patients with coronary artery disease: 26 patients with acute coronary syndrome, including unstable angina pectoris and myocardial infarction(ACS group), 26 patients with stable angina pectoris(SAP group). 27 healthy persons acted as controls (control group). Blood samples were drawn from theelbow vein, and serum concentrations of sCD40L, plasma concentrations of sICAM-1 and sE-selectin were measured by enzyme-linked immunosorbent assay(ELISA).In ACS group and ASP group ,the measurements were carried out within 24 hours following an episode of chest pain. Results 1. The Serum concentration of sCD40L in ACS group was significantly higher(5.86±1.59ng/ml) in comparison to both in control group(1.99±1.04ng/ml,P<0.01) and in ASP group(2.70±1.29ng/ml,P<0.01);There were no differences between the serum concentration of sCD40L in ASP group and in control group as determined(P>0.05).2. The plasma concentration of sICAM-1 in ACS group and ASP group was higher when compared to those found in control group(447.56±72.60ng/ml vs 243.89±50.10ng/ml, P<0.01; 284.47±64.50ng/ml vs 243.89±50.10ng/ml,P<0.05).The plasma concentration of sICAM-1 in ACS group was also higher than ASP group(P<0.01). 3. The plasma concentration of sE-selectin in ACS group(58.89±8.73ng/ml) was significantly higher than that in control group(43.43±11.64 ng/ml,P<0.01)and ASP group(48.87±9.63 ng/ml,P<0.01),but there were no differences between ASP group and control group.4.The sCD40L concentration was correlated with sICAM-1(r=0.554,P<0.01).5.The sCD40L concentration was correlated with sE-selectin (r=0.753,P<0.01). 6.The sCD40L concentration was negatively correlated with high density lipoprotein cholesterol(HDL-C),but positively correlated with and apoprotein B(apoB).Conclusions The elevated concentration of sCD40L,sICAM-1 and sE-selectin in patients with ACS suggested that there was a closed relation of CD40L and adhesion molecules to the pathogenesis of ACS and CD40L may promote the triggering and propagation of ACS by up-regulating adhesion molecules expression.